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British Journal of Sports Medicine Oct 2023To investigate potential moderating effects of resistance exercise dose components including intensity, volume and frequency, for the management of common tendinopathies. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate potential moderating effects of resistance exercise dose components including intensity, volume and frequency, for the management of common tendinopathies.
DESIGN
Systematic review with meta-analysis and meta-regressions.
DATA SOURCES
Including but not limited to: MEDLINE, CINAHL, SPORTDiscus, ClinicalTrials.gov and ISRCTN Registry.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Randomised and non-randomised controlled trials investigating resistance exercise as the dominant treatment class, reporting sufficient information regarding ≥2 components of exercise dose.
RESULTS
A total of 110 studies were included in meta-analyses (148 treatment arms (TAs), 3953 participants), reporting on five tendinopathy locations (rotator cuff: 48 TAs; Achilles: 43 TAs; lateral elbow: 29 TAs; patellar: 24 TAs; gluteal: 4 TAs). Meta-regressions provided consistent evidence of greater pooled mean effect sizes for higher intensity therapies comprising additional external resistance compared with body mass only (large effect size domains: = 0.50 (95% credible interval (CrI): 0.15 to 0.84; p=0.998); small effect size domains ( = 0.04 (95% CrI: -0.21 to 0.31; p=0.619)) when combined across tendinopathy locations or analysed separately. Greater pooled mean effect sizes were also identified for the lowest frequency (less than daily) compared with mid (daily) and high frequencies (more than once per day) for both effect size domains when combined or analysed separately (p≥0.976). Evidence for associations between training volume and pooled mean effect sizes was minimal and inconsistent.
SUMMARY/CONCLUSION
Resistance exercise dose is poorly reported within tendinopathy management literature. However, this large meta-analysis identified some consistent patterns indicating greater efficacy on average with therapies prescribing higher intensities (through inclusion of additional loads) and lower frequencies, potentially creating stronger stimuli and facilitating adequate recovery.
Topics: Humans; Resistance Training; Rotator Cuff; Exercise Therapy; Patella; Tendinopathy
PubMed: 37169370
DOI: 10.1136/bjsports-2022-105754 -
International Journal of Surgery Case... Jan 2024A bipartite patella is a rare anatomical variant of the patella. A patella bipartite is often asymptomatic and is often an incidental finding on radiological imaging....
INTRODUCTION
A bipartite patella is a rare anatomical variant of the patella. A patella bipartite is often asymptomatic and is often an incidental finding on radiological imaging. The patella remains bipartite when secondary ossification centers fail to fuse. Herein, a case of bipartite patella improved after knee arthroscopy and surgical removal.
PRESENTATION OF THE CASE
A 57-year-old male with a history of polytrauma. He complained of progressive pain in the right knee area. A radiological investigation reported a right bipartite patella. The condition improved after the open removal of the accessory patella.
DISCUSSION
This case is considered type III according to Saupe's classification. Due to its location and radiological appearance, it is a painful synchondrosis of a bipartite patella.
CONCLUSION
After the failure of conservative management, the removal of the bipartite patella was necessary and unavoidable to restore everyday activities.
PubMed: 38142546
DOI: 10.1016/j.ijscr.2023.109165