Xiao Liufeng, Zhou Heng, He Jia, Liu Hua, Li Yongchao, Liu Ziyi, Hu Hao
Department of Orthopedics/Sports Medicine Center, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China.
School of Sports Medicine, Wuhan Sports University, Wuhan, Hubei Province, 430079, China.
BMC Sports Sci Med Rehabil. 2024 Oct 10;16(1):213. doi: 10.1186/s13102-024-01004-2.
Patellar tendinopathy (PT) is a common sport injury prone to recurrence. Heavy Slow Resistance Training (HSR) and High-Dose Therapeutic Ultrasound (TUS) are frequently used interventions for PT. However, the combined effectiveness of these therapies remains unclear. This study investigated the impact of combination therapy on functional outcomes in patients with PT.
Fifty-one college students aged 18-25, diagnosed with PT via musculoskeletal ultrasound, were randomly assigned to one of three groups (n = 17 per group): combined HSR and high-dose TUS, HSR training alone, or high-dose TUS alone. The eight-week intervention included assessments using the Victorian Institute of Sport Assessment-Patella (VISA-P), Visual Analogue Scale (VAS), Y-balance Test (YBT), Modified Thomas Test (MTT), Horizontal Jumping Distance, Maximum Isometric Muscle Strength Test, and musculoskeletal ultrasound for patellar tendon thickness and blood flow. Assessments were conducted at baseline and post-intervention, with a follow-up VISA-P assessment at week 16. This randomized, single-blind controlled trial was registered on ISRCTN11447397 ( www.ISRCTN.com ) on February 17, 2024 (retrospectively registered).
All groups demonstrated significant improvements in VISA-P scores at the end of the intervention compared to baseline (p < 0.01), with the combined group showing the greatest improvement (21 points). Follow-up at week 16 revealed continued improvement in VISA-P scores for the combined and HSR groups, while the TUS group showed a slight decrease (from 74 to 70). All groups displayed significantly reduced VAS scores post-intervention (p < 0.01) compared to baseline, indicating decreased pain. While no significant between-group differences were observed in pre-intervention VAS scores, post-intervention results revealed significant differences between the combined and HSR groups (p < 0.05), as well as between the combined and TUS groups (p < 0.01).
Both exercise intervention and high-dose TUS appear effective in reducing pain and improving motor function in individuals with PT. However, the therapeutic effect of high-dose TUS alone seems limited compared to exercise intervention. The combined application of both methods yielded the most significant improvements in pain relief and motor function enhancement.
髌腱病（PT）是一种常见的运动损伤，容易复发。重负荷慢速抗阻训练（HSR）和高剂量治疗性超声（TUS）是常用于治疗PT的干预措施。然而，这些疗法的联合有效性尚不清楚。本研究调查了联合疗法对PT患者功能结局的影响。
51名年龄在18至25岁之间、通过肌肉骨骼超声诊断为PT的大学生被随机分为三组之一（每组n = 17）：HSR与高剂量TUS联合组、单独HSR训练组或单独高剂量TUS组。为期八周的干预包括使用维多利亚运动评估 - 髌骨量表（VISA - P）、视觉模拟量表（VAS）、Y平衡测试（YBT）、改良托马斯测试（MTT）、水平跳跃距离、最大等长肌力测试以及对髌腱厚度和血流进行肌肉骨骼超声检查等评估。在基线和干预后进行评估，并在第16周进行VISA - P随访评估。这项随机、单盲对照试验于2024年2月17日在ISRCTN11447397（www.ISRCTN.com）上注册（回顾性注册）。
与基线相比，所有组在干预结束时VISA - P评分均有显著改善（p < 0.01），联合组改善最大（21分）。第16周的随访显示，联合组和HSR组的VISA - P评分持续改善，而TUS组略有下降（从74降至70）。与基线相比，所有组在干预后VAS评分均显著降低（p < 0.01），表明疼痛减轻。虽然干预前VAS评分在组间未观察到显著差异，但干预后结果显示联合组与HSR组之间存在显著差异（p < 0.05），联合组与TUS组之间也存在显著差异（p < 0.01）。
运动干预和高剂量TUS似乎都能有效减轻PT患者的疼痛并改善运动功能。然而，单独高剂量TUS的治疗效果与运动干预相比似乎有限。两种方法的联合应用在缓解疼痛和增强运动功能方面产生了最显著的改善。
