Effects of isometric, eccentric, or heavy slow resistance exercises on pain and function in individuals with patellar tendinopathy: A systematic review

Lim, Hui Yin; Wong, Shi Hui

doi:10.1002/pri.1721

Cited by 73 publications

(81 citation statements)

References 24 publications

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“…[22][23][24][25] Previous systematic reviews have evaluated eccentric and combined concentric/eccentric programmes, but only one review to date has evaluated isometric exercise. 26 This review focused on patellar tendinopathy and concluded that isometric exercise programmes appeared to be effective in short-term pain relief in athletes during the competitive season. Despite their recent popularity, it is unclear if isometric exercise provides superior pain relief when directly compared with other interventions.…”

Section: What Are the New Findingsmentioning

confidence: 99%

Effectiveness of isometric exercise in the management of tendinopathy: a systematic review and meta-analysis of randomised trials

Clifford

Challoumas

Paul

et al. 2020

BMJ Open Sport Exerc Med

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ObjectiveTo systematically review and critically appraise the literature on the effectiveness of isometric exercise in comparison with other treatment strategies or no treatment in tendinopathy.DesignA systematic review and meta-analysis of randomised controlled trials.Data sourcesElectronic searches of Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE and Cochrane were undertaken from inception to May 2020.MethodsOverall quality of each study was determined based on a combined assessment of internal validity, external validity and precision. For each outcome measure, level of evidence was rated based on the system by van Tulder et al.ResultsTen studies were identified and included in the review, including participants with patellar (n=4), rotator cuff (n=2), lateral elbow (n=2), Achilles (n=1) and gluteal (n=1) tendinopathies. Three were of good and seven were of poor overall quality. Based on limited evidence (level 3), isometric exercise was not superior to isotonic exercise for chronic tendinopathy either immediately following treatment or in the short term (≤12 weeks) for any of the investigated outcome measures. Additionally, for acute rotator cuff tendinopathy, isometric exercise appears to be no more effective than ice therapy in the short term (limited evidence; level 3).SummaryIsometric exercise does not appear to be superior to isotonic exercise in the management of chronic tendinopathy. The response to isometric exercise is variable both within and across tendinopathy populations. Isometric exercise can be used as part of a progressive loading programme as it may be beneficial for selected individuals.PROSPERO registration numberCRD42019147179.

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Section: What Are the New Findingsmentioning

confidence: 99%

Effectiveness of isometric exercise in the management of tendinopathy: a systematic review and meta-analysis of randomised trials

Clifford

Challoumas

Paul

et al. 2020

BMJ Open Sport Exerc Med

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“…Conventional treatments such as eccentric exercise (EE) programs for the quadriceps tendon, as a part of standard treatment, has demonstrated to have positive results, to the point that many authors have defended this technique as the gold standard for the treatment of tendinopathies [ 9 – 12 ]. A recent systematic review reported that the best exercise for improving knee function and reducing pain in the long term is based on EE and heavy slow resistance exercises (HSR) [ 13 ]. In addition, recent research has focused on minimally invasive techniques (MIT) using needles, with high expectations of success.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Minimally Invasive Techniques in the Treatment of Patellar Tendinopathy: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

López-Royo

Ortiz-Lucas

Gómez-Trullén

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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The aim was to determine the effectiveness of minimally invasive techniques (MIT) in patients with patellar tendinopathy. Database searches were performed for randomized controlled trials (RCTs) in electronic databases (WOS, Cochrane Central, SportDiscus, and Medline via PubMed and PEDro). The inclusion criteria used were published in English or Spanish and involving adults with patellar tendinopathy (pain on the inferior pole of the patella for a minimum of 3 months), with at least one group receiving MIT. The quality of the relevant RCTs was evaluated using the PEDro scale. The primary outcome was functionality using the VISA-p questionnaire. Secondary outcome was focused on pain. A total of 1164 studies were screened for possible inclusion in our systematic review. Finally, 10 RCTs were included with a total of 326 individuals. Five RCTs were included in the meta-analysis. The quality assessment revealed that all the studies included were considered to possess high methodological quality. All studies analyzing MIT such as platelet-rich plasma (PRP), dry needling, or skin-derived tenocyte-like cells, when combined with exercise, proved to be effective for patellar tendinopathy. Moreover, the PRP technique with doses greater than 4 mL together and combined with an exercise program lasting over 6 weeks obtained better results in functionality and pain than other treatments in the short term. However, in the long term, dry needling and skin-derived tenocyte-like cells are more effective than PRP. Although the infiltration of drugs was effective at posttreatment, these improvements were not maintained over time and may have secondary effects. Although there are no RCTs analyzing the effectiveness of MIT like percutaneous needle electrolysis, there has been an increasing number of publications achieving excellent results in the last years. However, it is necessary to develop RCTs analyzing not only the effect but also comparing the effectiveness between different MIT such as dry needling and percutaneous needle electrolysis.

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“…Isometric exercises have gained popularity in recent years in the management of other lower limb tendinopathies 11. An isometric exercise programme was compared with an isotonic programme in Australian volleyball and basketball players with patella tendinopathy 12.…”

Section: Introductionmentioning

confidence: 99%

Isometric versus isotonic exercise for greater trochanteric pain syndrome: a randomised controlled pilot study

Clifford

Paul

Syme

et al. 2019

BMJ Open Sport Exerc Med

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ObjectivesGreater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain. Limited evidence exists for the effectiveness of exercise for GTPS. This study aimed to compare the effectiveness of isometric and isotonic exercise for individuals with GTPS.MethodsThis randomised controlled pilot trial recruited 30 participants with GTPS. Both programmes consisted of daily, progressive home exercise for 12 weeks with 8 individual physiotherapy sessions over the trial period. The primary outcome measure was the Victorian Institute of Sport Assessment-Gluteal (VISA-G) and secondary outcome measures included the Numeric Pain Rating Scale (0–10) and an 11-point Global Rating of Change Scale. Outcome measures were assessed at baseline, 4 and 12 weeks.ResultsTwenty-three participants completed the trial. After 12 weeks, mean VISA-G scores improved in both groups; 55–65 in the isometric group and 62–72 in the isotonic group. 55% of the isometric group and 58% of the isotonic group achieved a reduction in pain of at least 2 points (minimally clinically important difference (MCID)) on the Numeric Pain Rating Scale. 64% of the isometric group and 75% of the isotonic group had improved by at least 2 points (MCID) on the Global Rating of Change Scale.ConclusionIsometric and isotonic exercise programmes appear to be effective for individuals with GTPS and should be considered in the loading management of patients with this condition.

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Effects of isometric, eccentric, or heavy slow resistance exercises on pain and function in individuals with patellar tendinopathy: A systematic review

Cited by 73 publications

References 24 publications

Effectiveness of isometric exercise in the management of tendinopathy: a systematic review and meta-analysis of randomised trials

Effectiveness of isometric exercise in the management of tendinopathy: a systematic review and meta-analysis of randomised trials

The Effectiveness of Minimally Invasive Techniques in the Treatment of Patellar Tendinopathy: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Isometric versus isotonic exercise for greater trochanteric pain syndrome: a randomised controlled pilot study

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