Effectiveness of Physiotherapy in Athletes with Patellar Tendinopathy: A Systematic Review.
Autori
Borghi Sara [Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum – University of Bologna, Bologna, Italy] [Department of Physical Medicine and Rehabilitation, Azienda USL Bologna, Ospedale di Bentivoglio, Bologna, Italy]
Tiberii Asia [Degree in Physiotherapy – Alma Mater Studiorum – University of Bologna, 40138 Bologna (BO)]
Peccerillo Vincenzo [Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum – University of Bologna, Bologna, Italy] [Department of Physical Medicine and Rehabilitation, IRCCS – Istituto Ortopedico Rizzoli, Bologna, Italy]
Background and aims
Patellar tendinopathy (PT) is an overuse injury caused by repetitive mechanical stress on the patellar tendon, also called “jumper’s knee” due to its prevalence among athletes involved in jumping sports. Currently, there are no estabilished guidelines for the rehabilitation treatment of PT. The aim of this systematic review is to investigate the effectiveness of physiotherapy in athletes with PT.
Methods
A systematic review of the literature was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. The databases PubMed, Embase, Cochrane Library, CINAHL, Scopus, PEDro, Web of Science and SPORTDiscus were searched up to August 1st, 2024. To be included, studies had to be randomized controlled trials (RCT) involving athletes affected by in-season PT; they had to evaluate at least one of the following relevant outcome: pain, functional status, psychosocial factors, in-season performance or quality of life; additionally, the experimental group had to receive a physiotherapy-based intervention. Studies written in languages other than English or Italian were excluded. Records were screened using the online software RAYYAN QCRI by two blinded reviewers (AT and SB) and a third blinded reviewer (VP) was involved in cases of disagreement. The risk of bias of the included RCT was assessed using the RoB 2.0 tool recommended by the Cochrane Collaboration.
Results
14 RCTs were included. The risk of bias was high in 9 studies and moderate in 5. A total of 615 athletes were included with a sample size ranging from 18 to 97 participants. Regarding pain outcome, kinesiology taping associated with squat and lunge exercises, the application of isometric exercise, isotonic exercise and eccentric exercise would seem to be effective in the post-intervention. For the outcome of functional state in the post-intervention only eccentric exercise showed effectiveness post-intervention. Finally, inconsistent evidence were found for quality of life.
Conclusion
To the best of our knowledge, this systematic review is the first to investigate the effectiveness of physiotherapy interventions in athletes with in-season PT. The findings suggest limited evidence supporting these treatments. Moreover, the results should be interpreted with great caution due to the heterogeneity in the types of physiotherapy interventions applied, the methods of application, the nature of control groups, the outcome measures used and the different time points of assessment. Further research will be necessary to produce clinical trials with greater methodological quality.
REFERENCES
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