Eccentric treatment for patellar tendinopathy: a prospective randomised short-term pilot study of two rehabilitation protocols.
OBJECTIVE
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 with the present standard eccentric rehabilitation programme on a decline board.


METHODS
Prospective, randomised clinical trial.


METHODS
Sports rehabilitation clinic, university sports laboratory, supplemented with home exercises.


METHODS
20 competitive and recreational athletes, all with clinical diagnosis of patellar tendinopathy, verified by MRI or ultrasound imaging.


METHODS
A 12-week rehabilitation period, either with bilateral eccentric overload strength training using the Bromsman device twice a week or with unilateral eccentric body load training using a decline board twice a week, supplemented with daily home exercises.


METHODS
The primary outcome was pain and function, assessed by the Swedish Victorian Institute of Sport Assessment for Patella (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 the 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 3-month rehabilitation period, most 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.


CONCLUSIONS
In patients with patellar tendinopathy pain, two-legged eccentric overload training twice per week, using the new device (Bromsman), was as efficient and safe as the present standard daily eccentric one-legged rehabilitation-training regimen using a decline board.
Frohm
Anna
A
Department of Molecular Medicine and Surgery, Section of Orthopedics and Sports Medicine & Stockholm Sport Trauma Research Center, Karolinska Institutet, Stockholm, Sweden. anna.frohm@telia.com
Saartok
Tönu
T
Halvorsen
Kjartan
K
Renström
Per
P
D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology / Q000534:rehabilitation; D010147:Pain Measurement; D017847:Patellar Ligament / Q000293:injuries*; D010865:Pilot Projects; D011446:Prospective Studies; D017751:Safety Management; D052256:Tendinopathy / Q000534:rehabilitation*; D016896:Treatment Outcome