Electromyographic activity of quadriceps muscles during eccentric squat exercises: implications for exercise selection in patellar tendinopathy

Candan, Sevim Acaröz; Sözen, Hasan; Arı, Erdal

doi:10.1080/15438627.2021.2010200

Cited by 4 publications

(5 citation statements)

References 29 publications

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“…However, 60° squats resulted in approximately half the peak loading when compared with full squats. This finding is in accordance with the results of a recent study that found that deeper squats (>60°) generate significantly more muscle activation of the rectus femoris, vastus medialis, and vastus lateralis (46). In this context, to progressively load the patellar tendon in rehabilitation, the clinician should consider progressing from double-leg squats to single-leg squats before progressing from 60° squats to full squats.…”

Section: Discussionsupporting

confidence: 93%

Patellar Tendon Load Progression during Rehabilitation Exercises: Implications for the Treatment of Patellar Tendon Injuries

SCATTONE SILVA,

SONG,

HULLFISH

et al. 2023

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose To evaluate patellar tendon loading profiles (loading index, based on loading peak, loading impulse, and loading rate) of rehabilitation exercises to develop clinical guidelines to incrementally increase the rate and magnitude of patellar tendon loading during rehabilitation. Methods Twenty healthy adults (10 females/10 males, 25.9 ± 5.7 years) performed 35 rehabilitation exercises, including different variations of squats, lunge, jumps, hops, landings, running, and sports specific tasks. Kinematic and kinetic data were collected and a patellar tendon loading index was determined for each exercise using a weighted sum of loading peak, loading rate, and cumulative loading impulse. Then, the exercises were ranked, according to the loading index, into tier 1 (loading index≤0.33), tier 2 (0.33 < loading index<0.66), and tier 3 (loading index≥0.66). Results The single-leg decline squat showed the highest loading index (0.747). Other tier 3 exercises included single-leg forward hop (0.666), single-leg countermovement jump (0.711), and running cut (0.725). The Spanish squat was categorized as a tier 2 exercise (0.563), as was running (0.612), double-leg countermovement jump (0.610), single-leg drop vertical jump (0.599), single-leg full squat (0.580), double-leg drop vertical jump (0.563), lunge (0.471), double-leg full squat (0.428), single-leg 60° squat (0.411), and the Bulgarian squat (0.406). Tier 1 exercises included 20 cm step up (0.187), 20 cm step down (0.288), 30 cm step up (0.321), and double-leg 60° squat (0.224). Conclusions Three patellar tendon loading tiers were established based on a combination of loading peak, loading impulse, and loading rate. Clinicians may use these loading tiers as a guide to progressively increase patellar tendon loading during the rehabilitation of patients with patellar tendon disorders and after anterior cruciate ligament reconstruction using the bone patellar tendon bone graft.

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Section: Discussionsupporting

confidence: 93%

Patellar Tendon Load Progression during Rehabilitation Exercises: Implications for the Treatment of Patellar Tendon Injuries

SCATTONE SILVA,

SONG,

HULLFISH

et al. 2023

Medicine &Amp; Science in Sports &Amp; Exercise

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“…They also found that dry needling or percutaneous needling combined with eccentric training were not statistically significant when compared to eccentric therapy alone [19]. Acaroz et al discovered that maximal voluntary isometric contractions displayed increased muscle activation throughout the quadriceps muscle group [20]. Macdonald et al demonstrated that eccentric exercises combined with concentric hip strengthening was not more effective than eccentric exercise alone [21].…”

Section: Resultsmentioning

confidence: 99%

Effects of Eccentric Exercise Associated with Patellofemoral Tendinopathy: A Systematic Review

Prall,

Gillen,

Talbot

et al. 2023

Phys Ther Rehabil Sci

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“…The use of a decline board with a decline angle of 25 • has been the cornerstone of therapy for the last two decades [30]. The efficacy of the usage of a 25 • decline board has been confirmed in various clinically and biomechanically oriented investigations [12,13,31,32]. Overall, the investigations indicate greater benefit of performing squats on the standard 25 • decline board than on the flat surface.…”

Section: Discussionmentioning

confidence: 99%

“…In order to achieve this aim, eccentric quadriceps exercise, which is performed to avoid the weakening of the tendon, has become the standard treatment option for the rehabilitation of patients with patellar tendinopathy. However, various ways to perform squats during these exercises have been described, and no squat has been generally accepted as superior to others [12,13]. In an interventional study performed on a relatively small number of patients, Purdam et al reported that patients who performed squats on a 25 • decline board recovered better than patients practicing on the flat position.…”

Section: Background and Objectivesmentioning

confidence: 99%

Eccentric Exercises on the Board with 17-Degree Decline Are Equally Effective as Eccentric Exercises on the Standard 25-Degree Decline Board in the Treatment of Patellar Tendinopathy

Knež,

Hudetz

2023

Medicina

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Background and Objectives: Patellar tendinopathy is one of the most significant problems in jumping and running athletes. Eccentric quadriceps exercise has been introduced into the therapy of patients with patellar tendinopathy in order to avoid weakening the tendon during rehabilitation. The use of decline boards with a decline angle of 25° has been the cornerstone of therapy over the last two decades. Biomechanical studies have suggested that an equal or potentially better outcome could be achieved with lower angles of decline (up to 16°). Materials and Methods: In this present research, we compared the effects of two various decline board angles on the clinical outcome of patients treated for patellar tendinopathy by performing eccentric quadriceps exercises. Patients were randomly allocated into two groups: patients practicing on the standard board with a 25° decline, and patients practicing on the 17° decline (n = 35 per group). Results: After 6 weeks of exercise, we found a significant improvement in all the clinical scores (VISA-P score, KOOS score, Lysholm Knee Questionnaire/Tegner Activity Scale, and VAS scale) of treated patients. However, there was no significant difference between the patients who performed eccentric quadriceps exercises on the standard 25° decline board and those exercising on the 17° decline board. A smaller additional degree of improvement was visible at the end of the follow-up period (at 12 weeks), but, again, no statistical difference could be detected between the investigated groups. We conclude that both treatment options provide similar short-term and midterm benefits regarding improvements in pain and clinical scores. The improvement in clinical scores does not depend on age, sex, BMI, or the professional sport of the patient. Conclusions: Our findings encourage changes in the decline angle of the board in the case of a patient’s discomfort in order to achieve better compliance without affecting the recovery.

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Electromyographic activity of quadriceps muscles during eccentric squat exercises: implications for exercise selection in patellar tendinopathy

Cited by 4 publications

References 29 publications

Patellar Tendon Load Progression during Rehabilitation Exercises: Implications for the Treatment of Patellar Tendon Injuries

Patellar Tendon Load Progression during Rehabilitation Exercises: Implications for the Treatment of Patellar Tendon Injuries

Effects of Eccentric Exercise Associated with Patellofemoral Tendinopathy: A Systematic Review

Eccentric Exercises on the Board with 17-Degree Decline Are Equally Effective as Eccentric Exercises on the Standard 25-Degree Decline Board in the Treatment of Patellar Tendinopathy

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