Abstract
BackgroundPatellar tendinopathy has a high prevalence rate among athletes. Different therapeutic options can be found in the current literature, but none of them has been clearly established as the gold standard. The purpose of this study is to compare, in a randomized controlled trial, the clinical efficacy of eccentric exercise combined with either an ultrasound-guided galvanic electrolysis technique (USGET) or conventional electrophysiotherapy to treat patellar tendinopathy.MethodsSixty patients diagnosed with patellar tendinopathy were randomized into two groups. Group 1 (n = 30) received electrophysiotherapy treatment consisting of ultrasound, laser and interferential current techniques. Group 2 (n = 30) received USGET. Both groups did the same standardized eccentric exercise program. Periodic assessments of the subjects were carried out with the Victorian Institute of Sport Assessment-Patella (VISA-P) score. An analysis of means and a survival study were performed.ResultsThere were statistically significant differences in the VISA-P between the baseline and final follow-up in each treatment group. Group 1 (conventional electrophysiotherapy) went from 52.5 ± 18.8 to 61.9 ± 13.7 (in VISA-P < 90 subgroup) and from 69.1 ± 9.1 to 95.2 ± 2.5 (in VISA-P > 90 subgroup). Group 2 (USGET) went from 51.4 ± 17.9 to 63.3 ± 14.3 (in VISA-P < 90 subgroup) and from 66.3 ± 13.1 to 97.1 ± 1.7 (in VISA-P > 90 subgroup). There were statistically significant correlations between the baseline and final score in the VISA-P > 90 subjects upon completing the study but no statistically significant correlations between subjects with VISA-P < 90. The mean number of sessions applied was 22.6 ± 2.5 in Group 1 and 3.2 ± 0.9 in Group 2. The success probability in Group 1 was 36.1% versus 72.4% in Group 2. The difference was statistically significant.ConclusionThe results obtained with the combination of USGET and eccentric exercise reported better outcomes than with the conventional electrophysiotherapy techniques in the treatment of patellar tendinopathy.
Highlights
Patellar tendinopathy has a high prevalence rate among athletes
Research questions The functional assessment according to the Victorian Institute of Sport Assessment-Patella (VISA-P) showed statistically significant differences (p
A correlation analysis was performed to study the relationship between the VISA-P scores at baseline and those at the last evaluation in all the subjects
Summary
Patellar tendinopathy has a high prevalence rate among athletes. Different therapeutic options can be found in the current literature, but none of them has been clearly established as the gold standard. Patellar tendinopathy has a high prevalence rate among athletes (Larsson et al, 2012) This is especially so in sports that involve repetitive movements that cause an overload of the tendon like jumping, changes of pace and direction as well as racing and pedalling. We know, histologically speaking, that we can find degenerated tissue with fragmentation, an alteration of the collagen and vascular hyperplasia, with inflammatory cells almost absent (Cook and Purdam, 2009; Khan et al, 2002). This increased understanding of the pathophysiology leads to a change in the therapeutic approach. The therapeutic techniques used in the treatment of tendinopathy have abandoned the goal of eliminating inflammation of the tendon and instead try to impact on the biology of the tendon to stimulate its regeneration (Cook and Purdam, 2009)
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