Literature DB >> 16244196

Superior results with eccentric compared to concentric quadriceps training in patients with jumper's knee: a prospective randomised study.

P Jonsson1, H Alfredson.   

Abstract

BACKGROUND: A recent study reported promising clinical results using eccentric quadriceps training on a decline board to treat jumper's knee (patellar tendinosis).
METHODS: In this prospective study, athletes (mean age 25 years) with jumper's knee were randomised to treatment with either painful eccentric or painful concentric quadriceps training on a decline board. Fifteen exercises were repeated three times, twice daily, 7 days/week, for 12 weeks. All patients ceased sporting activities for the first 6 weeks. Age, height, weight, and duration of symptoms were similar between groups. Visual analogue scales (VAS; patient estimation of pain during exercise) and Victorian Institute of Sport Assessment (VISA) scores, before and after treatment, and patient satisfaction, were used for evaluation.
RESULTS: In the eccentric group, for 9/10 tendons patients were satisfied with treatment, VAS decreased from 73 to 23 (p<0.005), and VISA score increased from 41 to 83 (p<0.005). In the concentric group, for 9/9 tendons patients were not satisfied, and there were no significant differences in VAS (from 74 to 68, p<0.34) and VISA score (from 41 to 37, p<0.34). At follow up (mean 32.6 months), patients in the eccentric group were still satisfied and sports active, but all patients in the concentric group had been treated surgically or by sclerosing injections.
CONCLUSIONS: In conclusion, eccentric, but not concentric, quadriceps training on a decline board, seems to reduce pain in jumper's knee. The study aimed to include 20 patients in each group, but was stopped at the half time control because of poor results achieved in the concentric group.

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Mesh:

Year:  2005        PMID: 16244196      PMCID: PMC1725058          DOI: 10.1136/bjsm.2005.018630

Source DB:  PubMed          Journal:  Br J Sports Med        ISSN: 0306-3674            Impact factor:   13.800


  21 in total

1.  A randomised clinical trial of the efficacy of drop squats or leg extension/leg curl exercises to treat clinically diagnosed jumper's knee in athletes: pilot study.

Authors:  L J Cannell; J E Taunton; D B Clement; C Smith; K M Khan
Journal:  Br J Sports Med       Date:  2001-02       Impact factor: 13.800

2.  Where is the pain coming from in tendinopathy? It may be biochemical, not only structural, in origin.

Authors:  K M Khan; J L Cook; N Maffulli; P Kannus
Journal:  Br J Sports Med       Date:  2000-04       Impact factor: 13.800

Review 3.  What is the most appropriate treatment for patellar tendinopathy?

Authors:  J L Cook; K M Khan
Journal:  Br J Sports Med       Date:  2001-10       Impact factor: 13.800

4.  Long-term prognosis for jumper's knee in male athletes. A prospective follow-up study.

Authors:  Jyrki A Kettunen; Martti Kvist; Erkki Alanen; Urho M Kujala
Journal:  Am J Sports Med       Date:  2002 Sep-Oct       Impact factor: 6.202

5.  In situ microdialysis in tendon tissue: high levels of glutamate, but not prostaglandin E2 in chronic Achilles tendon pain.

Authors:  H Alfredson; K Thorsen; R Lorentzon
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  1999       Impact factor: 4.342

6.  Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group.

Authors:  B D Coleman; K M Khan; N Maffulli; J L Cook; J D Wark
Journal:  Scand J Med Sci Sports       Date:  2000-02       Impact factor: 4.221

7.  A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy.

Authors:  C R Purdam; P Jonsson; H Alfredson; R Lorentzon; J L Cook; K M Khan
Journal:  Br J Sports Med       Date:  2004-08       Impact factor: 13.800

8.  Chronic Achilles tendon pain treated with eccentric calf-muscle training.

Authors:  Martin Fahlström; Per Jonsson; Ronny Lorentzon; Håkan Alfredson
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2003-08-26       Impact factor: 4.342

9.  Abnormal tenocyte morphology is more prevalent than collagen disruption in asymptomatic athletes' patellar tendons.

Authors:  J L Cook; J A Feller; S F Bonar; K M Khan
Journal:  J Orthop Res       Date:  2004-03       Impact factor: 3.494

10.  Is vasculo-neural ingrowth the cause of pain in chronic Achilles tendinosis? An investigation using ultrasonography and colour Doppler, immunohistochemistry, and diagnostic injections.

Authors:  Håkan Alfredson; Lars Ohberg; Sture Forsgren
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2003-08-09       Impact factor: 4.342

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  57 in total

Review 1.  The pain of tendinopathy: physiological or pathophysiological?

Authors:  Ebonie Rio; Lorimer Moseley; Craig Purdam; Tom Samiric; Dawson Kidgell; Alan J Pearce; Shapour Jaberzadeh; Jill Cook
Journal:  Sports Med       Date:  2014-01       Impact factor: 11.136

Review 2.  Strategies for the prevention of volleyball related injuries.

Authors:  J C Reeser; E Verhagen; W W Briner; T I Askeland; R Bahr
Journal:  Br J Sports Med       Date:  2006-07       Impact factor: 13.800

3.  Biomechanical analysis of the single-leg decline squat.

Authors:  J Zwerver; S W Bredeweg; A L Hof
Journal:  Br J Sports Med       Date:  2007-01-15       Impact factor: 13.800

Review 4.  The role of stretching in tendon injuries.

Authors:  E Witvrouw; N Mahieu; P Roosen; P McNair
Journal:  Br J Sports Med       Date:  2007-01-29       Impact factor: 13.800

5.  An isokinetic eccentric programme for the management of chronic lateral epicondylar tendinopathy.

Authors:  Jean-Louis Croisier; Marguerite Foidart-Dessalle; France Tinant; Jean-Michel Crielaard; Bénédicte Forthomme
Journal:  Br J Sports Med       Date:  2007-01-15       Impact factor: 13.800

6.  Descriptive epidemiology of collegiate women's volleyball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004.

Authors:  Julie Agel; Riann M Palmieri-Smith; Randall Dick; Edward M Wojtys; Stephen W Marshall
Journal:  J Athl Train       Date:  2007 Apr-Jun       Impact factor: 2.860

7.  The effect of mild symptomatic patellar tendinopathy on the quadriceps contractions and the Fente motion in elite fencers.

Authors:  Taegyu Kim; Eunkuk Kim; Jongchul Park; Hyunyong Kang
Journal:  J Sports Sci Med       Date:  2011-12-01       Impact factor: 2.988

8.  Effects of Concentric and Eccentric Training on the Stiffness and Blood Circulation of the Patellar Tendon.

Authors:  Keitaro Kubo; Hideaki Yata
Journal:  Sports Med Int Open       Date:  2017-03-15

9.  Loss of homeostatic strain alters mechanostat "set point" of tendon cells in vitro.

Authors:  Steven P Arnoczky; Michael Lavagnino; Monika Egerbacher; Oscar Caballero; Keri Gardner; Marisa A Shender
Journal:  Clin Orthop Relat Res       Date:  2008-05-06       Impact factor: 4.176

Review 10.  Achilles and patellar tendinopathy loading programmes : a systematic review comparing clinical outcomes and identifying potential mechanisms for effectiveness.

Authors:  Peter Malliaras; Christian J Barton; Neil D Reeves; Henning Langberg
Journal:  Sports Med       Date:  2013-04       Impact factor: 11.136

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