与等张收缩相比，等长收缩在减轻季节性髌骨肌腱病运动员疼痛方面的有效性,Journal of Sport Rehabilitation

2025-10-13 14:59:03

临床情景：髌腱病是一种常见的肌肉骨骼疾病，影响下肢，对于处于赛季中的运动员来说是一种难以治疗的疾病。为了促进功能改善和减轻疼痛，髌腱病的初始治疗通常是保守的。传统的干预措施可能包括离心训练、冷冻疗法、髌骨反力带、口服消炎药、注射剂、超声导入、离子导入、矫形器、治疗性超声和体外冲击波。此外，最近的文献表明，实施等长和等张收缩可能有效减轻髌腱疼痛。重点临床问题：与等张收缩相比，等长收缩在减轻季节性髌腱病运动员疼痛方面的效果如何？主要发现摘要：实施等长和等张运动在 4 周的短期内从统计学上降低了季节性运动员的疼痛水平；然而，与等张收缩相比，等长收缩在干预后 45 分钟内立即提供了统计学上更大的疼痛缓解。临床底线：目前的证据支持使用等长收缩和等张收缩来减轻有髌腱病的季节性运动员的疼痛。根据回顾的文献，临床医生应考虑使用重负荷等长训练或渐进的重负荷等渗运动，这表明干预后立即和两个干预组的 4 周随访时疼痛水平均有所降低。等长收缩似乎在干预后立即提供更大的疼痛缓解。推荐强度：来自 2 项 2 级随机对照试验和 1 项 3 级随机交叉研究的 B 级证据支持使用等长收缩和等张收缩来减轻季节性运动员的髌腱疼痛。

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The Effectiveness of Isometric Contractions Compared With Isotonic Contractions in Reducing Pain For In-Season Athletes With Patellar Tendinopathy

Clinical Scenario: Patellar tendinopathy is a common musculoskeletal disorder affecting the lower-extremities and a difficult condition to manage for athletes that are in season. To facilitate improvement in function and to decrease pain, initial treatment for patellar tendinopathy is typically conservative. Traditional interventions may include eccentric training, cryotherapy, patellar counterforce straps, oral anti-inflammatories, injectable agents, phonophoresis, iontophoresis, orthotics, therapeutic ultrasound, and extracorporeal shockwave. In addition, recent literature suggests that implementing isometric and isotonic contractions may be effective in reducing patellar tendon pain. Focused Clinical Question: How effective are isometric contractions compared with isotonic contractions in reducing pain for in-season athletes with patellar tendinopathy? Summary of Key Findings: Implementation of isometric and isotonic exercises statistically reduced pain levels in the short term of 4 weeks for in-season athletes; however, isometric contractions provided statistically greater pain relief immediately for up to 45 minutes postintervention compared with isotonic contractions. Clinical Bottom Line: Current evidence supports the use of isometric and isotonic contractions to reduce pain for in-season athletes with patellar tendinopathy. Based on the reviewed literature, clinicians should consider utilizing heavy loaded isometrics or progressive heavy loaded isotonic exercises, which showed reduction in pain levels immediately after intervention and at 4-week follow-up for both intervention groups. Isometric contractions appear to provide greater pain relief immediately after intervention. Strength of Recommendation: There is Grade B evidence from 2 level 2 randomized controlled trials and 1 level 3 randomized crossover study supporting the use of isometric and isotonic contractions to reduce patellar tendon pain for in-season athletes.