The effect of resistance training versus other type of exercise for pain and function for patellar tendinopathy: a systematic review

Background: Patients diagnosed with patellar tendinopathy (PT) are commonly treated with resistance training, although the most appropriate mode of resistance training is not clear. The purpose of this study is to evaluate the newest evidence and provide an updated review of what mode of resistance training provides the best effect regarding pain and function for treating PT. Methods: Systematic review with a narrative analysis using pain and function as primary outcome measurements. Scientific databases were searched in December 2021 and included Medline, CINAHL, Embase, PEDro, Epistemonikos and The Cochrane library. Studies investigating resistance training as an intervention compared to other types of exercise therapy or different modes of resistance training where included. The Cochrane risk of bias tool for randomised trials were used to assess the risk of bias. The National Health and Medicine Research Council Body of Evidence Framework was used to construct recommendations for clinical practice. Results: 11 randomised controlled trials were identified for this review. Two studies received a low risk of bias, six received some concerns regarding risk of bias, while three had a high risk of bias. Eccentric, concentric, isotonic, isometric, heavy slow resistance training, moderate slow resistance training and progressive tendon loading exercise were the different modes of resistance training included. Conclusion: The findings of this systematic review support the use of eccentric and heavy slow resistance training in treating patellar tendinopathy (grade B), while concentric exercises should not be the treatment of choice (grade D). Isotonic and isometric exercises is a satisfactory option (grade C). Moderate slow resistance and progressive tendon - loading exercises appears effective, but further research is needed (grade C)