Eccentric treatment for patellar tendinopathy - a prospective randomised short-term pilot study of two rehabilitation protocols

Anna M Frohm ^1*, Tönu Saartok ¹, Kjartan Halvorsen ² and Per Renstrom ¹

¹ Section of Orthopedics and Sports Medicine and Stockholm Sport Trauma Research Center, Sweden
² Biomechanics and Motor Control Laboratory, Dept of Sports and Health Science, University of Physica, Sweden

^* To whom correspondence should be addressed. E-mail: anna.frohm{at}telia.com.

Accepted 15 January 2007

Abstract

The aim was to compare the efficacy and safety of two eccentric rehabilitation protocols for patients with symptomatic patellar tendinopathy. A new eccentric overload training device was compared to the present standard eccentric rehabilitation program on a decline board.

Design: Prospective, randomised clinical trial. Setting: Sports rehabilitation clinic, university sports laboratory supplemented with home exercises.

Patients: 20 competitive and recreational athletes, all with clinical diagnosis of patellar tendinopathy, verified by MRI or ultrasound imaging. Interventions: A 12-week rehabilitation period, either, with bilateral eccentric overload strength training using the Bromsman® device twice a week, or unilateral eccentric body load training using a decline board twice a week supplemented with daily home exercises.

Outcome measures: The primary outcome was pain and function, assessed by the Swedish VISA-P score. Secondary outcome measures were isokinetic muscle torque, dynamic function, and muscle flexibility as well as pain level estimations using Visual Analogue Scale (VAS). Side effects were registered.

Results: Both treatment groups improved in short term according to the VISA-P scores during the 12-week rehabilitation period. However, there were no significant differences between the groups in terms of pain and function. After a three months rehabilitation period, the majority of the patients could be regarded as improved enough to be able to return to training and sports. No serious side effects were detected in either group.

Conclusion: In patients with patellar tendinopathy pain, two-legged eccentric overload training twice per week, using the new device (Bromsman®), were as efficient and safe as the present standard daily eccentric one- legged rehabilitation-training regimen using a decline board.

Key Words: VISA-P score, eccentric training, overload training, patellar tendinopathy, randomised clinical trial

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