The effect of isometric versus isotonic exercise on pain and strength in people with hamstring tendon pain.
- Conditions
- Proximal hamstring tendinopathyMusculoskeletal - Other muscular and skeletal disorders
- Registration Number
- ACTRN12620001243909
- Lead Sponsor
- aTrobe University
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Recruiting
- Sex
- All
- Target Recruitment
- 40
Initial Phone Screening. Participants must meet all of the following criteria:
1.Reports of localised (defined as an area smaller than a tennis ball) ischial tuberosity region pain of gradual onset and at least 3 months in duration
2.Willingness to participate in three sessions of testing and intervention as part of the trial, over a 9 to 21 day period
3.Age between 18 and 60 inclusive
4.Fluency in English sufficient to complete questionnaires and to enable understanding to the intervention.
5.Agreeing to refrain from other interventions wherever possible for the treatment period of the trial, aside from consultation with medical practitioners and medication.
6.Agreeing to refrain from activity that would aggravate symptoms for 48 hours prior to each session.
Clinical examination screening
7.Positive findings (reproduction of lower buttock pain) with single leg arabesque AND with 2 or more of three additional diagnostic criteria:
oSupine single leg bridge with heel on standardised height platform (bent knee)
oProlonged sitting >30 minutes
oModified bent-knee hamstring stretch test (Cacchio, 2012)
(Symptoms must be >=2/10 with arabesque only)
8.A clear increase in activity levels precipitating onset of symptoms
A group of control participants without PHT are also being recruited. The inclusion criteria for this group is:
1.Willingness to participate in two sessions of testing and intervention as part of the trial, over a 3 to 7 day period
2.Age between 18 and 60 inclusive
3.Fluency in English sufficient to complete questionnaires and to enable understanding to the intervention.
Clinical examination screening
4.Negative findings (lower buttock pain) with single leg arabesque AND with all three additional diagnostic criteria:
oSupine single leg bridge with heel on standardised height platform (bent knee)
oProlonged sitting >30 minutes
oModified bent-knee hamstring stretch test (Cacchio, 2012)
(Symptoms must be >=2/10 with arabesque only)
Initial Phone Screening
1.Previous surgery to the hamstring complex, as we wish to study treatment effects independent to the effects of surgical procedures.
2.Previous injection to the hamstring tendon within the last 6 weeks, as we wish to study treatment effects independent to the effects of injections.
3.Previous imaging (MRI, Ultrasound) performed since onset of symptoms showing normal hamstring tendon appearance, as a radiologically normal tendon is unlikely to be pain generating.
4.Treatment with ESWT for PHT in the last 3 months, as we wish to study treatment effects independent to the effects of ESWT.
5.Current pregnancy, or recent childbirth (within 6 months) as this could impair ability to undertake testing and intervention.
6.Diagnosis with autoimmune disease as we do not wish to evaluate tendon response where there is a potential autoimmune influence
7.Previous imaging (MRI, ultrasound) showing perineural sciatic nerve oedema as this suggests a pain generator that is not the proximal hamstring tendon
Clinical examination screening
8.Pain that is predominantly due to lumbar dysfunction including lumbar spine radiculopathy, or lumbar spine somatic referral
9.Pain that is reasoned from clinical examination to be predominantly due to other structures or conditions, including sciatic nerve entrapment, ischiofemoral impingement, hip joint, local sciatic nerve irritation, and adductor magnus tendinopathy
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Pain (measured on a 100 mm Visual Analogue Scale) during a functional task (modified arabesque)[Session 1 (orientation): baseline<br>Sessions 2 and 3: pre-intervention, and 0, 45 minutes and 24 hours after each intervention session (primary timepoint is 0 minutes after intervention)];Knee flexion strength, measured with a Biodex dynamometer[Session 1 (orientation): baseline<br>Sessions 2 and 3: pre-intervention, and 0 and 45 minutes after intervention session (primary timepoint is 0 minutes after intervention). <br>]
- Secondary Outcome Measures
Name Time Method Sitting pain, measured with a Patient Specific Functional Scale (PSFS)[Session 1 (orientation): baseline<br>Sessions 2 and 3: pre-intervention, and 24 hours after each intervention session];Steadiness of contraction using analysis of torque data from Biodex dynamometer[During isometric intervention session only];Victorian Institute of Sport - Hamstring (VISA-H) score<br>The VISA-H measures pain, function and sporting activity in people with PHT[Session 1: at start of session<br>Sessions 2 and 3: at start of session]