Resistance Exercise for Lower Limb Tendinopathy
Protocol for a Systematic Review of Systematic Reviews Evaluating Effectiveness
Keywords:Tendon, Tendinopathy, Heavy slow resistance training, Resistance Training
Review Objective: Perform a systematic review of systematic reviews to synthesize the best available evidence on the effectiveness of resistance exercise interventions for treating lower limb tendinopathies.
Introduction: Recent evidence suggests various forms of resistance exercise such as heavy slow resistance training, eccentric and isometric training are effective for treating lower limb tendinopathies. However, it is unclear which type of resistance training is most effective, with no systematic reviews of systematic reviews existing on the topic, and optimal treatment protocols and clinical recommendations are lacking.
Inclusion criteria: Systematic reviews of systematic reviews of randomised controlled trials evaluating the effectiveness of resistance exercise interventions any lower limb tendinopathy in adults will be included.
Methods: The authors will search for a wide range of sources to find published studies via EBSCOhost, including, but not limited to, MEDLINE, SPORTDiscus, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and Allied and Complementary Medicine Database (AMED). Studies published in a language other than English will only be considered if a translation is available. The AMSTAR tool will be used to assess methodological quality and internal validity of included systematic reviews, with a corrected cover area analysis to determine overlap of primary studies. Data synthesis will be conducted using a narrative synthesis.
ALBERS, I.S., ZWERVER, J., DIERCKS, R.L., DEKKER, J.H. and VAN DEN AKKER-SCHEEK, I., 2016. Incidence and prevalence of lower extremity tendinopathy in a Dutch general practice population: a cross sectional study. BMC musculoskeletal disorders, 17, pp. 16-016-0885-2.
ARNOLD, M.J. and MOODY, A.L., 2018. Common Running Injuries: Evaluation and Management. American Family Physician, 97(8), pp. 510-516.
BEYER, R., KONGSGAARD, M., HOUGS KJAER, B., OHLENSCHLAEGER, T., KJAER, M. and MAGNUSSON, S.P., 2015. Heavy Slow Resistance Versus Eccentric Training as Treatment for Achilles Tendinopathy: A Randomized Controlled Trial. The American Journal of Sports Medicine, 43(7), pp. 1704-1711.
BOONSTRA, A.M., SCHIPHORST PREUPER, H.R., RENEMAN, M.F., POSTHUMUS, J.B. and STEWART, R.E., 2008. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. International journal of rehabilitation research.Internationale Zeitschrift fur Rehabilitationsforschung.Revue internationale de recherches de readaptation, 31(2), pp. 165-169.
BUDIMAN-MAK, E., CONRAD, K.J., MAZZA, J. and STUCK, R.M., 2013. A review of the foot function index and the foot function index - revised. Journal of foot and ankle research, 6(1), pp. 5-1146-6-5.
CARDOSO, T.B., PIZZARI, T., KINSELLA, R., HOPE, D. and COOK, J.L., 2019. Current trends in tendinopathy management. Best practice & research.Clinical rheumatology, 33(1), pp. 122-140.
CHALLOUMAS, D., PEDRET, C., BIDDLE, M., NG, N.Y.B., KIRWAN, P., COOPER, B., NICHOLAS, P., WILSON, S., CLIFFORD, C. and MILLAR, N.L., 2021. Management of patellar tendinopathy: a systematic review and network meta-analysis of randomised studies. BMJ open sport & exercise medicine, 7(4), pp. e001110.
DEAN, B.J.F., DAKIN, S.G., MILLAR, N.L. and CARR, A.J., 2017. Review: Emerging concepts in the pathogenesis of tendinopathy. The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland, 15(6), pp. 349-354.
GAIDA, J.E. and COOK, J., 2011. Treatment options for patellar tendinopathy: critical review. Current sports medicine reports, 10(5), pp. 255-270.
HENNESSY, E.A. and JOHNSON, B.T., 2020. Examining overlap of included studies in meta-reviews: Guidance for using the corrected covered area index. Research synthesis methods, 11(1), pp. 134-145.
HERDMAN, M., GUDEX, C., LLOYD, A., JANSSEN, M., KIND, P., PARKIN, D., BONSEL, G. and BADIA, X., 2011. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 20(10), pp. 1727-1736.
HOPKINS, C., FU, S.C., CHUA, E., HU, X., ROLF, C., MATTILA, V.M., QIN, L., YUNG, P.S. and CHAN, K.M., 2016. Critical review on the socio-economic impact of tendinopathy. Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology, 4, pp. 9-20.
JANSSEN, I., VAN DER WORP, H., HENSING, S. and ZWERVER, J., 2018. Investigating Achilles and patellar tendinopathy prevalence in elite athletics. Research in sports medicine (Print), 26(1), pp. 1-12.
KONGSGAARD, M., KOVANEN, V., AAGAARD, P., DOESSING, S., HANSEN, P., LAURSEN, A.H., KALDAU, N.C., KJAER, M. and MAGNUSSON, S.P., 2009. Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Scandinavian Journal of Medicine & Science in Sports, 19(6), pp. 790-802.
KORAKAKIS, V., WHITELEY, R., KOTSIFAKI, A., STEFANAKIS, M., SOTIRALIS, Y. and THORBORG, K., 2021. A systematic review evaluating the clinimetric properties of the Victorian Institute of Sport Assessment (VISA) questionnaires for lower limb tendinopathy shows moderate to high-quality evidence for sufficient reliability, validity and responsiveness-part II. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 29(9), pp. 2765-2788.
LIAN, O.B., ENGEBRETSEN, L. and BAHR, R., 2005. Prevalence of jumper's knee among elite athletes from different sports: a cross-sectional study. The American Journal of Sports Medicine, 33(4), pp. 561-567.
MAGNUSSON, S.P. and KJAER, M., 2019. The impact of loading, unloading, ageing and injury on the human tendon. The Journal of physiology, 597(5), pp. 1283-1298.
MALLIARAS, P., BARTON, C.J., REEVES, N.D. and LANGBERG, H., 2013. Achilles and patellar tendinopathy loading programmes : a systematic review comparing clinical outcomes and identifying potential mechanisms for effectiveness. Sports medicine (Auckland, N.Z.), 43(4), pp. 267-286.
MALLOWS, A., DEBENHAM, J., WALKER, T. and LITTLEWOOD, C., 2017. Association of psychological variables and outcome in tendinopathy: a systematic review. British journal of sports medicine, 51(9), pp. 743-748.
MARTIN, R.L., IRRGANG, J.J., BURDETT, R.G., CONTI, S.F. and VAN SWEARINGEN, J.M., 2005. Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot & ankle international, 26(11), pp. 968-983.
PIEPER, D., BUECHTER, R.B., LI, L., PREDIGER, B. and EIKERMANN, M., 2015. Systematic review found AMSTAR, but not R(evised)-AMSTAR, to have good measurement properties. Journal of clinical epidemiology, 68(5), pp. 574-583.
PIEPER, D., KOENSGEN, N., BREUING, J., GE, L. and WEGEWITZ, U., 2018. How is AMSTAR applied by authors - a call for better reporting. BMC medical research methodology, 18(1), pp. 56-018-0520-z.
POLLOCK, M., FERNANDES, R.M. and HARTLING, L., 2017. Evaluation of AMSTAR to assess the methodological quality of systematic reviews in overviews of reviews of healthcare interventions. BMC medical research methodology, 17(1), pp. 48-017-0325-5.
RATHLEFF, M.S., MOLGAARD, C.M., FREDBERG, U., KAALUND, S., ANDERSEN, K.B., JENSEN, T.T., AASKOV, S. and OLESEN, J.L., 2015. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scandinavian Journal of Medicine & Science in Sports, 25(3), pp. e292-300.
RIEL, H., JENSEN, M.B., OLESEN, J.L., VICENZINO, B. and RATHLEFF, M.S., 2019. Self-dosed and pre-determined progressive heavy-slow resistance training have similar effects in people with plantar fasciopathy: a randomised trial. Journal of physiotherapy, 65(3), pp. 144-151.
RIEL, H., LINDSTROM, C.F., RATHLEFF, M.S., JENSEN, M.B. and OLESEN, J.L., 2019. Prevalence and incidence rate of lower-extremity tendinopathies in a Danish general practice: a registry-based study. BMC musculoskeletal disorders, 20(1), pp. 239-019-2629-6.
SCOTT, A., LIAN, O., BAHR, R., HART, D.A., DURONIO, V. and KHAN, K.M., 2008. Increased mast cell numbers in human patellar tendinosis: correlation with symptom duration and vascular hyperplasia. British journal of sports medicine, 42(9), pp. 753-757.
SEITZ, A.L., MCCLURE, P.W., FINUCANE, S., BOARDMAN, N.D.,3RD and MICHENER, L.A., 2011. Mechanisms of rotator cuff tendinopathy: intrinsic, extrinsic, or both? Clinical biomechanics (Bristol, Avon), 26(1), pp. 1-12.
SHEA, B.J., GRIMSHAW, J.M., WELLS, G.A., BOERS, M., ANDERSSON, N., HAMEL, C., PORTER, A.C., TUGWELL, P., MOHER, D. and BOUTER, L.M., 2007. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC medical research methodology, 7, pp. 10-2288-7-10.
SKJONG, C.C., MEININGER, A.K. and HO, S.S., 2012. Tendinopathy treatment: where is the evidence? Clinics in sports medicine, 31(2), pp. 329-350.
SPRAGUE, A.L., SMITH, A.H., KNOX, P., POHLIG, R.T. and GRAVARE SILBERNAGEL, K., 2018. Modifiable risk factors for patellar tendinopathy in athletes: a systematic review and meta-analysis. British journal of sports medicine, 52(24), pp. 1575-1585.
STEINMANN, S., PFEIFER, C.G., BROCHHAUSEN, C. and DOCHEVA, D., 2020. Spectrum of Tendon Pathologies: Triggers, Trails and End-State. International journal of molecular sciences, 21(3), pp. 10.3390/ijms21030844.
ZWERVER, J., BREDEWEG, S.W. and VAN DEN AKKER-SCHEEK, I., 2011. Prevalence of Jumper's knee among nonelite athletes from different sports: a cross-sectional survey. The American Journal of Sports Medicine, 39(9), pp. 1984-1988.
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