Tendinopathy Clinical Trial
Official title:
Is There a Mechanistic Reason for the Response or Non-response to Isometric Exercise in Tendinopathy?
In early phase tendinopathy, isometric exercises are seen as ideal to provide pain relief to
patients. This approach is mainly based on a paper by Rio et al (2016), where they found that
isometric exercises of a certain load magnitude and time (5 repetitions of 45 second hold at
70% of maximum) gave 100% pain relief for 45 minutes in patients with patellar tendinopathy.
This then helps patients to perform their more heavy load exercises during rehabilitation,
which would otherwise be too painful.
Unfortunately, the study of Rio et al only consisted of 6 participants, and recent papers
have contradicted the findings. In Achilles tendinopathy, plantar fasciopathy and lateral
elbow tendinopathy, the pain relief was not consistently present, with "responders" and
"non-responders" being found in these studies. Also, a study yet to be published (poster at
conference), replicating Rio et al, also found a heterogeneous response, debunking the "one
size fits all" approach that seemed to work.
However, in our understanding, isometric exercises do have a crucial role in early
tendinopathy management, but the way the exercise is performed, in which position, what
magnitude of load, time under tension, … has an important influence. The same protocol (5
repetitions of 45 second hold at 70% of maximum) might lead to big inter-individual
differences. Therefore, there might be a mechanistic reason why some patients respond, and
others do not.
Fortunately, the P.I. of this current trial application has recently optimized an
ultrasound-based method to quantify local tendon deformation during exercises. The main
purpose of this trial is therefore to evaluate the local tendon deformation pattern of
patients with tendinopathy during isometric exercises and evaluate whether there is an
interindividual difference in pattern between "responders" and "non-responders".
n/a
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