Physical Therapy Rehabilitation Science

  • 제12권4호
  • /
  • Pages.448-453
  • /
  • 2023
  • /
  • 2287-7576(pISSN)
  • /
  • 2287-7584(eISSN)
물리치료재활과학회 (korean Academy of Physical Therapy Rehabilitation Science)
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Effects of Eccentric Exercise Associated with Patellofemoral Tendinopathy: A Systematic Review

  • Joshua Mark Prall (Department of Physical Therapy, Lebanon Valley College) ;
  • Madison Gillen (Department of Physical Therapy, Lebanon Valley College) ;
  • Elizabeth Talbot (Department of Physical Therapy, Lebanon Valley College) ;
  • Samantha Flater (Department of Physical Therapy, Lebanon Valley College) ;
  • Ryan Bibeau (Department of Physical Therapy, Lebanon Valley College) ;
  • John Ricciuti (Department of Physical Therapy, Lebanon Valley College) ;
  • Stan Dacko (Department of Physical Therapy, Lebanon Valley College)
  • 투고 : 2023.10.10
  • 심사 : 2023.12.20
  • 발행 : 2023.12.31
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초록

Background: Patellofemoral tendinopathy is a common condition that is associated with anteromedial knee pain due to chronic repetitive tendon overloading. Physical therapy in combination with an eccentric exercise program has been thought to be the gold standard of treatment for patellofemoral tendinopathy. The aim of this study was to examine the literature regarding the effectiveness of treating patellofemoral tendinopathy with eccentric exercise and other interventions. Methods: A literature search of Medline Complete, PubMed, CINAHL Complete, and Journal of Science and Medicine in Sports was conducted using PEDro guidelines. Results: Eight articles met our selection criteria. The 8 articles investigated individuals who all had pain at the inferior pole of the patella or were diagnosed via ultrasound for patellar tendinopathy. The articles investigated the effects of eccentric exercise versus other treatments such as, progressive tendon-loading exercise therapy (PTLE), extracorporeal shock wave therapy (ESWT), percutaneous electrolysis (PNE), dry needling (DN), and concentric hip muscle strengthening. Ultimately, each treatment resulted in decreased pain and patellar stiffness, along with improvement in outcome measures, but it was found that no intervention was more effective than eccentric exercise alone, besides progressive tendon-loading exercise therapy. Conclusions: Moderate to strong mixed evidence exists to show the effect of eccentric exercise in combination with other interventions decreases patellofemoral pain and increased functional mobility in individuals with patellofemoral tendinopathy. Progressive tendon-loading exercise therapy was the one treatment that showed more significant improvements in outcome measures compared to eccentric exercise therapy and requires further research to back this finding.

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참고문헌

  1. Schwartz A, Watson JN, Hutchinson MR. Patellar Tendinopathy. Sports Health. 2015 Sep-Oct;7(5):415-20. doi: 10.1177/1941738114568775. 
  2. Challoumas D, Pedret C, Biddle M, et al. Management of patellar tendinopathy: A systematic review and network meta-analysis of Randomised Studies. BMJ Open Sport & Exercise Medicine. 2021;7(4). doi:10.1136/bmjsem-2021-001110 
  3. Scott A, Squier K, Alfredson H, et al. Icon 2019: international scientific tendinopathy symposium consensus: clinical terminology. Br J Sports Med 2020;54:260-2. 
  4. Hopkins C, Fu S-C, Chua E, et al. Critical review on the socioeconomic impact of tendinopathy. Asia Pac J Sports Med Arthrosc Rehabil Technol 2016;4:9-20. 
  5. Ian OB, Engebretsen L, Bahr R. Prevalence of jumper's knee among elite athletes from different sports: a cross-sectional study. Am J Sport Med 2005;33:561-7. 
  6. Doelen TV, Jelly W. Non-surgical treatment of Patellar tendinopathy: a systematic review of randomised controlled trials. JSAMS 2020;23:118-24. 
  7. Gaida JE, Cook J. Treatment options for Patellar tendinopathy: critical review. Curr Sports Med Rep 2011;10:255-70. 
  8. Lee W-C, Ng GY-F, Zhang Z-J, Malliaras P, Masci L, Fu S-N. Changes on Tendon Stiffness and Clinical Outcomes in Athletes Are Associated With Patellar Tendinopathy After Eccentric Exercise. Clinical journal of sport medicineofficial journal of the Canadian Academy of Sport Medicine. 2020;30(1):25-32. doi:10.1097/JSM.0000000000000562 
  9. Lim HY, Wong SH. Effects of isometric, eccentric, or heavy slow resistance exercises on pain and function in individuals with Patellar tendinopathy: a systematic review. Physiother Res Int 2018;23:e1721. 
  10. Higgins JPT, Altman DG, Gotzsche PC, et al. The Cochrane collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928. 
  11. Breda SJ, Oei EHG, Zwerver J, et al. Effectiveness of progressive tendon-loading exercise therapy in patients with patellar tendinopathy: A randomised clinical trial. Br J Sports Med. 2021;55(9):501-509. doi:10.1136/bjsports-2020-103403 
  12. Guyatt GH, Oxman AD, Vist GE, et al. Grade: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924-6. 
  13. Puhan MA, Schunemann HJ, Murad MH, et al. A grade Working group approach for rating the quality of treatment effect estimates from network meta-analysis. BMJ 2014;349:g5630. 
  14. Ma J, Liu W, Hunter A, et al. Performing meta-a nalysis with incomplete statistical information in clinical trials. BMC Med Res Methodol 2008;8:56. 
  15. Abat F, Sanchez-Sanchez JL, Martin-Nogueras AM, et al. Randomized controlled trial comparing the effectiveness of the ultrasound-guided galvanic electrolysis technique(USGET) versus conventional electro-physiotherapeutic treatment on Patellar tendinopathy. J Exp Orthop 2016;3:34. 
  16. Breda SJ, de Vos RJ, Krestin GP, Oei EHG. Decreasing patellar tendon stiffness during exercise therapy for patellar tendinopathy is associated with better outcome. J Sci Med Sport. 2022;25(5):372-378. doi:10.1016/j.jsams.2022.01.002 
  17. Agergaard A-S, Svensson RB, Malmgaard-Clausen NM, et al. Clinical outcomes, structure, and function improve with both heavy and moderate loads in the treatment of Patellar tendinopathy: a randomized clinical trial. Am J Sports Med 2021;49:982-93. 
  18. Bahr R, Fossan B, Loken S, et al. Surgical treatment compared with eccentric training for Patellar tendinopathy (jumper's knee). A randomized, controlled trial. J Bone Joint Surg Am 2006;88:1689-98. 
  19. Lopez-Royo MP, Rios-Diaz J, Galan-Diaz RM, Herrero P, Gomez-Trullen EM. A comparative study of treatment interventions for patellar tendinopathy: A randomized controlled trial. Arch Phys Med Rehabil. 2021;102(5):967-975. doi:10.1016/j.apmr.2021.01.073. 
  20. Acaroz Candan S, Sozen H, Ari E. Electromyographic activity of quadriceps muscles during eccentric squat exercises: implications for exercise selection in patellar tendinopathy[published online ahead of print, 2021 Dec 2]. Res Sports Med. 2021;1-11. doi:10.1080/15438627.2021.2010200. 
  21. MacDonald K, Day J, Dionne C. Effect of Eccentric Exercises at the Knee with Hip Muscle Strengthening to Treat Patellar Tendinopathy in Active Duty Military Personnel: A Randomized Pilot. Orthopaedic Physical Therapy Practice. 2019;31(1):8-16. Accessed September15, 2022. 
  22. Abian-Vicen J, Martinez F, Jimenez F, Abian P. Effects of Eccentric Single-Leg Decline Squat Training Performed With Different Execution Times on Maximal Strength and Muscle Contraction Properties of the Knee Extensor Muscles[published online ahead of print, 2021 Jun 2]. J Strength Cond Res. 2021; 10.1519/JSC.0000000000004063. doi:10.1519/JSC.0000000000004063. 
  23. Lopez-Royo MP, Gomez-Trullen EM, Ortiz-Lucas M, et al. Comparative study of treatment interventions for patellar tendinopathy: A protocol for a randomised controlled trial. BMJ Open. 2020;10(2). doi:10.1136/bmjopen-2019-034304.