The Acute Effect of Isometric Versus Isotonic Resistance Exercise in Patients With Patellar Tendinopathy: a Randomized, Participant Blinded, Crossover Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 21
- 试验地点
- 2
- 主要终点
- Change in pain during aggravating activity
研究概览
简要总结
The purpose of this study is to compare the acute effects of two different types of resistance exercise (isometric versus isotonic) on exercise induced hypoalgesia during an aggravating activity, in participants with patellar tendinopathy.
详细描述
Exercise is a commonly prescribed treatment for patients with musculoskeletal pain, and is effective in treating tendon pain. It is well documented, that an acute bout of aerobic or resistance type exercise reduces sensitivity to pain in healthy individuals. Therefore the efficacy of exercise as an intervention may be partially due to the analgesic effect of exercise, also termed exercise-induced hypoalgesia (EIH).
For tendinopathies, high load resistance exercise is frequently used during rehabilitation.
However, the optimal mode and dosages required for reducing pain in patients with tendinopathies is unknown. Understanding the effect of different forms of exercise on pain may help optimize the prescription of exercise for pain management.
A recent study by Rio and colleagues documented the acute effect of two different forms of resistance exercise in patients with patellar tendinopathy. The study compared, isometric resistance exercise (static muscular contractions), in comparison to isotonic resistance exercise (dynamic contractions) and found that isometric exercise induced greater participantive pain relief in response to an aggravating task. This study was the first to compare the analgesic effect of different forms of resistance exercise in patients with tendinopathy.
Although the results appear promising, a limitation of the study was that it did not quantify the effect of the different exercises on measures of pain sensitivity as in previous studies examining EIH.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Other
- 盲法
- Single (Participant)
盲法说明
Participants will be blinded to the study hypothesis
入排标准
- 年龄范围
- 18 Years 至 40 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Men and women aged 18-40 years, with patellar tendinopathy will be included. Diagnosis of patellar tendinopathy, will be made by a physiotherapist (who has been trained by an experienced rheumatologist) as follows, similar to previously outlined criteria:
- •pain localised to the inferior pole of the patella during jumping and landing activities
- •pain during testing on the single-leg decline squat (SLDS)
- •The diagnosis will be confirmed by the presence of characteristic features on ultrasound imaging (eg, hypoechoic area and focal enlarged tendon).
- •Minimum pain of 3cm on a 10cm visual analogue scale (VAS)
- •Other concurrent diagnosable knee pathologies
排除标准
- •Previous surgery of the knee
- •Pregnancy
- •Corticosteroid injection within the previous 6 months
研究组 & 干预措施
Isometric exercise
Participants will complete isometric quadriceps exercise
干预措施: Isometric exercise (Other)
Isotonic exercise
Participants will complete dynamic leg extension
干预措施: Isotonic Exercise (Other)
结局指标
主要结局
Change in pain during aggravating activity
时间窗: baseline; immedietely after exercise
The single leg decline squat (SLDS) will be used as the provocative activity, as this is an activity that usually induces pain in patients with patellar tendinopathy. Participants will be asked to stand on one limb, with their heel raised, so they are in approximately 25 degrees of plantar flexion. They will then be asked to perform a small squat, to about 60 degrees of knee flexion. This will be repeated three times. Participants will provide a numerical pain rating score for the decline squat on an 11-point numerical rating scale (NRS), anchored at left with '0, no pain' and at right with '10, worst possible pain'. If participants have bilateral patellar tendinopathy, data from the 'most painful' limb (indicated by participants) will be used for the primary outcome.
次要结局
- change in pressure pain threshold (kPa)(Baseline; Immediately after exercise; 45 min post exercise)
- change in pain during aggravating activity(baseline; 45 minutes post exercise)
- Change in patellar tendon thickness (mm)(Baseline; Immedietly after exercise)
研究者
Sinead Holden
Post- Doctoral Research Fellow
Aalborg University