Impact of Patellar Tendinopathy on Knee Proprioception

Torres, Rosângela Pavan; Ferreira, João Marcos Bemfica Barbosa; Silva, Diogo C. F.; Rodrigues, Elisa; Bessa, Isabel M.; Ribeiro, Fernando

doi:10.1097/jsm.0000000000000295

Cited by 18 publications

(12 citation statements)

References 30 publications

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“…The physiopathology and the tretaments of tendinopathies, and especially of the patellar tendinopathy, are more and more studied but remain not clearly understood (1,4,13,(16)(17)(19)(20)(21)(22)(23). Moreover, the repercussion of this condition on strength of the thigh is poorly described.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, the latter generally aims to clearing the symptoms and restoring the tendon's structure and ability to bear loads. However, few to no study has been devoted to the investigation of the loss of muscular strength in the pathological limb (1,4,17,(19)(20)(21)(22)(23). Thus, the main objective of this report was to quantify this parameter and look for a trend in the muscle weakness and muscular unbalance between the two legs after recovery.…”

Section: Discussionmentioning

confidence: 99%

“…Nearly one volleyball player out of 2 will suffer from this tendon condition during his sport career. Even if there exist lots of study to understand its physiopathology, to evaluated its mechanical repercussions and to propose treatments (1,4,(10)(11)17,(19)(20)(21)(22)(23), however, the quadriceps strength profile of subjects with proximal patellar tendinopathies remains poorly described.…”

Section: Introductionmentioning

confidence: 99%

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Isokinetic strength profile of subjects with proximal patellar tendinopathy

Kaux

Croisier

Libertiaux

2019

Muscle Ligaments and Tendons J

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Background. Proximal patellar tendinopathy is relatively common among sportsmen. However, the strength profile of subjects with proximal patellar tendinopathies is poorly described. Purpose. We aimed to determine the isokinetic strength profile in order to estimate the difference of muscular performance between the healthy and pathological limbs of subjects suffering of this chronic pathology. Study design. cohort study. Methods. 43 subjects with chronic proximal patellar tendinopathy were involved. It has been based on the evaluation of the quadriceps and the hamstrings muscular performance of the healthy and pathological member on isokinetic dynamometer at the speed of 60°/s (C60) and of 240°/s (C240) in concentric mode and at the speed of 30°/s (E30) in eccentric mode. A visual analogic scale of pain (VAS) has been also realized after each isokinetic test. Results. The results of the isokinetic tests comparing the healthy to the pathological limb are meaningful for the different conditions of contraction and test speeds, just like the results of the VAS associated to those tests (p<0,01). Indeed, pathological knees had a maximum peak torque for the quadriceps in C60 lower than healthy. Conclusion. In our study, the isokinetic results show a significant difference in performance isokinetic between the healthy and the pathological limb as well as VAS associated with these tests. However, the diversity of outcomes recorded in the patients suggests us that an individualized treatment is the case of patellar tendon pathology. Finally, it would seem that an isokinetic test in eccentric in some patients is, in addition to a test of provocation of the tendon, a pain assessment tool.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Isokinetic strength profile of subjects with proximal patellar tendinopathy

Kaux

Croisier

Libertiaux

2019

Muscle Ligaments and Tendons J

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“…Patellar tendinopathy is a debilitating condition that affects professional [5] and recreational [6] athletes. It is characterized by pain at the patella’s apex [7, 8] and presents with tendon pathology [9–11], reduced tendon stiffness [12], muscle recruitment inhibition, biomechanical impairments [13–15], and proprioceptive deficits [16, 17].…”

Section: Introductionmentioning

confidence: 99%

High-energy dose of therapeutic ultrasound in the treatment of patellar tendinopathy: protocol of a randomized placebo-controlled clinical trial

Jesus

Albuquerque²,

Shimba³

et al. 2019

BMC Musculoskelet Disord

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Background: Patellar tendinopathy is an extremely debilitating condition and its treatment usually requires a combination of clinical approaches. Therapeutic ultrasound (TUS) is one of the most available electrophysical agent in rehabilitation settings; however, there is also a lack of high-quality studies that test different dosimetric aspects of TUS. Thus, the purpose of this study is to evaluate the short-, medium-, and long-term effects of the combination of high-energy TUS with a rehabilitation program for patellar tendinopathy. Methods: This will be a randomized, placebo-controlled trial with blinding of patients, assessors, and therapist. The setting is an outpatient physical therapy clinic. We will recruit 66 participants (male and female) aged between 18 and 40 years and presenting with patellar tendinopathy. A treatment combining high-energy dose TUS and a rehabilitation program for patellar tendinopathy will be delivered twice a week for 8 weeks. The control group will receive the same treatment, but with a placebo TUS. The effectiveness of the intervention will be measured at the beginning (baseline), midpoint (4 weeks), and end of treatment (8 weeks), as well as at 3-and 6-months posttreatment. Primary outcomes will be pain intensity (visual analogue scale, VAS), and VISA-P questionnaire and primary time points will be baseline (T0) and the end of the program (T2). Also, IPAQ-short form questionnaire, muscle strength (manual dynamometry), 2D kinematics, pain pressure threshold (PPT) algometry, thermography, and magnetic resonance imaging (MRI) will be collected. Discussion: TUS will be applied in an attempt to enhance the results obtained with the rehabilitation program proposed in this study, as well as stimulate some repair responses in individuals undergoing treatment for patellar tendinopathy, which in turn may optimize and improve treatment programs for patellar tendinopathy as well as to establish new guidelines for the application of TUS. Trial registration: This study was prospectively registered at April-3rd-2018 and updated at September-1st-2019 in the Brazilian Registry of Clinical Trials (REBEC) under the registration number: RBR-658n6w.

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“…However, in daily sports and military training [ 15 ], longitudinal impacts to the knee in a straight state often occur. In the above studies, the knee joint is mostly in a bent state [ 16 ], and studies assessing the mechanical response to longitudinal impacts to the knee in an extended state are relatively limited. As a result, the mechanical changes of the femoral-knee-tibiofibular structure and the mechanical responses of the accessory structures in the joint cavity while sustaining a longitudinal impact are still not clear.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Responses and Injury Characteristics of Knee Joints under Longitudinal Impacts of Different Velocities

Xiong

Zhao

Xiang

et al. 2018

Applied Bionics and Biomechanics

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Background and Objective Knee joint collision injuries occur frequently in military and civilian scenarios, but there are few studies assessing longitudinal impacts on knee joints. In this study, the mechanical responses and damage characteristics of knee longitudinal collisions were investigated by finite element analysis and human knee impact tests. Materials and methods Based on a biocollision test plateau, longitudinal impact experiments were performed on 4 human knee joints (2 in the left knee and 2 in the right knee) to measure the impact force and stress response of the bone. And then a finite element model of knee joint was established from the Chinese Visible Human (CVH), with which longitudinal impacts to the knee joint were simulated, in which the stress response was determined. The injury response of the knee joint-sustained longitudinal impacts was analyzed from both the experimental model and finite element analysis. Results The impact experiments and finite element simulation found that low-speed impact mainly led to medial injuries and high-speed impact led to both medial and lateral injuries. In the knee joint impact experiment, the peak flexion angles were 13.8° ± 1.2, 30.2° ± 5.1, and 92.9° ± 5.45 and the angular velocities were 344.2 ± 30.8 rad/s, 1510.8 ± 252.5 rad/s, and 9290 ± 545 rad/s at impact velocities 2.5 km/h, 5 km/h, and 8 km/h, respectively. When the impact velocity was 8 km/h, 1 knee had a femoral condylar fracture and 3 knees had medial tibial plateau fractures or collapse fractures. The finite element simulation of knee joints found that medial cortical bone stress appeared earlier than the lateral peak and that the medial bone stress concentration was more obvious when the knee was longitudinally impacted. Conclusion Both the experiment and FE model confirmed that the biomechanical characteristics of the injured femur and medial tibia are likely to be damaged in a longitudinal impact, which is of great significance for the prevention and treatment of longitudinal impact injuries of the knee joint.

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Impact of Patellar Tendinopathy on Knee Proprioception

Abstract: Athletes with patellar tendinopathy have a diminished perception of force signals required for weight discrimination, whereas JPS remains unaffected in these athletes.

Cited by 18 publications

References 30 publications

Isokinetic strength profile of subjects with proximal patellar tendinopathy

Isokinetic strength profile of subjects with proximal patellar tendinopathy

High-energy dose of therapeutic ultrasound in the treatment of patellar tendinopathy: protocol of a randomized placebo-controlled clinical trial

Biomechanical Responses and Injury Characteristics of Knee Joints under Longitudinal Impacts of Different Velocities

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