# Developing a Novel Clinical Care Model for Chronic Patellar Tendinopathy Utilizing Whole Person Healthcare

> **NIH NIH K23** · DUKE UNIVERSITY · 2024 · $153,113

## Abstract

Abstract
Individuals with chronic MSK pain conditions who experience disability-related limitations in physical activity
participation are at higher risk for poor physical and mental health outcomes. Chronic patellar tendinopathy is a
highly prevalent chronic MSK condition that severely limits performance, physical activity, self-perceived
function, and quality of life. Whole person health (WPH) is a comprehensive framework that considers
interconnected domains (biological, behavioral, social, environmental) that foster health, and is designed to
facilitate multicomponent therapeutic interventions. The applicant’s long-term career objective is to establish
a funded research program that develops and evaluates a WPH model to decrease disability and improve
quality of life for individuals with for chronic musculoskeletal pain conditions. Current standard of clinical care
for patients with chronic patellar tendinopathy take a unifocal approach, emphasizing local tendon pain and
capacity, does not incorporate other factors (psychological, social, environmental) that may contribute to the
patient’s overall health. The overall objective of this study for this career development award is to develop a
WHP framework that is responsive to the critical gaps in the literature and will inform future intervention
approaches for patellar tendinopathy. The approach will expand the standard of care progressive loading
exercise treatment (PLE) utilizing individualized biofeedback augmented movement retraining and behavioral
graded exposure techniques to develop and refine a novel patellar tendon WPH intervention (WPH), and
evaluate feasibility, acceptability, and responsiveness of key biopsychosocial outcomes (landing mechanics,
psychological distress, tendon stiffness). The central hypothesis of this study is that individuals with chronic
patellar tendinopathy who utilize novel WPH for patellar tendinopathy rehabilitation will demonstrate
improvements in self-reported function, landing biomechanics, and tissue capacity. The hypothesis will be
tested through three specific aims: 1) refine WPH intervention protocols through a small case series study
using mixed-methods approach, 2) establish feasibility and acceptability benchmarks, and 3) determine safety
and responsiveness of WPH compared to PLE on primary outcome of (a) patient self-reported function and
psychological distress, and secondary outcomes of (b) landing biomechanics and (c) patellar tendon stiffness
through a pilot randomized controlled study. The proposed work is innovative, in that: 1) it will be the first
study to utilize a WPH framework compared to standard of care and evaluate a novel combination of outcomes
for the treatment of chronic tendinopathy. The study is significant as it addresses an important gap in
knowledge, moving beyond outdated traditional care models to create novel clinical care model designed to
mitigate the debilitating effects of tendon pain on quality of life. Doing so take...

## Key facts

- **NIH application ID:** 10904918
- **Project number:** 5K23AR081932-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Laura Stanley Pietrosimone
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $153,113
- **Award type:** 5
- **Project period:** 2023-08-10 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10904918

## Citation

> US National Institutes of Health, RePORTER application 10904918, Developing a Novel Clinical Care Model for Chronic Patellar Tendinopathy Utilizing Whole Person Healthcare (5K23AR081932-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10904918. Licensed CC0.

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