Abstract
BackgroundPatellar tendinopathy is an extremely debilitating condition and its treatment usually requires a combination of clinical approaches. Therapeutic ultrasound (TUS) is one of the most available electrophysical agent in rehabilitation settings; however, there is also a lack of high-quality studies that test different dosimetric aspects of TUS. Thus, the purpose of this study is to evaluate the short-, medium-, and long-term effects of the combination of high-energy TUS with a rehabilitation program for patellar tendinopathy.MethodsThis will be a randomized, placebo-controlled trial with blinding of patients, assessors, and therapist. The setting is an outpatient physical therapy clinic. We will recruit 66 participants (male and female) aged between 18 and 40 years and presenting with patellar tendinopathy. A treatment combining high-energy dose TUS and a rehabilitation program for patellar tendinopathy will be delivered twice a week for 8 weeks. The control group will receive the same treatment, but with a placebo TUS. The effectiveness of the intervention will be measured at the beginning (baseline), midpoint (4 weeks), and end of treatment (8 weeks), as well as at 3- and 6-months post-treatment. Primary outcomes will be pain intensity (visual analogue scale, VAS), and VISA-P questionnaire and primary time points will be baseline (T0) and the end of the program (T2). Also, IPAQ-short form questionnaire, muscle strength (manual dynamometry), 2D kinematics, pain pressure threshold (PPT) algometry, thermography, and magnetic resonance imaging (MRI) will be collected.DiscussionTUS will be applied in an attempt to enhance the results obtained with the rehabilitation program proposed in this study, as well as stimulate some repair responses in individuals undergoing treatment for patellar tendinopathy, which in turn may optimize and improve treatment programs for patellar tendinopathy as well as to establish new guidelines for the application of TUS.Trial registrationThis study was prospectively registered at April-3rd-2018 and updated at September-1st-2019 in the Brazilian Registry of Clinical Trials (REBEC) under the registration number: RBR-658n6w.
Highlights
Patellar tendinopathy is an extremely debilitating condition and its treatment usually requires a combination of clinical approaches
The differences between groups and their respective confidence intervals will be calculated for all outcomes, using mixed linear models for the interaction of groups by time. These analyses will be carried out using statistical software (Statistical Package for Social Sciences (SPSS) version 15.0). This randomized, placebo-controlled, blinded clinical trial aims to examine the effectiveness of the combination of high-energy dose of Therapeutic ultrasound (TUS) and a multiphase exercise rehabilitation program for patellar tendinopathy and determine whether TUS influences pain modulation and other outcomes such as muscle strength, lower limb motor function and morphological tendon characteristics
Patellar tendinopathy is a condition with difficult clinical management due to its multifactorial etiology [74, 75]
Summary
Patellar tendinopathy is an extremely debilitating condition and its treatment usually requires a combination of clinical approaches. Patellar tendinopathy is a debilitating condition that affects professional [5] and recreational [6] athletes It is characterized by pain at the patella’s apex [7, 8] and presents with tendon pathology [9,10,11], reduced tendon stiffness [12], muscle recruitment inhibition, biomechanical impairments [13,14,15], and proprioceptive deficits [16, 17]. The management of patellar tendinopathy remains complex and difficult since a combined clinical approach that takes into account tendon pathology [19] and functional impairments [4, 20] has not yet been investigated
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