166 Chapter 9 are a cause of this difference. Future research should focus on the underlying mechanisms for this difference in treatment response. Several other studies have evaluated potential prognostic factors in patients with Achilles tendinopathy. Imaging and patient-specific factors as age, sex, BMI and duration of symptoms do not have any prognostic value for predicting long term outcome based on several studies with relatively small sample size.3,66-68 More recently, one study examined the potential prognostic value of physical tests at baseline. It was found that patients with less pain during pain provocation tests at baseline (pain on palpation and pain with 10hops) have a larger improvement in pain, function and activities after 24 weeks compared to patients with high baseline pain scores.69 These identified and refuted prognostic factors are in contrast with findings in patients with patellar tendinopathy. In patients with patellar tendinopathy physical and pain-provoking test at baseline do not have any prognostic value70 whereas higher age and longer symptom duration were found to negatively influence treatment outcome.71 When evaluating prognostic factors in other tendinopathy locations some similarities, as well as numerous differences, can be found. A systematic review on prognostic factors in patients with rotator cuff tendinopathy showed evidence that high baseline pain, high baseline disability and a longer duration of symptoms were associated with an unfavourable outcome and sex and age were not associated with the outcome.72 In patients with lateral elbow tendinopathy, greater baseline pain and disability were also associated with a poor long-term prognosis. Although it is debatable whether different tendinopathy locations can be directly compared, apart from patellar tendinopathy, a similarity in prognostic factors becomes apparent with greater baseline pain and disability negatively influencing treatment outcome in tendinopathy patients. Further research is needed to evaluate potential patient-specific prognostic factors such as activity/loading profiles and larger datasets are necessary to confirm or refute the prognostic role of age, sex, BMI and duration of symptoms in Achilles tendinopathy patients.
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