Eccentric Exercise Program Research Articles

Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial

ObjectivesTo investigate if daily treatment with glyceryl trinitrate (GTN) ointment, over 24 weeks combined with a 12-week eccentric exercise programme is more effective for chronic mid-portion Achilles tendinopathy than placebo...

Innovative Physiotherapy Approaches in Managing Patellar Tendinopathy (Jumper’s Knee): An Updated Literature Review

Introduction: Patellar tendinopathy (jumper's knee) is an overuse injury that usually has a gradual onset of pain. This condition is common in jumping athletes, characterized by local pain at the attachment of the proximal tendon to the bone and dysfunction of the patellar tendon during jumping and landing. Patellar tendinopathy clinically results from high loads on the tendon, such as jumping and changing direction. Patellar tendinopathy can affect health and quality of life by limiting participation in sports and activities for athletes. Objective: This study aims to summarize secondary data related to physiotherapy management of patellar tendinopathy. Methods: The research method used is a literature study using secondary data in the form of journals related to the topic of patellar tendinopathy (jumper's knee) obtained through Google Scholar, Science Direct, and PubMed. Results: From five recent journal articles obtained with various physiotherapy intervention protocols, the results were able to reduce symptoms in patients with patellar tendinopathy. Conclusion: Physiotherapeutic interventions such as progressive tendon-loading exercises (PTLE), Eccentric exercise programmes, Kinesio-tape® and isometric exercises are effective in reducing symptoms in patients with patellar tendinopathy. Keyword: patellar tendinopathy, jumper's knee, physiotherapy

Placebo and nocebo effects of percutaneous needle electrolysis and dry-needling: an intra and inter-treatment sessions analysis of a three-arm randomized double-blinded controlled trial in patients with patellar tendinopathy.

This study aimed to investigate the influence of potential placebo and nocebo effects on pain perception of percutaneous needle electrolysis (PNE) in individuals with patellar tendinopathy. In this secondary analysis of a three-arm randomized double-blinded controlled trial, intra and inter-session pain perception data from 48 sporting participants with patellar tendinopathy between 18 and 45 years were investigated. Participants were divided into 3 parallel groups: "no-sham group" [PNE intervention], "single-sham group" [sham PNE by using dry needling], and "double-sham group" [sham PNE by using sham needles]. Every group received 4 sessions of the needling therapies targeting the patellar tendon over 8 weeks and was instructed to perform a unilateral eccentric exercise program of the quadriceps muscle on the affected side. Clinical and needle-related pain was assessed before, during, and after each treatment session using a visual analog scale. No differences were found between groups intra- or inter-session in terms of pain reduction (P = 0.424) despite clinical pain decreased in all groups since the first treatment session (P < 0.001). Furthermore, although the double-sham group showed a lower percentage of participants reporting needle-related pain during needle intervention (P = 0.005), the needle-related pain intensity after needle intervention was similar between groups (P = 0.682). Moreover, there were no group differences for the duration of pain sensation after any needle intervention (P = 0.184), extending in many cases beyond 24 h. Needling therapies for individuals with patellar tendinopathy are prone to elicit placebo effects regarding clinical pain and nocebo effects regarding needling-related pain. Clinicians and physical therapists treating musculoskeletal pain conditions should consider the added value and potential mechanisms of action before routinely using needle techniques.

EFFECTS OF DAILY 5-MINUTE ECCENTRIC-BIASED EXERCISES ON PHYSICAL FITNESS, BODY COMPOSITION, CRITICAL HEALTH MARKERS AND WELL-BEING IN SEDENTARY INDIVIDUALS

INTRODUCTION Exercise is fundamental for maintaining and improving health and fitness; however, many individuals do not participate in regular exercise, with perceived lack of time a key barrier. Minimal dose strategies, which reduce weekly exercise volumes to less than recommended guidelines, might improve health outcomes with minimal time investment. However, minimal dose strategies and their effects on health and fitness are still unclear. Therefore, we developed a bodyweight eccentric-biased exercise program consisting of 4 exercises (1 set of 10 repetitions each), which took just 5-min to complete, and investigated the effects of the program performed daily for 4 weeks on health and fitness outcomes in sedentary individuals. METHODS We recruited 22 healthy but sedentary individuals (32 – 69 years) whose daily steps were &amp;lt;5000. Participants completed a two-week control period, followed by a 4-week daily exercise intervention. Muscular strength, physical fitness, body composition and critical health markers were assessed before (PRE-1) and after the control period (PRE-2), as well as after the intervention (POST). RESULTS Participants adhered to the exercise program &amp;gt;90%. No significant changes in any measures were observed from PRE-1 to PRE-2. Following the exercise intervention, no significant changes in body mass, bone mineral density, fat mass, lean mass, heart rate, blood pressure, grip strength, squat jump or countermovement jump were evident. However, isometric mid-thigh pull, representing lower limb muscle strength (13%), push-ups (42%) and sit-ups (44%), representing upper body strength and sit and reach, representing flexibility (12%) increased significantly (P&amp;lt;0.05), and the increase in heart rate from a 3-minute step test was attenuated (8%) from PRE-2 to POST (P&amp;lt;0.05). Finally, mental health assessed by SF-36 significantly improved (15%) (P&amp;lt;0.05). CONCLUSION These results suggest that the 5-min eccentric exercise program was effective for improving physical fitness and mental health of sedentary individuals when performed every day for 4 weeks.

Structural and Functional Changes in Supraspinatus Tendinopathy through Percutaneous Electrolysis, Percutaneous Peripheral Nerve Stimulation and Eccentric Exercise Combined Therapy: A Single-Blinded Randomized Clinical Trial.

Shoulder tendinopathies produce pain and reduce functionality. The aim of this randomized clinical trial was to analyze the effects of Percutaneous electrolysis (PE), Percutaneous peripheral Nerve Stimulation (PNS) and eccentric exercise (EE) on pain (NPRS), strength, electromyographic activity, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and functionality (DASH and SPADI) in individuals with supraspinatus tendinopathy. Participants (n = 50) were divided into two groups; they received 4 treatment sessions, 1 per week, of PE and PNS (n = 25) or 10 treatment sessions of TENS and US (n = 25). Both groups performed the EE program consisting of 3 sets of 10 repetitions of each of the 3 exercises, twice a day, during the 4 weeks. Follow-up was carried out at 4, 12 and 24 weeks after the start of the intervention. There are statistically significant differences in the analysis between groups (p < 0.001) in the post-treatment and follow-up measurements favorable to the PE+PNS+EE treatment on pain (NPRS), strength, supraspinatus electromyographic amplitude, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and DASH and SPADI questionnaires. The combined treatment with PE, PNS and EE is an effective option in the clinical management of tendinopathies, with positive results in the short and long term on the variables studied.

Effectiveness of Eccentric Exercise Training on Chronic Achilles Tendinopathy in Postmenopausal Women

Background: In the Postmenopausal phase, there is a drastic reduction in estrogen levels which may alter tendon metabolism and production of different growth factors, resulting in chronic tendon disorders or tendon rupture. Achilles tendinopathy predominantly affects athletes, but it may also impact individuals with sedentary lifestyles, especially women in their postmenopausal stage. We studied the effectiveness of eccentric exercise training on chronic Achilles tendinopathy in postmenopausal women. Methods: 31 females (aged 45-60, average age 51, BMI 27.6 ± 4.7, range 22.9- 32.3) in their postmenopausal phase with clinical diagnosis of chronic unilateral Achilles tendinopathy both insertional and mid-portion were assessed for pain and functional outcomes with VAS (on rest and on activity ) and VISA-A questionnaire before commencing the exercise and after completion of the training after a duration of 4 weeks. Results: Participants showed an acute improvement in pain on rest and activity and the VISA-A score post-intervention. There was no significant difference in the pre- and post-score on the VAS scale and the VISA- Questionnaire. The mean VAS scale score on rest was 3.580 pre-intervention and 2.903 post-intervention, while the VAS scale score (on activity) was 7.451 pre-intervention which reduced to 6.096 post-intervention. The mean VISA-A score pre-intervention was 39.80, and post-intervention was 46.35. Conclusion: Postmenopausal women suffering from chronic Achilles tendinopathy showed a significant result through training with an eccentric exercise program KEYWORDS: Achilles tendon, Postmenopausal women, Eccentric exercises.

Comparability of the Effectiveness of Different Types of Exercise in the Treatment of Achilles Tendinopathy: A Systematic Review.

Achilles tendinopathy (AT) is a common condition both in athletes and the general population. The purpose of this study is to highlight the most effective form of exercise in managing pain-related symptoms and functional capacity as well as in a return to life activities, ensuring the quality of life of patients with AT, and creating a protocol to be used in rehabilitation. We conducted a systematic review of the published literature in Pubmed, Scopus, Science Direct, and PEDro for Randomised Controlled Trials concerning interventions that were based exclusively on exercise and delivered in patients 18-65 years old, athletes and non-athletes. An amount of 5235 research articles generated from our search. Five met our inclusion criteria and were included in the review. Research evidence supports the effectiveness of a progressive loading eccentric exercise program based on Alfredson's protocol, which could be modified in intensity and pace to fit the needs of each patient with AT. Future research may focus on the optimal dosage and load of exercise in eccentric training and confirm the effectiveness of other type of exercise, such as a combination of eccentric-concentric training or heavy slow resistance exercise. Pilates could be applied as an alternative, useful, and friendly tool in the rehabilitation of AT.

Poster 180: A prospective randomized comparative study between isolated eccentric versus conventional exercise therapy in athletes with rotator cuff tendinopathy

Objectives: To compare the effectiveness of an isolated Eccentric exercise program versus Conventional exercise program in athletes with rotator cuff tendinopathy. Methods: The study included 80 athletes with rotator cuff (RC) tendinopathy (diagnosed on Magnetic resonance imaging) presenting to author’s tertiary level institute. Patients were randomized into two groups of 40 each. The eccentric exercise group (n = 40, mean age = 26.4years ) received an isolated eccentric training combined with stretching, while the conventional exercise group received scapular stabilization exercises, concentric RC strengthening exercises and stretching. (n = 40, mean age = 25.2years). Patients in both groups fulfilled 12 week daily home based exercise program and received treatments twice a week for 3 months. Primary outcome measures were shoulder pain (a 0–100mm Visual Analog Scale; VAS) and function measured with the Constant Murley score and Disabilities of the Arm, Shoulder and Hand (DASH) score. Secondary outcome measures were isometric abduction strength in 45° in the scapular plane (Hand held dynamometer) and shoulder range of motion (forward elevation, abduction and external rotation). All measurements were taken at baseline, at 12, and 24weeks. There was no statistically significant difference in pre-intervention scores between two groups. The study was approved by Institutional Review Board. Results: After 24 weeks, both groups showed a significant decrease in VAS scores and DASH score and a significant increase in the Constant Murley score. No statistically significant differences were found between the groups for any of the evaluated outcome measures. In the EE group, there was a slight deterioration in both CM and VAS scores between 12 and 24 weeks, but this did not reach statistical significance. Both groups also had a significant increase in isometric muscle strength between baseline and 24 weeks. Conclusions: A 12 week isolated eccentric training program of the rotator cuff is as effective (but not superior to) as conventional exercise program for the rotator cuff tendinopathy in athletes.

Effectiveness of Eccentric Exercise in The Rehabilitation of Post-Immobilization Stiffness of Wrist: A Case Study

Post-immobilization deficiency in wrist motion is a common complication following distal radius fractures and it interferes with daily life activities. The wrist and the hand play a vital role in the manipulation grasping and releasing of objects. Achieving a functional range of motion and adequate muscle power to perform daily activities remains a challenge for therapists involved in rehabilitation. The present case is a 27-year-old electrician who visited our outpatient physiotherapy department with wrist joint stiffness. He had a history of falls and sustained a distal radius fracture on his right forearm and was operated on with a buttress plate and screws 2 months ago. In this case study an eccentric exercise-based rehabilitation program was prescribed in addition to conventional wrist and hand rehabilitation. An eccentric exercise program is modified and progressed according to the patientrsquos tolerance. Pain range of motion muscle strength of wrist and disability of the arm shoulder and hand score were used as outcome measures. Following two weeks of the eccentricbased rehabilitation program the patient achieved improvement in wrist motions and disability of the arm shoulder and hand score results. The eccentric exercise program is effective in improving wrist range motion muscle power and hand function following stiffness.

The Effect of a Short Foot Eccentric Endurance Exercise on Foot Center of Pressure: A Pilot study

PURPOSE: This study aimed to investigate the effect of a 5-week short foot eccentric endurance training program on the foot center of pressure measures in healthy university graduate students.METHODS: Eleven healthy students between the ages of 18 and 35 years (n=11, 3 males, 8 females; mean age 26.5±2.5 years; BMI 23.9±2.6 kg/m&lt;sup&gt;2&lt;/sup&gt;) were included in the study. The participants volunteered in a 5-week progressive eccentric contraction short foot exercise program performed three times per week. The main outcome pressure measurements pre- and post-intervention in static double leg stance were measured using a MatScan&lt;sup&gt;®&lt;/sup&gt; Pressure Mapping System.RESULTS: Statistically significant differences were found in the base of support (&lt;i&gt;p&lt;/i&gt;=.002, ES=2.59), time to boundary (&lt;i&gt;p&lt;/i&gt;=.024, ES=1.63), and overall minima measures (&lt;i&gt;p&lt;/i&gt;=.05, ES=1.36) pre- and post-intervention.CONCLUSIONS: A 5-week progressive eccentric contraction short foot exercise program significantly decreased the center of pressure excursion measures, demonstrating improved postural control.

Functional Gains Using Radial and Combined Shockwave Therapy in the Management of Achilles Tendinopathy

Achilles tendinopathy is a common condition and many patients have functional limitations after initial conservative treatment. Shockwave therapy has been shown to improve function within patients; however, comparative outcomes for different forms of shockwave are poorly described. In this retrospective cohort study, we describe findings from a quality improvement initiative evaluating safety and functional outcomes after treatment with radial shockwave therapy (n=58) or combined radial and focused shockwave therapy (n=29) for patients with Achilles tendinopathy refractory to exercise therapy. All patients were prescribed an eccentric exercise program. We hypothesized both groups would see improvements in function quantified using the Victorian Institute of Sports Assessment-Achilles with similar safety outcomes. Overall, the minimal clinically important difference (defined at 7 for insertional and 12 for noninsertional Achilles tendinopathy) was met in a greater proportion of patients treated with combined shockwave compared to radial shockwave (26 [89.7%] vs 37 [63.8%], p=.022). The change in Victorian Institute of Sports Assessment-Achilles from baseline to final treatment was not different between combined and radial-only groups (23.3 ± 12.6 vs 19.9 ± 18.7, p=.2). Within group differences from baseline to final follow-up measures (mean duration 17.9 ± 14.8 weeks) demonstrated overall functional improvement for both groups (both p < .0001). No serious adverse effects were observed. Our findings suggest combined radial and focused shockwave therapy may provide more predictable functional gains for treatment of Achilles tendinopathy compared to radial shockwave therapy.

어깨 관절 부딪힘 증후군 환자의 신장성 수축 운동이 통증 및 기능, 관절가동범위와 근력 변화에 미치는 영향

Purpose: The purpose of this study is to investigate how participation in the eccentric contraction exercise program affects pain & function, range of motion, and muscle strength in patients with subacromial impingement syndrome.<BR> Method: The subjects of the study were 20 female patients diagnosed with subacromial impingement syndrome in the age of 40s-50s. They were allocated wirelessly to the ECG group and the AGG group. Data processing was two-way repeated ANOVA, paired t-test and independent t-test. A significant level of hypothesis verification was set-up (p<.05).<BR> Results: The results of this study are as follows. 1) OSS was significantly improved in all of the timing, interaction, and group (p<.001). And in comparison between groups, ECG improved significantly (p<.01). 2) The change in ROM of Flexion was significantly improved in timing (p<.001), interaction (p<.05), and group (p<.001). ECG was significantly improved in comparison between groups (p<.001). The change in ROM of Abduction was significantly improved in timing (p<.001), interaction (p<.05), and group (p<.001). And ECG was significantly improved in comparison between groups p(<.001). The change in ROM of external rotation was significantly improved in all of the timing, interaction, and group (p<.001). In comparison between groups, ECG was significantly improved (p<.001). 3) The change in external rotation strength was significantly improved in time, interaction (p<.001), and group (p<.01). In the comparison between groups, ECG was found to be significantly improved (p<.001).<BR> Conclusion: Therefore, the eccentric contraction exercise program implemented in this study appears to be an effective treatment method for symptomatic improvement in patients with subacromial impingement syndrome, and future studies will require comparative studies involving gender, various age groups, and more patients with impingement syndrome.

Exercise-induced muscle damage: multi-parametric MRI quantitative assessment

BackgroundTo explore the value of magnetic resonance quantitative analysis using diffusion tensor imaging, T2 mapping, and intravoxel incoherent motion in the evaluation of eccentric exercise-induced muscle damage and to compare the effects of various eccentric exercise modes at different time points in rats.MethodsA total of 174 Sprague-Dawley male rats were randomly divided into five groups: control, once-only exercise, continuous exercise, intermittent exercise, and once-fatigue exercise groups. Each experimental group was divided into seven time-subgroups: 0.5 h, 24 h, 48 h, 72 h, 96 h, 120 h and 168 h after exercise. The quadriceps femoris muscles were then scanned using magnetic resonance imaging. The apparent diffusion coefficient and fractional anisotropy values of diffusion tensor imaging, T2 values of T2 mapping, D and D* values of intravoxel incoherent motion and optical density values of desmin were measured. Associations among different eccentric exercise programmes, magnetic resonance imaging findings, and histopathological results were evaluated. Dunnett’s test, two-way repeated measures analysis of variance, and Pearson correlation analysis were used for statistical analysis.ResultsDiffusion tensor imaging showed that the number of muscle fibre bundles decreased to varying degrees with different time points and eccentric exercises. Apparent diffusion coefficient values of the exercise groups showed a trend that first increased and then decreased, the opposite of fractional anisotropy. The specimens in all eccentric exercise programmes showed high signal T2 values after exercise, the highest among which was in the once-fatigue exercise group. D and D* in the experimental groups were significantly higher than those in the control group at 0.5–48 h after exercise. The apparent diffusion coefficient, fractional anisotropy, T2, D and D* values correlated with the optical density values of desmin.ConclusionsDiffusion tensor imaging, T2 mapping, and intravoxel incoherent motion technology accurately reflect the degree of skeletal muscle damage and recovery associated with eccentric exercise. The degree of muscle damage was the lowest in the continuous exercise group and the highest in the once-fatigue exercise group, which may provide more information and guidance for the formulation of physical and athletic training programmes.

A Comparative Study of Treatment Interventions for Patellar Tendinopathy: A Randomized Controlled Trial

ObjectivesTo determine the additional effect of dry needling (DN) or percutaneous needle electrolysis (PNE) combined with eccentric exercise (EE) and determine which is the most effective for patients with patellar tendinopathy (PT). DesignBlinded, randomized controlled trial, with follow-up at 10 and 22 weeks. SettingsRecruitment was performed in sport clubs. Diagnosis and intervention were conducted at San Jorge University. ParticipantsPatients (N=48) with PT with pain for at least 3 months between the ages of 18 and 45 years. InterventionsThree interventions were carried out: DN and EE, PNE and EE, and EE with sham needle as the control group. Main Outcome MeasuresDisability was measured using the Victorian Institute of Sports Assessment Questionnaire, patellar tendon. Visual analog scale was used to measure pain over time, the Short Form-36 was used to measure quality of life, and ultrasound was used to measure structural abnormalities. ResultsA total of 48 participants (42 men, 6 women; average age, 32.46y; SD, 7.14y) were enrolled. The improvement in disability and pain in each group between baseline and post-treatment and baseline and follow-up was significant (P≤.05), without differences among groups. ConclusionDN or PNE combined with an EE program has not shown to be more effective than a program of only EE to improve disability and pain in patients with PT in the short (10wk) and medium (22wk) terms. Clinical improvements were not associated with structural changes in the tendon.

Isokinetic eccentric exercise substantially improves mobility, muscle strength and size, but not postural sway metrics in older adults, with limited regression observed following a detraining period

IntroductionEccentric exercise can reverse age-related decreases in muscle strength and mass; however, no data exist describing its effects on postural sway. As the ankle may be more important for postural sway than hip and knee joints, and with older adults prone to periods of inactivity, the effects of two 6-week seated isokinetic eccentric exercise programmes, and an 8-week detraining period, were examined in 27 older adults (67.1 ± 6.0 years).MethodsNeuromuscular parameters were measured before and after training and detraining periods with subjects assigned to ECC (twice-weekly eccentric-only hip and knee extensor contractions) or ECCPF (identical training with additional eccentric-only plantarflexor contractions) training programmes.ResultsSignificant (P < 0.05) increases in mobility (decreased timed-up-and-go time [− 7.7 to − 12.0%]), eccentric strength (39.4–58.8%) and vastus lateralis thickness (9.8–9.9%) occurred after both training programmes, with low-to-moderate weekly rate of perceived exertion (3.3–4.5/10) reported. No significant change in any postural sway metric occurred after either training programme. After 8 weeks of detraining, mobility (− 8.2 to − 11.3%), eccentric strength (30.5–50.4%) and vastus lateralis thickness (6.1–7.1%) remained significantly greater than baseline in both groups.ConclusionDespite improvements in functional mobility, muscle strength and size, lower-limb eccentric training targeting hip, knee and ankle extensor muscle groups was not sufficient to influence static balance. Nonetheless, as the beneficial functional and structural adaptations were largely maintained through an 8-week detraining period, these findings have important implications for clinical exercise prescription as the exercise modality, low perceived training intensity, and adaptive profile are well suited to the needs of older adults.

Percutaneous Electrolysis in the Treatment of Lateral Epicondylalgia: A Single-Blind Randomized Controlled Trial.

Few studies have considered the effects of percutaneous electrolysis (PE) in the treatment of lateral epicondylalgia (LE). For this reason, the objective of this study was to compare the effects of PE with an evidence-based approach—trigger point dry needling (TDN)—in patients with LE. A randomized controlled trial was conducted in which 32 participants with LE were randomly assigned to two treatment groups, the PE group (n = 16) and the TDN group (n = 16). Both groups received four therapy sessions and an eccentric exercise program to be performed daily. The numerical pain rating scale (NPRS), pressure pain thresholds (PPT), quality of life, and range of motion were measured before treatment, at the end of treatment, and at one- and three-month follow-ups. Significant between-group mean differences were found after treatment for NPRS (p < 0.001) and flexion movement (p = 0.006). At one-month follow-up, significant mean differences between groups were found for NPRS (p < 0.001), PPT (p = 0.021), and flexion (p = 0.036). At three-months follow-up, significant mean differences between groups were found for NPRS (p < 0.001), PPT (p = 0.004), and flexion (p = 0.003). This study provides evidence that PE could be more effective than TDN for short- and medium-term improvement of pain and PPTs in LE when added to an eccentric exercise program.

Safety, Feasibility, and Efficacy of an Eccentric Exercise Intervention in People with Multiple Sclerosis with Ankle Contractures.

The primary aim of this study was to investigate the safety and feasibility of an eccentric exercise program for people with multiple sclerosis (MS) who have ankle contractures, ie, reduced ankle range of motion (ROM). Secondary aims were to explore the efficacy of this eccentric exercise on ankle joint ROM and functional mobility. Five adults with MS with ankle contractures (three women and two men; mean ± SD age, 50.8 ± 9.4; MS duration, 7.6 ± 5.6 years) completed two eccentric exercise training sessions (10-45 minutes) per week for 12 weeks. The training involved walking backward downhill on an inclined treadmill (gradient, 10°-14°) at a self-selected pace. The intervention was assessed for safety (adverse events), feasibility (recruitment rates, adherence rates, enjoyment levels, difficulty, and discomfort), and clinical outcomes, including passive/active ankle ROM and distance walked in 6 minutes. There were no adverse events during or after the eccentric exercise training. There was a 100% adherence rate. All participants enjoyed the training and experienced low levels of muscle soreness/discomfort. The training program improved passive/active ankle ROM in all participants; however, improvements did not translate to improvements in walking for all participants. Walking backward and downhill is a safe and feasible training modality for people with MS with ankle contractures. Clinical outcomes (greater passive/active ankle ROM) after this eccentric exercise training were evident. However, translation to clinically meaningful changes in walking function requires further examination.

Comparative study of treatment interventions for patellar tendinopathy: a protocol for a randomised controlled trial

IntroductionPatellar tendinopathy is a degenerative disease of the patellar tendon, which affects athletes from a variety of sports, and is especially predominant in sports involving high-impact jumping. The aim of...

Vibration increases multifidus cross-sectional area versus cryotherapy added to chronic non-insertional Achilles tendinopathy eccentric exercise

ObjectiveTo assess multifidus muscle thickness, cross-sectional area (CSA) and disability in patients with chronic non-insertional Achilles tendinopathy (AT) who developed an eccentric exercise (EE) vibration program compared to an EE program with cryotherapy. DesignSingle-blinded randomized clinical trial. SettingOutpatient clinic. ParticipantsA total sample of 61 patients diagnosed with chronic non-insertional AT was recruited and randomly divided into two groups. A group (n = 30) developed the EE program plus vibration and B group (n = 31) received the EE program plus cryotherapy for 12 weeks. Multifidus thickness and CSA were measured at rest and during maximal isometric contraction by ultrasound imaging. The Victorian Institute for Sport Assessment (VISA-A) was used to asses functionality. ResultsMultifidus CSA was statistically significant increased (P < 0.05) for the EE vibration program group with respect to EE plus cryotherapy during maximal isometric contraction and at rest at 12-weeks after intervention in individuals with chronic non-insertional AT. Despite both interventions showed differences for the multifidus thickness and AT disability variables over time, there were not between-groups differences. ConclusionsAuthors encourage the use of vibration with respect to cryotherapy added to EE programs in order to enhance multifidus CSA in addition to lower limb functionality in individuals who suffer from chronic non-insertional AT.

Effectiveness of Eccentric Exercises on Selfie Elbow

Background: Selfitis is an genuine mental condition where people have an obsessive-compulsive desire to take photos of one self and post them on social media as a way to make up for the lack of self- esteem. While clicking a selfie, there is always a possibility that by incorrect stretching of the tendons, an injury can occur to joints like the elbow. Selfie elbow is more of an abnormal and repetitive loading of muscles around elbow, leading to micro ruptures, which cause inflammation and pain. Hence, this study intended to analyze the effects of eccentric exercises on selfie elbow. Aim: To analyze the effectiveness of eccentric exercises on selfie elbow. Method: This is an experimental study done in Faculty of physiotherapy, Dr. M.G.R Educational and Research Institute. After approval of the study by Institutional Review Board, both male and female with severe selfitis (using selfie behaviour questionnaire) between 18-21 years having pain on lateral epicondyle &amp; lateral forearm with positive cozens were included in the study. The subjects with any musculoskeletal injuries, neurological disorders and having pain due to other reasons were excluded. Eccentric exercises protocol was given for four weeks along with patient education program. All the exercises was performed 5times/weeks, 3 sets, 1 set = 15 rep, 1 min rest between each Set. Results: A Positive Association was found between the selfie behaviour scale &amp; oxford elbow pain questionnaire in subjects with selfitis and on comparing the oxford elbow pain questionnaire score significant improvement in the post test mean value was seen which suggest that eccentric exercise program is effective in selfie elbow. Conclusion: The result of this study suggests that proper patient education and eccentric exercise program among selfie takers with sefie elbow will reduce the pain over the lateral epicondyle.