The Mechanical,Physiological and Therapeutic Effects of Eccentric Exercise Combined With Extracorporeal Shockwave Therapy in Athletes With Patellar Tendinopathy

Study Overview
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Brief Summary
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Patellar tendinopathy is one of the most common injuries in jumping athletes. Changes in mechanical and physiological properties of tendon are the two proposed forms of pathogenesis. The efficacy of eccentric exercise when applied alone and combined with extrocoporeal shockwave therapy had been reported; however, the underlying treatment mechanisms of pain and dysfunction are not clear. This project aimed to explore the mechanical, physiological and therapeutic effects of eccentric exercise when applied as a single treatment and as an adjunct to extracorporeal shockwave therapy.

Official Title
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The Mechanical,Physiological and Therapeutic Effects of Eccentric Exercise Combined With Extracorporeal Shockwave Therapy in Athletes With Patellar Tendinopathy

Conditions
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Patellar Tendinopathy

Intervention / Treatment
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* Behavioral: Eccentric exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Competitive athletes Pain at the inferior pole of the patella with training for at least 3 months Tenderness at the inferior pole of the patella on palpation Exclusion Criteria: Patellofemoral pain syndrome, fat pad irritations, meniscus injury, osteoarthritis, rheumatoid arthritis or infections History of fracture over lower limbs and inflammatory myopathies Cortisone injuection and other interventions within 3 months Contraindication to extracorporeal shockwave therapy
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Combined<br>12 weeks eccentric exercise combined with 6 sessions of extracorporeal shockwave therapy in the initial 6 weeks | Behavioral: Eccentric exercise<br>* Knee eccentric exercise with sham or focused extrocorporeal shockwave therapy for 12 weeks<br>* Other names: Extracoporeal shockwave therapy (Minilith SL1, Storz Medical);|
| Sham Comparator: Exercise<br>12 weeks eccentric exercise combined with 6 sessions of sham extracorporeal shockwave therapy in the initial 6 weeks | Behavioral: Eccentric exercise<br>* Knee eccentric exercise with sham or focused extrocorporeal shockwave therapy for 12 weeks<br>* Other names: Extracoporeal shockwave therapy (Minilith SL1, Storz Medical);|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tendon stress in pascals at baseline | Tendon stress measured by ultrasonography and dynamometry | Before intervention | 
| Change of tendon stress in pascals at 12 weeks | Tendon stress measured by ultrasonography and dynamometry | 12 weeks | 
| Change of tendon stress in pascals at 16 weeks | Tendon stress measured by ultrasonography and dynamometry | 16 weeks | 
| Tendon vascularity index as percentage at baseline | Tendon vascularity measured by power doppler ultrasonography | Before intervention | 
| Change of tendon vascularity index as percentage at 12 weeks | Tendon vascularity measured by power doppler ultrasonography | 12 weeks | 
| Change of tendon vascularity index as percentage at 16 weeks | Tendon vascularity measured by power doppler ultrasonography | 16 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tendon related pain on visual analogy scale at baseline | Maximal intensity of self-perceived pain in the past 7 days, pain during single-leg declined-squat test | Before intervention | 
| Change of tendon related pain on visual analogy scale at 12 weeks | Maximal intensity of self-perceived pain in the past 7 days, pain during single-leg declined-squat test | 12 weeks | 
| Change of tendon related pain on visual analogy scale at 16 weeks | Maximal intensity of self-perceived pain in the past 7 days, pain during single-leg declined-squat test | 16 weeks | 
| Tendon related dysfunction by questionnaire at baseline | Victorian Institute of Sport Assessment Questionnaire - Patellar Tendon | Before intervention | 
| Change of tendon related dysfunction by questionnaire at 12 weeks | Victorian Institute of Sport Assessment Questionnaire - Patellar Tendon | 12 weeks | 
| Change of tendon related dysfunction by questionnaire at 16 weeks | Victorian Institute of Sport Assessment Questionnaire - Patellar Tendon | 16 weeks |