| Ruffino et al. 2021,[@127445] RCT, n=42, patellar tendinopathy |
1. Heavy slow resistance training (squat, hack squat, leg press). 2. Inertial Flywheel training (squat, leg press, knee extension). 12 weeks |
Sets: 4, Reps: 12(10 max effort), Freq: 1 x WK, Prog: NR, Int: 8-RM, reps 1–2 were used for increasing the inertial resistance, and reps 3–12 were executed
with maximal effort. Rest: 2-3 MIN between sets. Session time: 20 MIN |
Three custom inertial flywheel machines: 2-legged squat, leg press and knee extension (Ivolution, Sunchales, Argentina). Each coupled concentric and eccentric actions were completed with a repetition cycle of about 3 seconds. Inertia loads were: 2.5 kg flywheel (moment inertia 0.05 kg/m2) from week 1-6 and 4 kg flywheel (moment inertia 0.10 kg/m2) from week 6-12. |
Pain & function (VISA-P), Patient Specific Functional Scale (PSFS), health status (EuroQol-5D), patient impression of change on pain and function, adherence, adverse events, pain provocation test for the patellar tendon (0-10), physical tests (strength & power), patellar tendon thickness and doppler signal on ultrasound. |
Both groups improved clinical outcomes, with no significant difference between groups in clinical outcomes, physical tests (strength & power), or tendon thickness & neovascularization. Adherence: diary, 88% (HSRT), 90% (Flywheel). |
| Romero-rodriguez et al.[@127446] 2011, case series, n=10, patellar tendinopathy |
1. Isoinertial flywheel ECCT, maximal effort, leg press, 6 weeks |
Sets: 4, Reps: 10, Freq: 1 x WK, Prog: NR, Int: 8-RM, reps 1–2 were used for increasing the
inertial resistance, and reps 3–10 were executed
with maximal effort. Rest: 2 MIN between sets. Session time: 20 MIN. |
Leg press device, provided by the manufacturer (YoYo Technology AB, Stockholm, Sweden). The concentric phase was executed from about 90º degrees knee angle to almost full extension about the knee joint.
Subjects were instructed to resist gently during the first two thirds of the eccentric action and then apply maximal force to bring the wheel to a stop at approximately 90º. Thus, eccentric overload was achieved in the last third of any eccentric action. |
Pain (VAS), function (VISA-P), lower limb maximal strength and vertical counter-movement-jump (CMJ) height. Surface electromyography (SEMG) |
Intervention was effective for improving clinical outcomes. Eccentric strength increased but power (CMJ) did not.
Adherence: NR |
| Abat et al.[@127447] 2014, cohort, n=33, patellar tendinopathy |
1. Intratissue Percutaneous Electrolysis (EPI) + Flywheel training, Isoinertial leg press training machine, 12 weeks |
Sets: 3, Reps: 10, Freq: 2 x WK, Prog: always maximum intensity, Int: 10-RM. |
Isoinertial resistance machines (YoYoTM Technology AB, Stockholm, Sweden). Each repetition was performed with the concentric phase with both extremities whereas the eccentric phase was only performed with the affected limb at a maximum 60º of knee flexion. |
Pain & function (VISA-P), Tegner scale, Roles and Maudsley scale. |
Significant improvement in pain & function
Adherence: supervised, %NR |
| Abat et al.[@127448] 2015, cohort, n=40, patellar tendinopathy |
1. Intratissue Percutaneous Electrolysis (EPI) + Isoinertial ECCT, leg press machine, 12 weeks |
Sets: 3, Reps: 10, Freq: 2 x WK, Prog: NR, Int: 10-RM |
Resistance isoinertial leg-press machine (YoYoTM Technology AB, Stockholm, Sweden). Each repetition was performed with the concentric phase with both extremities, whereas the eccentric phase was only performed with the affected limb at a maximum of 60º of knee flexion. |
Pain & function (VISA-P), Tegner score, Blazina’s classification, Roles and Maudsley scale. |
Combination was effective for improving clinical outcomes. Adherence: supervised, %NR |