The implementation of resistance training principles in exercise interventions for lower limb tendinopathy: A systematic review

Burton, Ian; McCormack, Aisling

doi:10.1016/j.ptsp.2021.04.008

Cited by 18 publications

(37 citation statements)

References 111 publications

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“…Given the increased research interest and clinical use of BFRT in musculoskeletal rehabilitation for non-tendon pathologies, the dearth of available studies applying BFRT to tendon pathologies could be considered somewhat surprising. This is particularly relevant considering resistance training is considered the gold-standard first-line treatment intervention for tendinopathies, particularly Achilles and patellar tendinopathy, due to a plethora of evidence showing the clinical efficacy of resistance training such as eccentric and heavy slow resistance training (Burton and McCormack, 2021 ). Perhaps the belief that resistance training in tendinopathy must include high training loads has been a limiting factor in the application of LL-BFRT and could explain why it is an underutilized tool in tendon rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Blood Flow Restriction Resistance Training in Tendon Rehabilitation: A Scoping Review on Intervention Parameters, Physiological Effects, and Outcomes

Burton

McCormack

2022

Front. Sports Act. Living

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ObjectiveTo identify current evidence on blood flow restriction training (BFRT) in tendon injuries and healthy tendons, evaluating physiological tendon effects, intervention parameters, and outcomes.MethodsThis scoping review was reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Databases searched included MEDLINE, CINAHL, AMED, EMBase, SPORTDiscus, Cochrane library (Controlled trials, Systematic reviews), and five trial registries. Two independent reviewers screened studies at title/abstract and full text. Following screening, data was extracted and charted, and presented as figures and tables alongside a narrative synthesis. Any study design conducted on adults, investigating the effects of BFRT on healthy tendons or tendon pathology were included. Data were extracted on physiological tendon effects, intervention parameters and outcomes with BFRT.ResultsThirteen studies were included, three on tendinopathy, two on tendon ruptures, and eight on healthy Achilles, patellar, and supraspinatus tendons. A variety of outcomes were assessed, including pain, function, strength, and tendon morphological and mechanical properties, particularly changes in tendon thickness. BFRT intervention parameters were heterogeneously prescribed.ConclusionDespite a dearth of studies to date on the effects of BFRT on healthy tendons and in tendon pathologies, preliminary evidence for beneficial effects of BFRT on tendons and clinical outcomes is encouraging. As BFRT is a relatively novel method, definitive conclusions, and recommendations on BFRT in tendon rehabilitation cannot be made at present, which should be addressed in future research, due to the potential therapeutic benefits highlighted in this review.

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Section: Discussionmentioning

confidence: 99%

Blood Flow Restriction Resistance Training in Tendon Rehabilitation: A Scoping Review on Intervention Parameters, Physiological Effects, and Outcomes

Burton

McCormack

2022

Front. Sports Act. Living

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“…Many AT exercise programs favor bodyweight loading and increase resistance as tolerated (e.g., 5 kg increments in a backpack) [ 40 ]…”

Section: Figurementioning

confidence: 99%

“…Most studies use 12-week long exercise interventions, though positive results have been found at six weeks [ 40 ]…”

Section: Figurementioning

confidence: 99%

“…Additionally, therapeutic exercise is consistently touted as a standard non-surgical treatment for AT [ 1 , 2 ], largely independent of muscle contraction type (i.e., concentric, eccentric, or isometric) [ 33 , 34 , 35 , 36 ]; however, the mechanism of therapeutic action is still a subject of debate and exploration [ 36 , 37 , 38 , 39 ]. Resultingly, much of the clinical research for AT has focused on combining resistance exercises with other treatments as opposed to optimizing the exercise program itself [ 40 , 41 ]. Although aspects of loading optimization have been investigated in healthy persons [ 42 , 43 , 44 ], the translation and applicability of these principles to individuals with AT has not been reported.…”

Section: Introductionmentioning

confidence: 99%

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Foundational Principles and Adaptation of the Healthy and Pathological Achilles Tendon in Response to Resistance Exercise: A Narrative Review and Clinical Implications

Merry

Napier

Waugh

et al. 2022

JCM

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Therapeutic exercise is widely considered a first line fundamental treatment option for managing tendinopathies. As the Achilles tendon is critical for locomotion, chronic Achilles tendinopathy can have a substantial impact on an individual’s ability to work and on their participation in physical activity or sport and overall quality of life. The recalcitrant nature of Achilles tendinopathy coupled with substantial variation in clinician-prescribed therapeutic exercises may contribute to suboptimal outcomes. Further, loading the Achilles tendon with sufficiently high loads to elicit positive tendon adaptation (and therefore promote symptom alleviation) is challenging, and few works have explored tissue loading optimization for individuals with tendinopathy. The mechanism of therapeutic benefit that exercise therapy exerts on Achilles tendinopathy is also a subject of ongoing debate. Resultingly, many factors that may contribute to an optimal therapeutic exercise protocol for Achilles tendinopathy are not well described. The aim of this narrative review is to explore the principles of tendon remodeling under resistance-based exercise in both healthy and pathologic tissues, and to review the biomechanical principles of Achilles tendon loading mechanics which may impact an optimized therapeutic exercise prescription for Achilles tendinopathy.

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“…Indeed, the possibility of developing a tendinopathy seems to be increased by the interaction between intrinsic (age, body structure, nutrition, metabolic, genetic) and extrinsic factors (fatigue, improper loading, disuse, exogenous damage) [9,10]. Among them, tendon overload in sports or in specific work activities has been reported to be a crucial factor promoting 2 of 14 tendinopathies [11,12]. Similarly, some metabolic and hormonal imbalances, including diabetes, thyroid hormones, estrogens, testosterone, growth hormone, cortisol, cholesterol and glutamatergic changes, occur [13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Why Use Adipose-Derived Mesenchymal Stem Cells in Tendinopathic Patients: A Systematic Review

et al. 2022

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The aim of the present systematic review was to provide a clear overview of the clinical current research progress in the use of adipose-derived mesenchymal stem cells (ASCs) as an effective therapeutic option for the management of tendinopathies, pathologies clinically characterized by persistent mechanical pain and structural alteration of the tendons. The review was carried out using three databases (Scopus, ISI Web of Science and PubMed) and analyzed records from 2013 to 2021. Only English-language papers describing the isolation and manipulation of adipose tissue as source of ASCs and presenting ASCs as treatment for clinical tendinopathies were included. Overall, seven clinical studies met the inclusion criteria and met the minimum quality inclusion threshold. Data extraction and quality assessment were performed by groups of three reviewers. The available evidence showed the efficacy and safety of ASCs treatment for tendinopathies, although it lacked a clear description of the biomolecular mechanisms underlying the beneficial properties of ASCs.

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The implementation of resistance training principles in exercise interventions for lower limb tendinopathy: A systematic review

Abstract: Please cite as: Burton, I. (2020). The implementation of resistance training principles in exercise interventions for lower limb tendinopathy: A systematic review. SportRxiv

Cited by 18 publications

References 111 publications

Blood Flow Restriction Resistance Training in Tendon Rehabilitation: A Scoping Review on Intervention Parameters, Physiological Effects, and Outcomes

Blood Flow Restriction Resistance Training in Tendon Rehabilitation: A Scoping Review on Intervention Parameters, Physiological Effects, and Outcomes

Foundational Principles and Adaptation of the Healthy and Pathological Achilles Tendon in Response to Resistance Exercise: A Narrative Review and Clinical Implications

Why Use Adipose-Derived Mesenchymal Stem Cells in Tendinopathic Patients: A Systematic Review

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