Background: Patellar tendinopathy is an overload injury, due to an imbalance in the ratio of load to load-bearing capacity of the patellar tendon, in which the painful symptomatology is well localized to the inferior pole of the patella and is exacerbated whenever a high-intensity stimulus is applied, then regresses once removed. Volleyball players, who are required to perform numerous vertical jumps and landings during games or practice, are among the individuals most at risk of developing this pathology, which can limit these athletes' participation in sports for a long time. Aim of the study: This study aims to evaluate different treatment options for the management of patellar tendinopathy in volleyball athletes, assessing their effectiveness in terms of pain reduction and return to function. Materials and Methods: In this literature review, scientific articles were searched from two online databases, Pubmed and The Cochrane Library. Only articles with publication dates not prior to 01/01/2013 and articles that included volleyball athletes with patellar tendinopathy in the study population were included in the analysis; however, narrative reviews, articles with publication dates prior to 01/01/2013, and studies in which the study population did not include volleyball players with patellar tendinopathy were excluded. The methodological quality of the articles included in this review was then assessed using the PEDro Scale for Randomized Clinical Trials validated in Italian. Results: The database search initially yielded 101 articles; of these, only 10 were included in this review, including 8 clinical trials, 1 case study, and 1 case report. It was possible to assess the methodological quality of 7 articles using PEDro's Scale for Randomized Clinical Trials. Discussion: Seven articles evaluated the short- and medium-term effects of exercise (isometric, isotonic, eccentric) in reducing pain and returning to function: isometric exercise, performed with certain characteristics, was found to be the most valuable in reducing symptoms in the short term. One study showed positive results on the use of an infrapatellar strap in the immediate reduction of pain when performing jump tests, but didn’t show improvements on jump performance. Similar results on immediate symptom improvement were obtained from the use of extracorporeal shock wave therapy. Conclusions: The data from this study suggest that therapeutic exercise and a load management program based on the characteristics of the patient and his or her pathology represent the best resource available to the physical therapist in guiding the volleyball player with patellar tendinopathy toward pain reduction and return to participation. Passive therapies such as the use of an infrapatellar strap and extracorporeal shock waves may be helpful in reducing pain in the immediate term, but because of the lack of evidence supporting their medium- and long-term effects, their use cannot be separated from a program of exercise and load management. Future studies should focus on analyzing the long-term effects of an exercise program and other treatment options. Keywords: rehabilitation, patellar tendinopathy, volleyball player.
Background: La tendinopatia rotulea è un infortunio da sovraccarico, dovuto ad uno sbilanciamento nel rapporto tra carico e capacità di carico del tendine rotuleo, nel quale la sintomatologia dolorosa è ben localizzata al polo inferiore della rotula e viene esacerbata ogni qualvolta venga applicato uno stimolo ad alta intensità, per poi regredire una volta rimosso. I pallavolisti, chiamati ad effettuare numerosi salti verticali ed atterraggi durante le partite o gli allenamenti, sono tra gli individui maggiormente a rischio di sviluppare questa patologia, la quale può limitare a lungo la partecipazione di questi atleti all’attività sportiva. Obiettivo dello studio: Questo studio si pone lo scopo di valutare le diverse opzioni di trattamento per la gestione della tendinopatia rotulea negli atleti di pallavolo, valutandone l’efficacia in termini di riduzione del dolore e ritorno alla funzione. Materiali e metodi: In questa revisione della letteratura, la ricerca degli articoli scientifici è stata effettuata su due banche dati online, Pubmed e The Cochrane Library. Sono stati inclusi nell’analisi solamente articoli con data di pubblicazione non antecedente al 01/01/2013 e articoli che includessero nella popolazione di studio atleti di pallavolo affetti da tendinopatia rotulea; sono state invece escluse le revisioni narrative, gli articoli con data di pubblicazione antecedente al 01/01/2013 e gli studi nei quali la popolazione di studio non comprendesse pallavolisti affetti da tendinopatia rotulea. La qualità metodologica degli articoli inclusi in questa revisione è stata poi valutata mediante la Scala di PEDro per i trial clinici randomizzati validata in lingua italiana. Risultati: La ricerca sulle banche dati ha inizialmente prodotto 101 articoli; di questi, solamente 10 sono stati inclusi in questa revisione, tra cui 8 trial clinici, 1 studio di casi e 1 case report. È stato possibile valutare la qualità metodologica di 7 articoli mediante la Scala di PEDro per i trial clinici randomizzati. Discussione: Sette articoli hanno valutato gli effetti a breve e medio termine dell’esercizio (isometrico, isotonico, eccentrico) nella riduzione del dolore e nel ritorno alla funzione: l’esercizio isometrico, eseguito con determinate caratteristiche, si è rivelato quello più valido nella riduzione della sintomatologia a breve termine. Uno studio ha dato risultati positivi sull’utilizzo di una cinghia infrapatellare nella riduzione immediata del dolore durante l’esecuzione di test di salto, ma non ha evidenziato miglioramenti sulla performance di salto. Risultati simili sul miglioramento dei sintomi nell’immediato sono stati ottenuti dall’utilizzo della terapia con onde d’urto extracorporee. Conclusioni: Dai dati emersi da questo studio si evince come l’esercizio terapeutico e un programma di gestione del carico basato sulle caratteristiche del paziente e della sua patologia, rappresentino la miglior risorsa a disposizione del fisioterapista nel guidare il pallavolista affetto da tendinopatia rotulea verso la riduzione del dolore e il ritorno alla partecipazione. Terapie passive come l’utilizzo di una cinghia infrapatellare e delle onde d’urto extracorporee possono essere utili a ridurre il dolore nell’immediato, ma, a causa della mancanza di evidenze che ne supportino gli effetti a medio e lungo termine, il loro utilizzo non può prescindere da un programma di esercizio e gestione del carico. Studi futuri dovranno concentrarsi sull’analizzare gli effetti a lungo termine di un programma di esercizi e delle altre opzioni terapeutiche. Parole chiave: riabilitazione, tendinopatia rotulea, pallavolista.
La riabilitazione della tendinopatia rotulea nel pallavolista: una revisione della letteratura.
PESCE, LORENZO
2022/2023
Abstract
Background: Patellar tendinopathy is an overload injury, due to an imbalance in the ratio of load to load-bearing capacity of the patellar tendon, in which the painful symptomatology is well localized to the inferior pole of the patella and is exacerbated whenever a high-intensity stimulus is applied, then regresses once removed. Volleyball players, who are required to perform numerous vertical jumps and landings during games or practice, are among the individuals most at risk of developing this pathology, which can limit these athletes' participation in sports for a long time. Aim of the study: This study aims to evaluate different treatment options for the management of patellar tendinopathy in volleyball athletes, assessing their effectiveness in terms of pain reduction and return to function. Materials and Methods: In this literature review, scientific articles were searched from two online databases, Pubmed and The Cochrane Library. Only articles with publication dates not prior to 01/01/2013 and articles that included volleyball athletes with patellar tendinopathy in the study population were included in the analysis; however, narrative reviews, articles with publication dates prior to 01/01/2013, and studies in which the study population did not include volleyball players with patellar tendinopathy were excluded. The methodological quality of the articles included in this review was then assessed using the PEDro Scale for Randomized Clinical Trials validated in Italian. Results: The database search initially yielded 101 articles; of these, only 10 were included in this review, including 8 clinical trials, 1 case study, and 1 case report. It was possible to assess the methodological quality of 7 articles using PEDro's Scale for Randomized Clinical Trials. Discussion: Seven articles evaluated the short- and medium-term effects of exercise (isometric, isotonic, eccentric) in reducing pain and returning to function: isometric exercise, performed with certain characteristics, was found to be the most valuable in reducing symptoms in the short term. One study showed positive results on the use of an infrapatellar strap in the immediate reduction of pain when performing jump tests, but didn’t show improvements on jump performance. Similar results on immediate symptom improvement were obtained from the use of extracorporeal shock wave therapy. Conclusions: The data from this study suggest that therapeutic exercise and a load management program based on the characteristics of the patient and his or her pathology represent the best resource available to the physical therapist in guiding the volleyball player with patellar tendinopathy toward pain reduction and return to participation. Passive therapies such as the use of an infrapatellar strap and extracorporeal shock waves may be helpful in reducing pain in the immediate term, but because of the lack of evidence supporting their medium- and long-term effects, their use cannot be separated from a program of exercise and load management. Future studies should focus on analyzing the long-term effects of an exercise program and other treatment options. Keywords: rehabilitation, patellar tendinopathy, volleyball player.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/56627