Abstract
ObjectiveTo systematically review and critically appraise the literature on the effectiveness of isometric exercise in comparison with other treatment strategies or no treatment in tendinopathy.DesignA systematic review and meta-analysis of randomised controlled trials.Data sourcesElectronic searches of Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE and Cochrane were undertaken from inception to May 2020.MethodsOverall quality of each study was determined based on a combined assessment of internal validity, external validity and precision. For each outcome measure, level of evidence was rated based on the system by van Tulder et al.ResultsTen studies were identified and included in the review, including participants with patellar (n=4), rotator cuff (n=2), lateral elbow (n=2), Achilles (n=1) and gluteal (n=1) tendinopathies. Three were of good and seven were of poor overall quality. Based on limited evidence (level 3), isometric exercise was not superior to isotonic exercise for chronic tendinopathy either immediately following treatment or in the short term (≤12 weeks) for any of the investigated outcome measures. Additionally, for acute rotator cuff tendinopathy, isometric exercise appears to be no more effective than ice therapy in the short term (limited evidence; level 3).SummaryIsometric exercise does not appear to be superior to isotonic exercise in the management of chronic tendinopathy. The response to isometric exercise is variable both within and across tendinopathy populations. Isometric exercise can be used as part of a progressive loading programme as it may be beneficial for selected individuals.PROSPERO registration numberCRD42019147179.
Highlights
Tendinopathy is the preferred term for persistent tendon pain and loss of function due to mechanical loading.[1]
This review focused on patellar tendinopathy and concluded that isometric exercise programmes appeared to be effective in short-term pain relief in athletes during the competitive season
Overall 10 eligible studies were identified with a total of n=294 participants
Summary
Tendinopathy is the preferred term for persistent tendon pain and loss of function due to mechanical loading.[1]. The burden of disease associated with tendinopathy is significant, accounting for 30% of all musculoskeletal conditions seen in general
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