Patellar Tendinopathy (PT) also known as Jumper's knee, is characterized by multifaceted activity-related pathology causing anterior knee pain and patellar-tendon dysfunction. It most commonly affects athletic activities that involve jumping and running. Tendinopathy is most likely to be related to mechanical loading and overuse. Athletes suffer from insidious well-localized pain, typically as the athlete starts the activity. Conservative treatment is the first line of treatment in tendinopathy, however, there is no consensus regarding the best treatment. In acute conditions, relative rest rather than immobilization is preferred. The most popular non-operative treatment involves eccentric exercise (EE). It is commonly accepted that surgical treatment must be indicated in motivated patients if carefully followed conservative treatment (physical training, injections, ESWT) is unsuccessful after 3-6 months. In recent studies, isometric and heavy slow resistance (HSR) exercises have demonstrated potential for pain reduction and functional improvement in patellar tendinopathy. A randomized controlled trial will be conducted at the Pakistan Sports Board (PSB) Coaching Center, Lahore. 18 Subjects will be randomized into two groups; Heavy slow resistance exercises plus eccentric exercises will be given to group A and exercises of 4 sets of 10-20 repetitions will be given. Group B will give Eccentric exercises in 3 sets of 10-20 repetitions. Pre-assessments will be taken through the Numeric Pain Rating Scale (NPRS) for pain, a goniometer for range of motion, Lower extremity function assessment scale to evaluate lower limb functional impairments, and a Visa-P scale for patellar dysfunction. Assessment will be done at baseline and post 4 weeks of training. Data will be analyzed using SPSS software version 21. The normality of data will be checked, and tests will be applied according to the normality of the data, either parametric or non-parametric tests will be used (within a group or between two groups).
The objective of the study is to compare the effects of heavy slow resistance training and eccentric overload training on pain, range of motion, and lower extremity functions in runners with patellar tendinopathy. .
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
30
Pre - assessment will be taken. Heavy slow resistance exercises will be given to group A and exercises of 4 sets of 10-20 repetitions will be given
Sessions should be conducted 2 times per week, similar to Group A, in 3 sets of 10-20 repetitions. Exercises focus solely on eccentric loading, such as eccentric squats, eccentric leg presses, and step-down exercises.
Pakistan Sports Board Coaching Center
Lahore, Punjab Province, Pakistan
Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire
This brief questionnaire assesses (i) symptoms, (ii) simple tests of function and (in') ability to play sport. Six of the eight questions are scored on a visual analogue scale from 0-10 with 10 representing optimal health. The maximal VISA score for an asymptomatic, fully performing individual is 100 points and the theoretical minimum is 0 points. We found the VISA scale to have excellent short-term test retest, and inter-tester reliability both, r\>0.95 as well as good short-term stability (r=0.87).(14)
Time frame: 4 weeks
NPRS
For the NPRS, the intraclass correlation coefficient (ICC) for all subjects is .76 (p \< .0001). The ICC, however, is .90 (p \< .0001)(15)
Time frame: 4 weeks
Goniometer
Goniometric measurements are used to quantify baseline limitations of motion, decide on appropriate therapeutic interventions, and document the effectiveness of these interventions
Time frame: 4 weeks
LEFS
The Lower Extremity Functional Scale (LEFS) is a questionnaire containing 20 questions about a person's ability to perform everyday tasks. The LEFS can be used by clinicians as a measure of patients' initial function, ongoing progress and outcome, as well as to set functional goals. Internal consistency is α=.96 (N=107). Test-retest reliability estimates were R=.86 (95% lower limit CI=.80) for the entire sample (n=98) and R=.94 (95% lower limit CI=.89) for the subset of patients with more chronic conditions (n=31)
Time frame: 4 weeks
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