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Eccentric training in chronic painful impingement syndrome of the shoulder: results of a pilot study
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Handkirurgi.
Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Diagnostisk radiologi.
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
2006 (engelsk)Inngår i: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 14, nr 1, s. 76-81Artikkel i tidsskrift (Fagfellevurdert) Published
sted, utgiver, år, opplag, sider
2006. Vol. 14, nr 1, s. 76-81
Emneord [en]
Adult, Aged, Chronic Disease, Exercise Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Muscle; Skeletal/physiopathology, Pain Measurement, Patient Satisfaction, Pilot Projects, Prospective Studies, Shoulder Impingement Syndrome/physiopathology/*rehabilitation, Treatment Outcome
HSV kategori
Identifikatorer
URN: urn:nbn:se:umu:diva-16999DOI: 10.1007/s00167-004-0611-8PubMedID: 15877219OAI: oai:DiVA.org:umu-16999DiVA, id: diva2:156672
Tilgjengelig fra: 2007-10-25 Laget: 2007-10-25 Sist oppdatert: 2018-06-09bibliografisk kontrollert
Inngår i avhandling
1. Eccentric training in the treatment of tendinopathy
Åpne denne publikasjonen i ny fane eller vindu >>Eccentric training in the treatment of tendinopathy
2009 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Chronic painful tendinopathies are common, not only in sports and recreationally active people, but also among people with a sedentary lifestyle. Both the lower and upper limbs are affected. There is lack of knowledge about the etiology and pathogenesis to tendinopathy, and many different treatments options have been presented. Unfortunately, most treatments have not been tested in scientific studies. Conservative (non-surgical) treatment has since long shown unsatisfactory results and surgical treatment is known to give unpredictable results.

The aim of this thesis was to evaluate new models of painful eccentric training for the conservative treatment of different chronic tendinopathies. After promising results in a pilot study, using painful eccentric calf muscle training in patients with chronic mid-portion Achilles tendinopathy, we investigated if these results could be reproduced in a larger group of patients with both mid-portion and insertional Achilles tendinopathy (study I). After 12 weeks, 89% of the patients with pain from the mid-portion were satisfied and back in previous activities. In the group with insertional Achilles tendinopathy the results were poor. A new model for eccentric training was designed for patients with insertional Achilles tendinopathy. The eccentric calf muscle training was done from tip-toe to floor level (study II). With this new regimen 67% of the patients were satisfied and back in previous activities. The next step was to investigate the effects of painful eccentric quadriceps training on patients with jumper´s knee/patellar tendinopathy (study III). Two different training protocols were used. Eccentric training performed on a 250 decline board showed promising results with reduced pain and a return to previous activities, while eccentric training without the decline board had poor results. In a following prospective study, patients with jumper´s knee/patellar tendinopathy were randomised to either concentric or eccentric painful quadriceps training on a 250 decline board (study IV). After 12 weeks of training, there were significantly better results in the group that did eccentric training. In a pilot study (study V), we investigated painful eccentric deltoideus and supraspinatus muscle training on a small group of patients on the waiting list for surgical treatment of subacromial impingement syndrome. After 12 weeks of training, 5 out of 9 patients were satisfied with the results of treatment and withdrew from the waiting list for surgery.

In conclusion, the present studies showed good clinical results with low risks of side effects and low costs. Thus, we suggest that painful eccentric training should be tried in patients with Achilles and patellar tendinopathy before intratendinous injections and surgery are considered. For patients with chronic painful impingement syndrome, the results of our small pilot study are interesting, and stimulates to randomised studies on larger materials.

sted, utgiver, år, opplag, sider
Umeå: Department of Surgical and Perioperative Sciences, Sports Medicine, 2009. s. 89
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 1279
Emneord
Eccentric training, Achilles tendon, patellar tendon, supraspinatus tendon, impingement, tendinopathy, tendinosis
Identifikatorer
urn:nbn:se:umu:diva-25856 (URN)978-91-7264-821-0 (ISBN)
Utgiver:
Idrottsmedicin, 901 87, Umeå
Disputas
2009-10-09, KBC-huset, hörsal KB3B1, Umeå, 09:00 (svensk)
Opponent
Veileder
Tilgjengelig fra: 2009-09-17 Laget: 2009-09-08 Sist oppdatert: 2010-01-18bibliografisk kontrollert

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