Clinical trial NCT06569433: Efficacy of Therapeutic Exercise Compared to Femoral Nerve Mobilisation in Knee Tendinosis
Official title: Efficacy of Therapeutic Exercise Compared to Femoral Nerve Mobilisation in Knee Tendinosis: Randomised Clinical Trial
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Chronic Patellar Tendinopathy
Lead sponsor: University of Alcala
Sponsor class: OTHER
First posted: 2024-08-26
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: The following criteria for inclusion and exclusion of participants have been established:

Inclusion criteria:

* Patients aged between 18 and 40 years.
* Patients with chronic or acute knee tendinosis.
* Patients with pain or functional limitation

Exclusion criteria:

* Patients with any contraindication to treatment.
* Patients with a history of recent knee surgery or serious injury
* Who present neurological pathologies
* Who are using other physiotherapy techniques

Prior to registration each participant must undergo a physical assessment, including a medical history check and provide information on neurological and trauma pathologies. Those who meet the criteria will be assigned to one of the two study groups.
Primary purpose: TREATMENT

Brief summary: Tendons, located between muscle and bone, transmit force from the former to the latter, allowing joint movement. They are composed mainly of collagen, elastin and water, and are divided into three zones: osteotendinous junction (tendon-bone), myotendinous junction (muscle-tendon) and the tendon body.

Knee tendinosis is a pathology that affects the tendons of this joint due to the breakdown of collagen in the tendon body, characterised by pain during and after exercise, inflammation and loss of function. It is common in athletes, especially in jumping sports such as basketball and volleyball, due to repetitive strain, injury or ageing. Factors such as weight, leg length and muscle strength can influence its development. Radiologically, patellar tendon thickening, and abnormalities are seen.

Treatment includes eccentric exercises, shock wave therapy, ultrasound-guided sclerosis, anti-inflammatory drugs, plasma injections and aprotinin. Neurodynamic theory suggests that altered mechanosensitivity of the femoral nerve may contribute to knee pain, and neurodynamic techniques can improve nerve mobility and reduce symptoms.

A strength exercise with isometric contractions can decrease pain for up to 45 minutes, being a therapeutic option for patellar tendinopathy without affecting muscle strength.

The research project presented in the master's thesis aims to compare the effectiveness of femoral nerve mobilisation and therapeutic exercise in the treatment of knee tendinosis.

Detailed description: Nowadays, tendon injuries affect a large part of the population, especially people who practice sports and the working population in industrial sectors, although they have also been observed in sedentary people. In terms of occupational diseases, these injuries account for more than 35% in the most industrialised countries of the European Union.

The indirect costs of tendinopathies can be significant in terms of lost productivity and workers' compensation.

Despite the lack of specific data on the economic impact of knee tendinosis on society, given the high prevalence of this condition, it is crucial to study its treatment to reduce recovery time and associated costs. Both therapeutic exercise and femoral nerve mobilisation are supported by scientific evidence suggesting their efficacy in the treatment of knee tendinitis. However, it is important to specifically investigate and compare how these interventions affect symptoms and function in patients with this condition.

Therapeutic exercise prevents injury and aids in the regeneration of the knee extensor system. The goal is to restore adequate strength, flexibility and endurance, as well as to correct joint limitations.

It has been studied that the success of treatment of tendinopathies may be determined by the adaptation of the exercise loads to the capacity of the tendons.

Eligibility criteria: Inclusion Criteria:

* - Patients aged 18 to 40 years old
* Patients with chronic or acute knee tendinosis
* Who have pain or functional limitation

Exclusion Criteria:

* Patients with a contraindication to treatment
* Patients with a history of recent knee surgery or serious injury
* Who present neurological pathologies
* Who are using other physiotherapy techniques

Primary outcomes:
measure: The 'pain' variable
timeFrame: 6 weeks
measure: functionality (VISA-P questionnaire)
timeFrame: 6 weeks
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
References: