Ejercicios isométricos en tendinopatía rotuliana / Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy

#tendinopatia rotuliana #patellar tendinopathy  #Ejercicios isométricos #Isometric exercise


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
http://www.anatomia-fisioterapia.es/28-systems/musculoskeletal/lower-extremity/knee/1203-ejercicios-isometricos-en-tendinopatia-rotuliana
De:
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

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]

Ejercicios isométricos en tendinopatía rotuliana

La tendinopatía rotuliana (TR) o “rodilla de saltador” es frecuente y de difícil tratamiento, especialmente en lo que respecta al tratamiento del dolor a corto plazo. Mientras que el ejercicio excéntrico es la base actual del tratamiento, su eficacia es cuestionable en aquellos atletas que se encuentran en mitad de la temporada de competición. Existen cada vez más pruebas que apoyan la utilización de contracciones isométricas y bebidas isotónicas para una reducción inmediata del dolor de TR. Este estudio investigó el efecto que prueba que estos dos últimos mecanismos aliviarían el dolor en TR.

En un estudio aleatorio participaron 6 jugadores de voleibol en el que se compararon los efectos ocurridos inmediatamente y 45 minutos tras las contracciones isométricas e isotónicas. Ambas formas de contracción redujeron el dolor a través de las sentadillas de una sola pierna (SLDS). Las contracciones isométricas fomentan una inhibición cortical, mientras que las bebidas isotónicas no. Además, el alivio del dolor en 45 minutos se sostuvo sólo después de las contracciones isométricas.

Este estudio demostró que ya con un corto periodo de entrenamiento isométrico se reducía el dolor de TR inmediatamente y durante al menos 45 minutos después. La información sobre su mecanismo fue proporcionada por el aumento simultáneo de inhibición cortical.

> De: Rio 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.