Sie sind auf Seite 1von 3

Downloaded from http://bjsm.bmj.com/ on June 9, 2015 - Published by group.bmj.

com

Abstracts

Abstract 14 Figure 1 Mean of average NRS-pain on SLDS per


participant per week for intervention groups
Abstract 13 Figure 1 RT-qPCR analysis of CCN1 and CCN2 following
strain and/or TGF-b administration
treatments; eccentric exercises in-season have resulted in worsen-
ing of symptoms [Fredberg, 2008; Visnes, 2007]. Other exercise
TGF-b increased CCN1- and CCN2-expression, but in the programs (isometric and isotonic exercises) have the potential to
strained cells this effect on CCN2 was abolished (Figure 1). decrease pain while continuing sport activities [Kongsgaard,
Discussion The downregulation of CCN1 and CCN2 following 2010; Naugle 2012]. The aim of this study was to compare an
cyclic strain, was unexpected, as skin fibroblasts – cells similar to isometric against an isotonic exercise protocol designed to
tenocytes – are known to react to strain with an upregulation of decrease patellar tendon pain in-season.
CCN2 [Chaqour 2006]. However, endothelial cells have been Methods Jumping athletes with patellar tendinopathy playing at
shown to downregulate CCN2 when strained, and this is least 3 times per week participated in this study. They were rand-
explained by the notion that physiological shear stress protects omised into an isometric exercise or isotonic exercise group. The
vessels from fibrosis and atherosclerotic disease [Chaqour 2006]. exercise programs consisted of 4 exercise sessions per week for 4
It may very well be that tendons are protected in a similar weeks. The exercise sessions consisted of 5 sets of 45 second iso-
manner, with tensile strain promoting an anti-fibrotic environ- metric holds for the isometric group and 4 sets of 8 repetitions
ment by downregulation of CCN2. It would seem that CCN1, heavy slow resistance for the isotonic group; both exercises were
with anti-fibrotic abilities, is upregulated in response to the profi- performed on a leg extension machine. Pain during a Single Leg
brotic TGF-b. Decline Squat (SLDS) on a Numeric Rating Scale (0–10) was
Further studies are required, but regulation of CCN1 and used as the main outcome measure. Participants kept a diary in
CCN2 may play a role in preventing fibrotic disease – such as which they scored the pre and post exercise pain scores when
tendinopathy – in tendons. they performed an exercise session. A Generalised Estimating
Equations (GEE) model was run with participants (id) as subject
REFERENCES
variable; main and interaction effects were determined for the
Jun et al. Nat Rev Drug Discov. 2011;10:945–63
Chaqour et al. FEBS J. 2006;273:3639–3649 factors time and type of intervention.
Results Preliminary results (n = 15) showed a significant
improvement of both groups over time (Wald chi-square =
14 EXERCISE PROGRAMS TO DECREASE PAIN IN ATHLETES 657.4, df =13, p ≤ 0.001). Both groups improved but showed a
WITH PATELLAR TENDINOPATHY IN-SEASON: A RCT significantly different effect over time (interaction effect time by
intervention, Wald chi-square = 3897.7, df =13, p ≤ 0. 001).
1,2
Mathijs van Ark, 2Jill Cook, 2Sean Docking, 1Johannes Zwerver, 1James Gaida, This difference seems to take place in week 2 and 3 (Figure 1).
1
Inge van den Akker-Scheek, 2Ebonie Rio. 1University of Groningen, University Medical There was no difference between groups (Wald chi-square =
Center Groningen, Center for Sports Medicine, Groningen, The Netherlands; 2Chool of
0.438, df =1, p = 0.508).
Physiotherapy, Monash University, Frankston, Victoria, Australia
Discussion Preliminary results showed that both isometric and iso-
10.1136/bjsports-2014-094114.14 tonic exercises result in a decrease in pain in athletes with patellar
tendinopathy symptoms over a 4 week period in-season. This is
Introduction Many athletes with patellar tendinopathy are still one of the first in-season studies that makes a direct comparison
participating in sports but have symptoms during or after activ- between exercise protocols for patellar tendinopathy and to our
ities. It is hard to decrease pain in-season with current knowledge the first study to investigate isometric exercises in a

Br J Sports Med 2014;48(Suppl 2):A1–A76 A9


Downloaded from http://bjsm.bmj.com/ on June 9, 2015 - Published by group.bmj.com

Abstracts

clinical setting. A decrease in pain score in week 2 and increase in


week 3 of the isometric group might possibly be explained by a fast
decrease in pain which might have resulted in an increase in activ-
ities and a related increase in pain. Isometric and isotonic exercise
programs are promising easy-to-use exercises to reduce pain from
patellar tendinopathy for athletes in-season.

REFERENCES
Fredberg et al. Am J Sports Med. 2008;36:451–460
Kongsgaard et al. Am J Sports Med. 2010;38:749–756
Naugle et al. J Pain. 2012;13(12):1139–1150
Visnes H et al. Br J Sports Med. 2007;41(4):217–223

15 DOES THE PATELLAR TENDON RESPOND TO 5 DAYS OF


LOADING DURING A VOLLEYBALL TOURNAMENT?
1,2
Mathijs van Ark, 2Sean Docking, 1Inge van den Akker-Scheek, 2Aliza Rudavsky,
2
Ebonie Rio, 1Johannes Zwerver, 2Jill Cook. 1University of Groningen, University Medical
Center Groningen, Center for Sports Medicine, Groningen, The Netherlands; 2School of
Physiotherapy, Monash University, Frankston, Victoria, Australia

10.1136/bjsports-2014-094114.15

Introduction Patellar tendinopathy (jumper’s knee – pain in the


tendon and dysfunction) has a high prevalence, especially in Abstract 15 Figure 2 Mean echo-type I during tournament days for
jumping athletes like volleyball players. Excess load on the patel- athletes with and without hypoechoic abnormality
lar tendon through high volumes of training and competition is
an important risk factor [Visnes, 2014]. Structural changes in the Generalised Estimating Equations (GEE) were used to test for
tendon are related with a higher risk of developing patellar ten- change of echo-type I and II over the tournament. Echo-type was
dinopathy [Cook, 2000]. The critical load that affects tendon used as dependent variable; main effect of time (days of tourna-
structure is unknown. The aim of this study was to investigate ment) was determined. In a second analysis the interaction effect
patellar tendon structure on each day of a five day volleyball time by hypoechoic abnormality was determined.
tournament in an adolescent population (16–18 years old). Results Participants played between 8 and 9 matches during the
Methods The right patellar tendon of 41 players in the Austral- tournament. Hypoechoic abnormalities were recorded in 14 ath-
ian Volleyball Schools Cup (AVSC) was scanned with Ultrasound letes. There was no significant change in echo-types over the 5
Tissue Characterisation (UTC) on every day of the tournament days of the study (echo-type I: Wald 2 =4.603, df = 4, p =
(Monday-Friday). UTC can quantify structure of a tendon into 0.331; echo-type II: Wald 2 = 6.070, df=4, p = 0.194; see fig-
four echo-types based on the stability of the echopattern. Hypoe- ure 1). Overall echopattern was stable across the tournament in
choic abnormalities on grey-scale were also recorded at baseline. participants without hypoechoic abnormalities while a (non-sig-
nificant) decrease in echo-type I (less stable echopattern) over
time (Wald 2 = 3.853, df =4, p = 0.426) was seen in athletes
with hypoechoic abnormalities (figure 2). Echo-type I was signifi-
cantly lower in athletes with abnormalities (Wald 2 = 16.545,
df=1, p < 0.001).
Discussion This study shows that patellar tendon structure of
16–18 year old volleyball players is not affected during 5 days of
cumulative loading during a volleyball tournament. Subgroups
might exist with a different response to load (e.g. existing hypoe-
choic abnormality). Further research should focus on different
loads and subgroups.

REFERENCES
Visnes et al. Scan J Med Sci Sports. 2014;[Epub]
Cook et al. J Ultrasound Med. 2000;19:473–479

16 MATRIX THERAPY WITH REGENERATING AGENT


IMPROVES HORSE TENDONITIS’ RECOVERY
1,2
D Barritault, 3N Crevier-Denoix, 4AG Dupays, 4V Coudry, 4S Jacquet, 4D Carnicer,
4
F Audigié, 3L Desquilbet, 3P Pourcelot, 1F Siñeriz, 1K Kichenin, 1S Filipe, 1L Sissoëff,
4
JM Denoix. 1OTR3 SAS, France; 2Paris-Est University, UMR CNRS 7149, France;
3
Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, France; 4CIRALE – Hippolia,
INRA USC BPLC 957, ENVA-UPEC, France

Abstract 15 Figure 1 Mean echo-type I and II percentages during 10.1136/bjsports-2014-094114.16


tournament days

A10 Br J Sports Med 2014;48(Suppl 2):A1–A76


Downloaded from http://bjsm.bmj.com/ on June 9, 2015 - Published by group.bmj.com

14 Exercise Programs To Decrease Pain In Athletes


With Patellar Tendinopathy In-season: A Rct
Mathijs van Ark, Jill Cook, Sean Docking, Johannes Zwerver, James Gaida, Inge van
den Akker-Scheek and Ebonie Rio

Br J Sports Med 2014 48: A9-A10


doi: 10.1136/bjsports-2014-094114.14

Updated information and services can be found at:


http://bjsm.bmj.com/content/48/Suppl_2/A9

These include:

Email alerting Receive free email alerts when new articles cite this article. Sign up in the box at the top
service right corner of the online article.

Notes

To request permissions go to:


http://group.bmj.com/group/rights-licensing/permissions

To order reprints go to:


http://journals.bmj.com/cgi/reprintform

To subscribe to BMJ go to:


http://group.bmj.com/subscribe/

Das könnte Ihnen auch gefallen