The effect of left/right judgement training on pain in people with Achilles tendinopathy: a randomised controlled experiment

Monique Wilson, Mark J Catley, G Lorimer Moseley

Enquiries: Monique Wilson, email:

LRJ are impaired in several painful conditions, including Achilles tendinopathy.

The purposes of this study is to determine whether a single training session of foot left/right judgements alters pain in people with Achilles tendinopathy. Based on pilot study findings and current evidence on the use of motor imagery as a treatment for pain in chronic conditions, we hypothesise that training left/right judgements will help reduce pain in Achilles tendinopathy sufferers. This study has been approved by the University of South Australia’s human ethics committee.


Participants will be eligible to participate if they provide informed consent, have use of a computer with internet-access and have undertaken activity sufficient to elicit Achilles tendon pain in the previous 24 hours. Participants who do not meet the diagnostic eligibility criteria for Achilles tendinopathy or have undertaken motor imagery treatment before will be excluded. 


Data will be collected as part of a randomised controlled experiment. The study will be conducted online, enabling extensive worldwide data collection. Participants will complete a demographics and diagnostic questionnaire, perform a couple of Achilles pain-evoking physical activities and record their pain levels. They will then undertake a left/right judgement performance assessment. Images of hands and feet will be presented in varying positions and their ability to quickly and correctly identify them as belonging to the left or right side will be assessed. Lastly, a single training session of left/right judgments will occur and post-intervention pain levels will again be recorded.


Pain levels will be measured using visual analogue scales (VAS).

Data Analysis

To determine the effect of a single training session of left/right judgements, data analysis will be performed by calculating the change scores of participants from their pre- and post-intervention scores. A Kolmogorov–Smirnov test will determine whether the sampling distribution of the change scores from the two groups (intervention and sham) are normally distributed. Assuming normality, data will be analysed using an independent t-test (two-sided) with significance set at α=0.05. The analysis will be blinded to group.