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针对维多利亚体育学院髌骨问卷,对患有髌腱病的成年人进行干预与离心、等长和重负荷慢速阻力训练的混合比较:一项系统评价和网状荟萃分析。

Mixed comparison of intervention with eccentric, isometric, and heavy slow resistance for Victorian Institute of Sport Assessment Patella Questionnaire in adults with patellar tendinopathy: A systematic review and network meta-analysis.

作者信息

Li Yifei, Sun Dong, Fang Yufei, Lu Zhenghui, Shi Feicun, Liu Gongju, Gu Yaodong

机构信息

Ningbo No. 2 Hospital, Ningbo, China.

Faculty of Sports Science, Ningbo University, 315211, Ningbo, China.

出版信息

Heliyon. 2024 Oct 29;10(21):e39171. doi: 10.1016/j.heliyon.2024.e39171. eCollection 2024 Nov 15.

Abstract

BACKGROUND

PT (Patellar Tendinopathy) is a degenerative disorder of the tendons induced via extended overstretching or overuse of the tendons instead than usual inflammation. In the past, humans have centered on a number of strategies of treating PT such as ultrasound and surgical treatment. However, they did no longer genuinely consider the effectiveness of eccentric, isometric, or HSR (Heavy Slow Resistance Training) education for PT; They did now not really outline the stage of PT to beautify the uniformity of the find out about participants; They did no longer immediately examine the affects of isometric, eccentric, and HSR training. This systematic assessment chosen eccentric, isometric, and heavy gradual resistance coaching for the remedy of patellar tendinopathy and their respective prognostic effects will supply valuable, top notch evidence-based insights as properly as vital facts and advice for future scientific administration of patellar tendinopathy.

METHODS

A thorough and comprehensive search was conducted across the Web of Science, PubMed, and Scopus databases, encompassing a wide range of relevant journals and sources, in order to perform a rigorous systematic review and network meta-analysis, ensuring the inclusion of all pertinent and high-quality studies. The selected studies satisfied predetermined eligibility requirements, which included: (1) PT patients included in the studies; (2) use of eccentric, isometric, and heavy slow resistance training as interventions; and (3) evaluation of VISA-P (Victorian Institute of Sport Assessment Patella Questionnaire) outcome measures. The effect magnitude was measured using the standard mean difference. The risk of bias inherent in each of the studies that were meticulously selected and included in the comprehensive analysis was rigorously evaluated and assessed using the well-established Cochrane Collaboration Risk of Bias Assessment Tool, ensuring the robustness and reliability of the research findings.

RESULTS

Three scientific databases yielded a total of 1460 studies, of which 7 were included in the final analysis. The findings indicated that eccentric training (0.01 in Rank 1 and 0.06 in Rank 8) is the worst method for increasing VISA-P level in patients with patellar tendinopathy, while moderate resistance slow training (0.25) and Rank 1 and Rank 8 are the best options.

CONCLUSIONS

While heavy slow resistance is more suited for attaining long-term improvements in knee function, progressive tendon-loading exercises combined with isometric training or moderate slow resistance training are more beneficial than eccentric training alone. Eccentric training gives a greater range of exercise venues and doesn't require any additional training equipment. The inability to directly compare the effects of heavy slow, eccentric, and isometric resistance training constitutes a significant drawback of this review. This limitation stems from the scarcity of research that compares the outcomes of these various therapeutic approaches. To address this constraint, future research endeavors should strive to conduct comparative studies of these strategies. By doing so, they can aim to bridge this evaluation gap and facilitate a more effective and comprehensive assessment of their respective efficacies.

摘要

背景

髌腱病(PT)是一种由于肌腱过度伸展或过度使用而非通常的炎症引起的肌腱退行性疾病。过去,人们专注于多种治疗髌腱病的策略,如超声和手术治疗。然而,他们并未真正考虑离心、等长或重负荷慢速抗阻训练(HSR)对髌腱病的有效性;他们没有明确界定髌腱病的阶段以提高研究参与者的同质性;他们没有直接比较等长、离心和HSR训练的效果。这项系统评价选择了离心、等长和重负荷慢速抗阻训练来治疗髌腱病及其各自的预后效果,将提供有价值的、高质量的循证见解以及重要信息和建议,以供未来髌腱病的临床管理参考。

方法

在科学网、PubMed和Scopus数据库中进行了全面且综合的检索,涵盖了广泛的相关期刊和来源,以进行严格的系统评价和网状Meta分析,确保纳入所有相关的高质量研究。所选研究满足预定的纳入标准,包括:(1)研究中纳入髌腱病患者;(2)使用离心、等长和重负荷慢速抗阻训练作为干预措施;(3)评估维多利亚运动评估髌骨问卷(VISA-P)的结果指标。效应量使用标准化均数差值进行测量。使用成熟的Cochrane协作偏倚风险评估工具对精心挑选并纳入综合分析的每项研究中固有的偏倚风险进行了严格评估,以确保研究结果的稳健性和可靠性。

结果

三个科学数据库共检索到1460项研究,其中7项被纳入最终分析。研究结果表明,离心训练(在排序1中为0.01,在排序8中为0.06)是提高髌腱病患者VISA-P水平的最差方法,而中等抗阻慢速训练(0.25)以及排序1和排序8是最佳选择。

结论

虽然重负荷慢速抗阻训练更适合实现膝关节功能的长期改善,但渐进式肌腱负荷运动结合等长训练或中等慢速抗阻训练比单独的离心训练更有益。离心训练提供了更广泛的运动场地,并且不需要任何额外的训练设备。无法直接比较重负荷慢速、离心和等长抗阻训练的效果是本综述的一个重大缺陷。这一局限性源于比较这些不同治疗方法结果的研究稀缺。为解决这一限制,未来的研究应努力对这些策略进行比较研究。通过这样做,他们可以旨在弥合这一评估差距,并促进对它们各自疗效的更有效和全面的评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2f7/11570476/675e0566f419/gr1.jpg

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