Long-Term Effectiveness of Combined Mechanotransduction Treatment in Jumper's Knee

Saggini, Raoul; Stefano, A. Di; Galati, V; Panelli, E.; Valeri, Madeleine; Pancrazio, L. Di; Iodice, Pierpaolo; Fulle, Stefania

doi:10.1177/1721727x1201000327

Cited by 4 publications

(14 citation statements)

References 30 publications

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“…Saggini et al . ( 2012 ) reported a definite correlation between an inferior patellar pole alignment and the probability to develop PT. Secondly, leg-length discrepancy, where the longer leg is the preferred take-off leg in jumping, can also be associated with PT.…”

Section: Resultsmentioning

confidence: 98%

“…In sporting activities where the level and acquisition of skills are important, the development of PT is a possibility, as noticed in five studies included in this review (Saggini et al . 2012 ; Samukawa 2011 ; Souza et al . 2010 ; Toppi et al .…”

Section: Resultsmentioning

confidence: 99%

“… 2012 ) and weight training for at least 5 hours per week (Saggini et al . 2012 ). Heavy physical work has a considerable effect on the development of PT in sports-related and non-sports-related basketball and volleyball players, which affects their work performance (De Vries et al .…”

Section: Resultsmentioning

confidence: 99%

“…Eccentric exercise (EE) is extremely popular in the conventional treatment of chronic lower limb tendinopathies (Saggini et al . 2012 ), and literature on EE dates back to 1938. It is therefore not surprising that 10 of the studies included for review described EE as a rehabilitation modality for PT.…”

Section: Resultsmentioning

confidence: 99%

“…Athletes with PT can experience uncomfortable symptoms and decreased function for up to 3 years (Saggini et al . 2012 ), which have a negative effect on quality of life (Toppi et al . 2015 ).…”

Section: Introductionmentioning

confidence: 99%

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Causative factors and rehabilitation of patellar tendinopathy: A systematic review

Morgan

Vuuren

Coetzee

2016

South African Journal of Physiotherapy

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BackgroundPatellar tendinopathy (PT) is a common chronic pathology of the knee, with a high prevalence in athletes and the general population.ObjectivesThe objectives of this article were to systematically investigate all the evidence applicable to the intrinsic and extrinsic causative factors and rehabilitation of PT, and then integrate and link rehabilitation with the main causative factors identified.MethodThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Various tools were used to evaluate the methodological quality of the eligible articles. Data were interpreted descriptively, and the causative factors and rehabilitation of PT were analysed.ResultsTwenty studies were included in the review. The distinctive factor responsible for PT is the mechanical theory. Seven intrinsic and four extrinsic risk factors were identified, with the main intrinsic risk factors being muscle flexibility and strength, and extrinsic risk factors being acquisition and level of skills. PT can be treated with numerous different therapeutic modalities, although eccentric muscle training showed exceptional results. The intrinsic and extrinsic risk factors can only be transformed and reduced by rehabilitation, which is inevitable to improve PT pain and function.ConclusionThe essence of an integrated management protocol for PT is to identify the dominant contributing factors, whether intrinsic or extrinsic, and to reduce the load on the patellar tendon by modifying these factors by either rehabilitation intervention or direct modification of the equipment or environment to obtain a positive outcome towards pain management and function.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Causative factors and rehabilitation of patellar tendinopathy: A systematic review

Morgan

Vuuren

Coetzee

2016

South African Journal of Physiotherapy

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Use of extracorporeal shockwave therapies for athletes and physically active individuals: a systematic review

Rhim,

Shin,

Kang

et al. 2024

Br J Sports Med

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ObjectiveTo determine the efficacy of extracorporeal shockwave therapy (ESWT) and investigate outcomes following the use of ESWT for athletes and physically active individuals.DesignSystematic review.Data sourcesWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and searched four databases: PubMed (NLM), Embase (Elsevier), CINAHL Complete (EBSCO) and Web of Science (Clarivate).Eligibility criteria for selecting studiesIncluded studies were randomised controlled trials, cohort and case–control studies, cases series and reports that evaluated outcomes following ESWT for athletes, physically active individuals and occupational groups requiring regular physical activity such as military cadets.Results56 studies with 1874 athletes or physically active individuals were included. Using the Oxford level of evidence rating, included studies were 18 level I (32.1%), 3 level II (5.4%), 10 level III (17.9%), 13 level IV (23.2%) and 12 level V (21.4%). Based on the level I studies, ESWT may be effective alone in plantar fasciitis, lateral epicondylitis and proximal hamstring tendinopathy and as an adjunct to exercise treatment in medial tibial stress syndrome and osteitis pubis in athletes or physically active individuals. In most studies, athletes were allowed to continue activities and training and tolerated ESWT with minimal side effects.ConclusionESWT may offer an efficacious treatment alone or as an adjunct to concurrent exercise therapy in selected sports-related injuries and without major adverse events. Further high-level research is needed to better define the role and clinical outcomes of ESWT.

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Exercise therapy for tendinopathy: a mixed-methods evidence synthesis exploring feasibility, acceptability and effectiveness

Cooper,

Alexander,

Brandie

et al. 2023

Health Technol Assess

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BackgroundTendinopathy is a common, painful and functionally limiting condition, primarily managed conservatively using exercise therapy.Review questions(i) What exercise interventions have been reported in the literature for which tendinopathies? (ii) What outcomes have been reported in studies investigating exercise interventions for tendinopathy? (iii) Which exercise interventions are most effective across all tendinopathies? (iv) Does type/location of tendinopathy or other specific covariates affect which are the most effective exercise therapies? (v) How feasible and acceptable are exercise interventions for tendinopathies?MethodsA scoping review mapped exercise interventions for tendinopathies and outcomes reported to date (questions i and ii). Thereafter, two contingent systematic review workstreams were conducted. The first investigated a large number of studies and was split into three efficacy reviews that quantified and compared efficacy across different interventions (question iii), and investigated the influence of a range of potential moderators (question iv). The second was a convergent segregated mixed-method review (question v). Searches for studies published from 1998 were conducted in library databases (n= 9), trial registries (n= 6), grey literature databases (n= 5) and Google Scholar. Scoping review searches were completed on 28 April 2020 with efficacy and mixed-method search updates conducted on 19 January 2021 and 29 March 2021.ResultsScoping review– 555 included studies identified a range of exercise interventions and outcomes across a range of tendinopathies, most commonly Achilles, patellar, lateral elbow and rotator cuff-related shoulder pain. Strengthening exercise was most common, with flexibility exercise used primarily in the upper limb. Disability was the most common outcome measured in Achilles, patellar and rotator cuff-related shoulder pain; physical function capacity was most common in lateral elbow tendinopathy.Efficacy reviews– 204 studies provided evidence that exercise therapy is safe and beneficial, and that patients are generally satisfied with treatment outcome and perceive the improvement to be substantial. In the context of generally low and very low-quality evidence, results identified that: (1) the shoulder may benefit more from flexibility (effect sizeResistance:Flexibility= 0.18 [95% CrI 0.07 to 0.29]) and proprioception (effect sizeResistance:Proprioception= 0.16 [95% CrI −1.8 to 0.32]); (2) when performing strengthening exercise it may be most beneficial to combine concentric and eccentric modes (effect sizeEccentricOnly:Concentric+Eccentric= 0.48 [95% CrI −0.13 to 1.1]; and (3) exercise may be most beneficial when combined with another conservative modality (e.g. injection or electro-therapy increasing effect size by ≈0.1 to 0.3).Mixed-method review– 94 studies (11 qualitative) provided evidence that exercise interventions for tendinopathy can largely be considered feasible and acceptable, and that several important factors should be considered when prescribing exercise for tendinopathy, including an awareness of potential barriers to and facilitators of engaging with exercise, patients’ and providers’ prior experience and beliefs, and the importance of patient education, self-management and the patient-healthcare professional relationship.LimitationsDespite a large body of literature on exercise for tendinopathy, there are methodological and reporting limitations that influenced the recommendations that could be made.ConclusionThe findings provide some support for the use of exercise combined with another conservative modality; flexibility and proprioception exercise for the shoulder; and a combination of eccentric and concentric strengthening exercise across tendinopathies. However, the findings must be interpreted within the context of the quality of the available evidence.Future workThere is an urgent need for high-quality efficacy, effectiveness, cost-effectiveness and qualitative research that is adequately reported, using common terminology, definitions and outcomes.Study registrationThis project is registered as DOI:10.11124/JBIES-20-00175(scoping review); PROSPERO CRD 42020168187 (efficacy reviews);https://osf.io/preprints/sportrxiv/y7sk6/(efficacy review 1);https://osf.io/preprints/sportrxiv/eyxgk/(efficacy review 2);https://osf.io/preprints/sportrxiv/mx5pv/(efficacy review 3); PROSPERO CRD42020164641 (mixed-method review).FundingThis project was funded by the National Institute for Health and Care Research (NIHR) HTA programme and will be published in full in HTA Journal; Vol. 27, No. 24. See the NIHR Journals Library website for further project information.

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Long-Term Effectiveness of Combined Mechanotransduction Treatment in Jumper's Knee

Cited by 4 publications

References 30 publications

Causative factors and rehabilitation of patellar tendinopathy: A systematic review

Causative factors and rehabilitation of patellar tendinopathy: A systematic review

Use of extracorporeal shockwave therapies for athletes and physically active individuals: a systematic review

Exercise therapy for tendinopathy: a mixed-methods evidence synthesis exploring feasibility, acceptability and effectiveness

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