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Effectiveness of Two Exercise Protocols in the Treatment of Patients With Patellar Tendinopathy

Not Applicable
Terminated
Conditions
Patellar Tendinopathy
Registration Number
NCT03196063
Lead Sponsor
Universidade Cidade de Sao Paulo
Brief Summary

Patellar tendinopathy is characterized by anterior pain in the knee, due to the great demand imposed on the extensor mechanism of the knee. Evidence shows that the most appropriate treatment for this condition is the conservative treatment, through strengthening with eccentric exercises. However, a recent editorial proposes a new treatment protocol based on concentric and eccentric exercises, with the initial prescription of isometric exercises. The hypothesis of this study is that the protocol is as good as the eccentric exercises, generating less pain.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
12
Inclusion Criteria
  • patients with chronic unilateral patellar tendinopathy confirmed by the reproduction of the pain during the palpation test in the region of the lower pole of the patella
  • presence of pain for three months or more
  • both genders
  • body mass index less than 30 kg/m²
  • age between 18 and 40 years
  • practice of physical activity on a regular basis
  • pain intensity ≥ 3 points on the pain numerical rating scale in the anterior region of the knee, specifically in the region of the lower pole of the patella when performing squatting, jumping or activities with change of direction
  • score < 80 points on the Victorian Institute of Sport Assessment-Patella (VISA-P)
  • blazine functional scale between 1 and 3
Exclusion Criteria
  • patients who have previous pain in the knee that does not correspond to patellar tendinopathy
  • previous rupture of the patellar tendon (blazin functional scale at level 4)
  • previous surgery or infiltration of the patellar tendon in the last six months
  • inflammatory diseases
  • diabetes mellitus
  • lower limbs injuries
  • other chronic pain conditions that prevent exercise, such as severe hip and knee osteoarthrosis and joint fractures.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Pain intensity during rest8 weeks after randomization

This outcome will be evaluated by an 11-point scale ranging from 0 to 10, in which 0 represents "no pain" and 10 represents "pain as bad as it could be." The participant will classify his average pain in the last 7 days.

Functional capacity8 weeks after randomization

VISA-P questionnaire assesses the symptoms and disability of patients with patellar tendinopathy. It is a questionnaire with eight questions, six of them on a Likert scale, ranging from 0 to 10 points, where 0 represents the maximum severity of the disease and 10 represents no pain or limitation. Question 7 has four possible answers (0, 4, 7 and 10 points). Question 8 has a subdivision (8A, 8B and 8C), in which only one can be answered, depending on the perception of pain during sport activities, varying up to 30 points. The total score of the questionnaire varies between 0 and 100 points, with 100 points corresponding to the absence of pain or disability.

Secondary Outcome Measures
NameTimeMethod
Muscular strength8 weeks after randomization

The hand dynamometer will be used to measure the strength of the quadriceps femoris, hamstring, gluteus maximus, gluteus medius and lateral hip rotators.

Pain intensity during rest12 weeks and 6 months after randomization

This outcome will be evaluated by an 11-point scale ranging from 0 to 10, in which 0 represents "no pain" and 10 represents "pain as bad as it could be." The participant will classify his average pain in the last 7 days.

Triple hop test8 weeks after randomization

The patient will perform a test composed of three consecutive jumps, as far as possible, always landing on the same foot.

Pressure pain threshold8 weeks after randomization

The patient will perform 10 repetitions of the complete unipodal squat on an inclined plane and sequentially will be placed on a stretcher lying comfortably with the knee flexed at 20 degrees. The patient should indicate the point of greatest pain in the tendon, which will be marked to be the location of the tip of the algometer, and the distance to the apex of the patella will be measured to use the same point in the assessment after treatment. If the patient does not present pain in the assessment after treatment, the point standardized in the initial evaluation will be used. If the patient still presents pain, the point of greatest pain will be evaluated. For measurement, pressure will be applied until the patient experiences a mild pain sensation (pain level 1), when he will be instructed to press the algometer button to stop the test.

Pain intensity during squat8 weeks after randomization

This outcome will be evaluated by an 11-point scale ranging from 0 to 10, in which 0 represents "no pain" and 10 represents "pain as bad as it could be". The patient will classify his pain during a complete isotonic unipodal squat on an inclined plane.

Functional capacity12 weeks and 6 months after randomization

VISA-P questionnaire assesses the symptoms and disability of patients with patellar tendinopathy. It is a questionnaire with eight questions, six of them on a Likert scale, ranging from 0 to 10 points, where 0 represents the maximum severity of the disease and 10 represents no pain or limitation. Question 7 has four possible answers (0, 4, 7 and 10 points). Question 8 has a subdivision (8A, 8B and 8C), in which only one can be answered, depending on the perception of pain during sport activities, varying up to 30 points. The total score of the questionnaire varies between 0 and 100 points, with 100 points corresponding to the absence of pain or disability.

Pain intensityEigth weeks, before and after each intervention session

This outcome will be evaluated by an 11-point scale ranging from 0 to 10, in which 0 represents "no pain" and 10 represents "pain as bad as it could be". The patient will rate the pain during rest before and after each intervention session.

Trial Locations

Locations (1)

Physical Therapy Outpatient Department

🇧🇷

São Paulo, Brazil

Physical Therapy Outpatient Department
🇧🇷São Paulo, Brazil
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