original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND: Previous reviews have highlighted the benefit of loaded therapeutic exercise in the treatment of tendinopathy. Changes in observable structural outcomes have been suggested as a possible explanation for this response to therapeutic exercise. However, the mechanism for the efficacy of therapeutic exercise remains unclear.
OBJECTIVE: To systematically review the relationship between the observable structural change and clinical outcomes following therapeutic exercise.
DATA SOURCES: An electronic search of AMED, CiNAHL, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PEDro and SPORTDiscus was undertaken from their inception to June 2012.
STUDY ELIGIBILITY CRITERIA: Any study design that incorporated observable structural outcomes and clinical outcomes when assessing the effect of therapeutic exercise on participants with tendinopathy.
STUDY APPRAISAL AND SYNTHESIS METHODS: Included studies were appraised for risk of bias using the tool developed by the Cochrane Back Review Group. Due to heterogeneity of studies, a qualitative synthesis was undertaken.
RESULTS: Twenty articles describing 625 patients were included. Overall, there is a strong evidence to refute any observable structural change as an explanation for the response to therapeutic exercise when treated by eccentric exercise training. Moderate evidence does exist to support the response of heavy-slow resistance training (HSR).
CONCLUSIONS: The available literature does not support observable structural change as an explanation for the response of therapeutic exercise except for some support from HSR. Future research should focus on indentifying other explanations including neural, biochemical and myogenic changes.
- “Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols,” Carl M Askling, Magnus Tengvar, and Alf Thorstensson, British Journal of Sports Medicine, 2013.
- “Acute hamstring injuries in Swedish elite sprinters and jumpers: a prospective randomised controlled clinical trial comparing two rehabilitation protocols,” Carl M Askling, Magnus Tengvar, Olga Tarassova, and Alf Thorstensson, British Journal of Sports Medicine, 2014.
- “Efficacy of eccentric exercise in lower limb tendinopathies in athletes,” Antonio Frizziero, Filippo Vittadini, Augusto Fusco, Arrigo Giombini, and Stefano Masiero, J Sports Med Phys Fitness, 2016.
- “Eccentric exercises; why do they work, what are the problems and how can we improve them?,” J D Rees, R L Wolman, and A Wilson, British Journal of Sports Medicine, 2009.
These two articles on PainScience.com cite Drew 2014 as a source:
- PS Eccentric Contraction — A weird bit of muscle physiology
- PS Achilles Tendinitis Treatment Science — Evidence-based guidelines for recovering as fast as possible
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.
- Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. Paige 2017 JAMA.