Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy
#reconstrucción de LCA #isometric exercise #patellar tendinopathy
Fuente
Este artículo es originalmente publicado en:
http://www.ncbi.nlm.nih.gov/pubmed/25979840
http://bjsm.bmj.com/content/early/2015/05/15/bjsports-2014-094386.long
Rio E1, Kidgell D2, Purdam C3, Gaida J4, Moseley GL5, Pearce AJ6, Cook J1
Br J Sports Med. 2015 May 15. pii: bjsports-2014-094386. doi: 10.1136/bjsports-2014-094386. [Epub ahead of print] Todos los derechos reservados para:
Copyright © 2015 BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine
Written by Lewis Ingram. Posted in Knee
Revisión de la reconstruccion del LCA y vuelta al deporte
La revisión de una reconstrucción de ligamento cruzado anterior (LCA) es un procedimiento cada vez más utilizado debido al alto número de reconstrucciones de LCA primarias y fracasos. La siguiente revisión subrayó que el 84% de los pacientes que fueron sometidos a una revisión de la reconstrucción de LCA, han vuelto a desarollar actividades deportivas; un 53% de los mismos, volviendo a su nivel anterior.
Dos resultados importantes tras la revisión de la reconstrucción y revisión primaria de LCA incluyen la capacidad para volver al deporte y alcanzar el nivel anterior a la lesión. El propósito de este meta-análisis fue determinar el índice de retorno al deporte tras la revisión de reconstrucción del LCA.
Se llevó a cabo una búsqueda sistemática, con 16 estudios identificados y seleccionados específicamente centrados en el retorno al deporte, vuelta al nivel previo a la lesión deportiva y la vuelta al deporte de alto nivel.
La media final de vuelta al deporte tras la revisión de reconstrucción de ACL fue de 4,7 años. El regreso al nivel deportivo previo a la lesión fue alcanzado en el 53,4% de los casos. Una diferencia de menos de 5mm de lado a lado durante las evaluaciones antriométricas, la prueba de grado I-II y de pivot shift se observaron en un 88% y 93% de los sujetos, respectivamente. A pesar del hecho de que 8 de 10 pacientes volvieron a practicar deporte tras una revisión de reconstrucción del LCA, sólo la mitad volvió a su nivel anterior.
> De: Grassi et al., Br J Sports Med (2015) (Publ. antes de impresión). Todos los derechos reservados: BMJ Publishing Group Ltd.Pincha aquí para acceder al resumen de Pubmed.. Traducido por Carmen Velasco.
Abstract
BACKGROUND:
Few interventions reduce patellar tendinopathy (PT) pain in the short term. Eccentric exercises are painful and have limited effectiveness during the competitive season. Isometric and isotonic muscle contractions may have an immediate effect on PT pain.
METHODS:
This single-blinded, randomised cross-over study compared immediate and 45 min effects following a bout of isometric and isotonic muscle contractions. Outcome measures were PT pain during the single-leg decline squat (SLDS, 0-10), quadriceps strength on maximal voluntary isometric contraction (MVIC), and measures of corticospinal excitability and inhibition. Data were analysed using a split-plot in time-repeated measures analysis of variance (ANOVA).
RESULTS:
6 volleyball players with PT participated. Condition effects were detected with greater pain relief immediately from isometric contractions: isometric contractions reduced SLDS (mean±SD) from 7.0±2.04 to 0.17±0.41, and isotonic contractions reduced SLDS (mean±SD) from 6.33±2.80 to 3.75±3.28 (p<0.001). Isometric contractions released cortical inhibition (ratio mean±SD) from 27.53%±8.30 to 54.95%±5.47, but isotonic contractions had no significant effect on inhibition (pre 30.26±3.89, post 31.92±4.67; p=0.004). Condition by time analysis showed pain reduction was sustained at 45 min postisometric but not isotonic condition (p<0.001). The mean reduction in pain scores postisometric was 6.8/10 compared with 2.6/10 postisotonic. MVIC increased significantly following the isometric condition by 18.7±7.8%, and was significantly higher than baseline (p<0.001) and isotonic condition (p<0.001), and at 45 min (p<0.001).
CONCLUSIONS:
A single resistance training bout of isometric contractions reduced tendon pain immediately for at least 45 min postintervention and increased MVIC. The reduction in pain was paralleled by a reduction in cortical inhibition, providing insight into potential mechanisms. Isometric contractions can be completed without pain for people with PT. The clinical implications are that isometric muscle contractions may be used to reduce pain in people with PT without a reduction in muscle strength.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
KEYWORDS:
Exercise; Knee; Neuromuscular; Sports & exercise medicine; Tendinopathy
- PMID:
- 25979840
- [PubMed – as supplied by publisher]
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