Journal
AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION
Volume 97, Issue 10, Pages 708-714Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PHM.0000000000000951
Keywords
Tendinopathy; Patellar Ligament; Tendons; Ultrasonography
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Funding
- Foundation De Drie Lichten
- Wetenschappelijk College Fysiotherapie
- Anna Foundation \ NOREF in the Netherlands
- Australian Institute of Sport (Clinical Research Fund)
- Australian Collaboration for Research into Sports Injury and Its Prevention (ACRISP), International Research Centres for the Prevention of Injury and Protection of Athlete Health - International Olympic Committee
- National Health and Medical Research Council [105849]
- Monash Postgraduate Publication Award
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Objectives The aim of this study was to investigate the effects of a 4-wk in-season exercise program of isometric or isotonic exercises on tendon structure and dimensions as quantified by ultrasound tissue characterization (UTC). Design This was a randomized clinical trial. Volleyball and basketball players (16-31 yrs, n = 29) with clinically diagnosed patellar tendinopathy were randomized to a 4-wk isometric or isotonic exercise program. The programs were designed to decrease patellar tendon pain. A baseline and 4-wk UTC scan was used to evaluate change in tendon structure. Results No significant change in tendon structure or dimensions on UTC was detected after the exercise program despite patellar tendinopathy symptoms improving. The percentage and mean cross-sectional area of aligned fibrillar structure (echo types I + II) (Z = -0.414, P = 0.679) as well as disorganized structure (echo types III + IV) (Z = -0.370, P = 0.711) did not change over the 4-wk exercise program. Change in tendon structure and dimensions on UTC did not differ significantly between the groups. Conclusion Structural properties and dimensions of the patellar tendon on UTC did not change after a 4-wk isometric or isotonic exercise program for athletes with patellar tendinopathy in-season, despite an improvement in symptoms. It seems that structural improvements are not required for a positive clinical outcome.
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