Frizziero Antonio, Trainito Sabina, Oliva Francesco, Nicoli Aldini Nicolò, Masiero Stefano, Maffulli Nicola
Department of Physical and Rehabilitation Medicine, University of Padova, Italy.
Department of Orthopaedics and Traumatology, University of Rome 'Tor Vergata' School of Medicine, Rome, Italy.
Br Med Bull. 2014 Jun;110(1):47-75. doi: 10.1093/bmb/ldu006. Epub 2014 Apr 15.
Sports injuries frequently involve tendons, muscles and ligaments. The variable outcome of surgery and medical treatment support early functional treatments. Eccentric exercise (EE) showed effectiveness in the management of Achilles tendinopathy (AT), patellar tendinopathy (PT) and lateral epicondyle tendinopathy (LET). Preliminary results of EE in other tendinopathies and sports injuries suggest its wide prescription in the sport rehabilitation field.
A comprehensive search of PubMed, Web of Science, the Cochrane Collaboration Database, Physiotherapy Evidence Database (PEDro), Evidence Based Medicine (EBM) Search review, National Guidelines, Scopus and Google Scholar was performed using keywords such as 'eccentric exercise', 'sports injuries rehabilitation', 'tendinopathy', 'hamstrings strain' 'adductor injuries' and 'ACL reconstruction rehabilitation'.
EE, alone or associated with other therapies, represents a feasible, cost-effective and successful tool in the treatment of well-known targets and might be promising in shoulder tendinopathy, adductor-related groin pain, hamstring strains, and ACL rehabilitation.
The lack of standardization of protocols, the variable amount, quality and follow-up of studies, the different anatomy and pathophysiology of the therapeutic targets limit the evidence of applicability of EE to sports injuries.
The role of pathology and biomechanics in the response to EE should be further investigated.
New randomized controlled trials should test the effectiveness of standardized EE regimens to various sites of sports injuries.
运动损伤常累及肌腱、肌肉和韧带。手术和药物治疗的效果各异，这支持早期功能治疗。离心运动（EE）在跟腱病（AT）、髌腱病（PT）和外侧上髁肌腱病（LET）的治疗中显示出有效性。EE在其他肌腱病和运动损伤中的初步结果表明，其在运动康复领域有广泛应用前景。
使用“离心运动”“运动损伤康复”“肌腱病”“腘绳肌拉伤”“内收肌损伤”和“前交叉韧带重建康复”等关键词，对PubMed、科学网、Cochrane协作数据库、物理治疗证据数据库（PEDro）、循证医学（EBM）搜索综述、国家指南、Scopus和谷歌学术进行了全面检索。
EE单独或与其他疗法联合，是治疗已知靶点的可行、经济有效且成功的工具，在肩袖肌腱病、内收肌相关腹股沟疼痛、腘绳肌拉伤和前交叉韧带康复方面可能很有前景。
方案缺乏标准化、研究数量、质量和随访情况各异、治疗靶点的解剖学和病理生理学不同，限制了EE对运动损伤适用性的证据。
应进一步研究病理和生物力学在对EE反应中的作用。
新的随机对照试验应测试标准化EE方案对各种运动损伤部位的有效性。
