Clinical improvements are not explained by changes in tendon structure on UTC following an exercise program for patellar tendinopathy

Mathijs van Ark, Ebonie Rio, Jill Cook, Inge van den Akker-Scheek, James E Gaida, Johannes Zwerver, Sean Docking

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Abstract

OBJECTIVES: The aim of this study was to investigate the effects of a 4-week in-season exercise program of isometric or isotonic exercises on tendon structure and dimensions as quantified by Ultrasound Tissue Characterization (UTC).

DESIGN: Randomized clinical trial. Volleyball and basketball players (16-31 years, n=29) with clinically diagnosed patellar tendinopathy were randomized to a 4-week isometric or isotonic exercise program. The programs were designed to decrease patellar tendon pain. A baseline and 4-week UTC scan was used to evaluate change in tendon structure.

RESULTS: No significant change in tendon structure or dimensions on UTC was detected after the exercise program, despite patellar tendinopathy symptoms improving. The percentage and mean cross-sectional area (mCSA) of aligned fibrillar structure (echo-types I+II) (Z=-0.414,p=0.679) as well as disorganized structure (echo-types III + IV) (Z=-0.370,p=0.711) did not change over the 4-week exercise program. Change in tendon structure and dimensions on UTC did not differ significantly between the groups.

CONCLUSION: Structural properties and dimensions of the patellar tendon on UTC did not change after a 4-week isometric or isotonic exercise program for athletes with patellar tendinopathy in-season, despite an improvement of symptoms. It seems that structural improvements are not required for a positive clinical outcome.

Original languageEnglish
Pages (from-to)708-714
Number of pages7
JournalAmerican Journal of Physical Medicine
Volume97
Issue number10
Early online date11 Apr 2018
DOIs
Publication statusPublished - 1 Oct 2018

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Tendinopathy
Tendons
Exercise
Patellar Ligament
Volleyball
Basketball
Athletes
Randomized Controlled Trials
Pain

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van Ark, Mathijs ; Rio, Ebonie ; Cook, Jill ; van den Akker-Scheek, Inge ; Gaida, James E ; Zwerver, Johannes ; Docking, Sean. / Clinical improvements are not explained by changes in tendon structure on UTC following an exercise program for patellar tendinopathy. In: American Journal of Physical Medicine. 2018 ; Vol. 97, No. 10. pp. 708-714.
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abstract = "OBJECTIVES: The aim of this study was to investigate the effects of a 4-week in-season exercise program of isometric or isotonic exercises on tendon structure and dimensions as quantified by Ultrasound Tissue Characterization (UTC).DESIGN: Randomized clinical trial. Volleyball and basketball players (16-31 years, n=29) with clinically diagnosed patellar tendinopathy were randomized to a 4-week isometric or isotonic exercise program. The programs were designed to decrease patellar tendon pain. A baseline and 4-week UTC scan was used to evaluate change in tendon structure.RESULTS: No significant change in tendon structure or dimensions on UTC was detected after the exercise program, despite patellar tendinopathy symptoms improving. The percentage and mean cross-sectional area (mCSA) of aligned fibrillar structure (echo-types I+II) (Z=-0.414,p=0.679) as well as disorganized structure (echo-types III + IV) (Z=-0.370,p=0.711) did not change over the 4-week exercise program. Change in tendon structure and dimensions on UTC did not differ significantly between the groups.CONCLUSION: Structural properties and dimensions of the patellar tendon on UTC did not change after a 4-week isometric or isotonic exercise program for athletes with patellar tendinopathy in-season, despite an improvement of symptoms. It seems that structural improvements are not required for a positive clinical outcome.",
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Clinical improvements are not explained by changes in tendon structure on UTC following an exercise program for patellar tendinopathy. / van Ark, Mathijs; Rio, Ebonie; Cook, Jill; van den Akker-Scheek, Inge; Gaida, James E; Zwerver, Johannes; Docking, Sean.

In: American Journal of Physical Medicine, Vol. 97, No. 10, 01.10.2018, p. 708-714.

Research output: Contribution to journalArticle

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AU - Gaida, James E

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AU - Docking, Sean

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