Mathijs van Ark1, Ebonie Rio, Jill Cook, Inge van den Akker-Scheek, James E Gaida, Johannes Zwerver, Sean Docking. 1. From the Department of Sport and Exercise Medicine, University Medical Center Groningen, University of Groningen, the Netherlands (MvA, IvdA-S, JZ); School of Physiotherapy, Monash University, Frankston, Australia (MvA, ER, JC, SD); Department of Physiotherapy, Hanze University of Applied Sciences Groningen, the Netherlands (MvA); Centre of Expertise Primary Care Groningen (ECEZG), the Netherlands (MvA); La Trobe University Sport and Exercise Medicine Research Centre. Bundoora, Australia (ER, JC, SD); Australian Collaboration for Research into Sports Injury and Its Prevention (ACRISP), Federation University, Ballarat, Australia (ER, SD); and University of Canberra Research Institute for Sport and Exercise (UCRISE), Australia (JEG).
Abstract
OBJECTIVES: The aim of this study was to investigate the effects of a 4-wk in-season exercise program of isometric or isotonic exercises on tendon structure and dimensions as quantified by ultrasound tissue characterization (UTC). DESIGN: This was a randomized clinical trial. Volleyball and basketball players (16-31 yrs, n = 29) with clinically diagnosed patellar tendinopathy were randomized to a 4-wk isometric or isotonic exercise program. The programs were designed to decrease patellar tendon pain. A baseline and 4-wk UTC scan was used to evaluate change in tendon structure. RESULTS: No significant change in tendon structure or dimensions on UTC was detected after the exercise program despite patellar tendinopathy symptoms improving. The percentage and mean cross-sectional area of aligned fibrillar structure (echo types I + II) (Z = -0.414, P = 0.679) as well as disorganized structure (echo types III + IV) (Z = -0.370, P = 0.711) did not change over the 4-wk exercise program. Change in tendon structure and dimensions on UTC did not differ significantly between the groups. CONCLUSION: Structural properties and dimensions of the patellar tendon on UTC did not change after a 4-wk isometric or isotonic exercise program for athletes with patellar tendinopathy in-season, despite an improvement in symptoms. It seems that structural improvements are not required for a positive clinical outcome.
RCT Entities:
OBJECTIVES: The aim of this study was to investigate the effects of a 4-wk in-season exercise program of isometric or isotonic exercises on tendon structure and dimensions as quantified by ultrasound tissue characterization (UTC). DESIGN: This was a randomized clinical trial. Volleyball and basketball players (16-31 yrs, n = 29) with clinically diagnosed patellar tendinopathy were randomized to a 4-wk isometric or isotonic exercise program. The programs were designed to decrease patellar tendon pain. A baseline and 4-wk UTC scan was used to evaluate change in tendon structure. RESULTS: No significant change in tendon structure or dimensions on UTC was detected after the exercise program despite patellar tendinopathy symptoms improving. The percentage and mean cross-sectional area of aligned fibrillar structure (echo types I + II) (Z = -0.414, P = 0.679) as well as disorganized structure (echo types III + IV) (Z = -0.370, P = 0.711) did not change over the 4-wk exercise program. Change in tendon structure and dimensions on UTC did not differ significantly between the groups. CONCLUSION: Structural properties and dimensions of the patellar tendon on UTC did not change after a 4-wk isometric or isotonic exercise program for athletes with patellar tendinopathy in-season, despite an improvement in symptoms. It seems that structural improvements are not required for a positive clinical outcome.
Authors: Mathieu Lalumiere; Sarah Perrino; Marie-Josée Nadeau; Christian Larivière; Martin Lamontagne; François Desmeules; Dany H Gagnon Journal: Front Rehabil Sci Date: 2021-08-12