title: The Role of Detraining in Tendon Mechanobiology.
abstract: BACKGROUND
  Several conditions such as training, aging, estrogen deficiency and drugs could affect the biological and anatomo-physiological characteristics of the tendon. Additionally, recent preclinical and clinical studies examined the effect of detraining on tendon, showing alterations in its structure and morphology and in tenocyte mechanobiology. However, few data evaluated the importance that cessation of training might have on tendon. Basically, we do not fully understand how tendons react to a phase of training followed by sudden detraining. Therefore, within this review, we summarize the studies where tendon detraining was examined.
  
  
  METHODS
  A descriptive systematic literature review was carried out by searching three databases (PubMed, Scopus and Web of Knowledge) on tendon detraining. Original articles in English from 2000 to 2015 were included. In addition, the search was extended to the reference lists of the selected articles. A public reference manager (www.mendeley.com) was adopted to remove duplicate articles.
  
  
  RESULTS
  An initial literature search yielded 134 references (www.pubmed.org: 53; www.scopus.com: 11; www.webofknowledge.com: 70). Fifteen publications were extracted based on the title for further analysis by two independent reviewers. Abstracts and complete articles were after that reviewed to evaluate if they met inclusion criteria.
  
  
  CONCLUSIONS
  The revised literature comprised four clinical studies and an in vitro and three in vivo reports. Overall, the results showed that tendon structure and properties after detraining are compromised, with an alteration in the tissue structural organization and mechanical properties. Clinical studies usually showed a lesser extent of tendon alterations, probably because preclinical studies permit an in-depth evaluation of tendon modifications, which is hard to perform in human subjects. In conclusion, after a period of sudden detraining (e.g., after an injury), physical activity should be taken with caution, following a targeted rehabilitation program. However, further research should be performed to fully understand the effect of sudden detraining on tendons.
authors.affiliation: Department of Physical and Rehabilitation Medicine, University of Padua Padua, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Frizziero
authors.affiliation: Laboratory of Biocompatibility, Technological Innovations and Advanced Therapies, RIT Department, Rizzoli Orthopedic Institute Bologna, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Salamanna
authors.affiliation: Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopedic InstituteBologna, Italy; Department of Experimental, Diagnostic and Specialty Medicine, University of BolognaBologna, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Della Bella
authors.affiliation: Department of Physical and Rehabilitation Medicine, University of Padua Padua, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Vittadini
authors.affiliation: Department of Physical and Rehabilitation Medicine, University of Padua Padua, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gasparre
authors.affiliation: Laboratory of Biocompatibility, Technological Innovations and Advanced Therapies, RIT Department, Rizzoli Orthopedic InstituteBologna, Italy; Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopedic InstituteBologna, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Nicoli Aldini
authors.affiliation: Department of Physical and Rehabilitation Medicine, University of Padua Padua, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Masiero
authors.affiliation: Laboratory of Biocompatibility, Technological Innovations and Advanced Therapies, RIT Department, Rizzoli Orthopedic InstituteBologna, Italy; Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopedic InstituteBologna, Italy.
authors.forename: Milena
authors.initials: M
authors.lastname: Fini
keywords: detraining; sudden detraining; systematic literature review; tendon; tenocyte