The Acute Effect of Isometric Versus Isotonic Resistance Exercise in Patients With Patellar Tendinopathy

NCT03528746 | Completed

• 1 other identifier: N-20160084
• Study Type: interventional
• Target: 21
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to compare the acute effects of two different types of resistance exercise (isometric versus isotonic) on exercise induced hypoalgesia during an aggravating activity, in participants with patellar tendinopathy.

Conditions

Patellar Tendinitis

Keywords

Patellar tendinopathy

Outcome Measures

Primary Outcomes (1)

• Change in pain during aggravating activity

  The single leg decline squat (SLDS) will be used as the provocative activity, as this is an activity that usually induces pain in patients with patellar tendinopathy. Participants will be asked to stand on one limb, with their heel raised, so they are in approximately 25 degrees of plantar flexion. They will then be asked to perform a small squat, to about 60 degrees of knee flexion. This will be repeated three times. Participants will provide a numerical pain rating score for the decline squat on an 11-point numerical rating scale (NRS), anchored at left with '0, no pain' and at right with '10, worst possible pain'. If participants have bilateral patellar tendinopathy, data from the 'most painful' limb (indicated by participants) will be used for the primary outcome.

  baseline; immedietely after exercise

Secondary Outcomes (3)

• change in pain during aggravating activity

  baseline; 45 minutes post exercise

• change in pressure pain threshold (kPa)

  Baseline; Immediately after exercise; 45 min post exercise

• Change in patellar tendon thickness (mm)

  Baseline; Immedietly after exercise

Other Outcomes (1)

• Pain (during exercise)

  Immediately after exercise set

Study Arms (2)

Isometric exercise

EXPERIMENTAL

Participants will complete isometric quadriceps exercise

Other: Isometric exercise

Isotonic exercise

ACTIVE COMPARATOR

Participants will complete dynamic leg extension

Other: Isotonic Exercise

Interventions

Isotonic Exercise OTHER

Participants will complete dynamic leg extension in a leg extension machine with a range of motion from approximately 90 degrees flexion to full extension. Each repetition will be completed with a 3s concentric contraction, 0s isometric and 4s eccentric contraction.This will be repeated for 8 repetitions and for 5 sets with 2 minutes rest between each set, as per Rio and colleagues. The load used during the isotonic exercise will be equivalent to participants 8 repetition maximum, which will be determined by an experienced tester in a standardised manner according to NSCA guidelines.

Also known as: resistance exercise

Isotonic exercise

Isometric exercise OTHER

Participants will complete isometric quadriceps exercise, where they must hold a load statically for 45s with their knee in 60° flexion. This will be repeated for 5 sets with 2 minutes rest between each set. A load of 70% of the maximal voluntary isometric contraction (MVIC) will be used. MVIC will be assessed in an isokinetic dynamometer as per Rio and colleagues. Participants will be seated in a stable position in the dynamometer with the knee at 60° of knee flexion. First they will be familiarised with the procedure. Standardised instructions will be issued for participants to perform a maximal effort knee extension against the dynamometer for 3seconds. After a short break, the test will be repeated three times and the MVIC will be peak torque recorded during these three efforts.

Isometric exercise

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Men and women aged 18-40 years, with patellar tendinopathy will be included. Diagnosis of patellar tendinopathy, will be made by a physiotherapist (who has been trained by an experienced rheumatologist) as follows, similar to previously outlined criteria:
• pain localised to the inferior pole of the patella during jumping and landing activities
• pain during testing on the single-leg decline squat (SLDS)
• The diagnosis will be confirmed by the presence of characteristic features on ultrasound imaging (eg, hypoechoic area and focal enlarged tendon).
• Minimum pain of 3cm on a 10cm visual analogue scale (VAS)
• Other concurrent diagnosable knee pathologies

You may not qualify if:

• Previous surgery of the knee
• Pregnancy
• Corticosteroid injection within the previous 6 months

Sponsors & Collaborators

• Aalborg University: lead

Study Sites (1)

Research Unit for General Practice in Aalborg

Aalborg, 9000, Denmark

Location

Related Publications (1)

• Rio E, Kidgell D, Purdam C, Gaida J, Moseley GL, Pearce AJ, Cook J. Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med. 2015 Oct;49(19):1277-83. doi: 10.1136/bjsports-2014-094386. Epub 2015 May 15.

  PMID: 25979840 BACKGROUND

MeSH Terms

Interventions

Resistance Training; Exercise

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Physical Conditioning, Human; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants will be blinded to the study hypothesis
• Purpose: OTHER
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Post- Doctoral Research Fellow

Model Details: The proposed study is a participant blinded, randomised crossover superiority trial, to examine acute effect of isometric versus isotonic resistance exercise on pain in patients with patellar tendinopathy.

Study Record Dates

• First Submitted: December 5, 2017
• First Posted: May 18, 2018
• Study Start: July 12, 2018
• Primary Completion: October 3, 2018
• Study Completion: October 3, 2018
• Last Updated: October 11, 2018

Record last verified: 2018-10

Locations

DK (1)