Lower limb strength in patellar tendinopathy - A systematic review with meta-analysis

ObjectiveThis review aimed to investigate whether lower limb strength is reduced in people with patellar tendinopathy (PT) compared to asymptomatic controls.MethodsThis study was a systematic review and meta-analysis of peer-reviewed, English language case-control studies. MEDLINE, PubMed, Scopus, a...

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Published in:Journal of athletic training 2023-04
Main Authors: Obst, Steven J, Peterson, Benjamin, Heales, Luke J
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Language:English
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Asymptomatic
Clinical Diagnosis
Control Groups
Meta Analysis
Muscular Strength
Physical Fitness
Systematic review
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Peterson, Benjamin
Heales, Luke J
description ObjectiveThis review aimed to investigate whether lower limb strength is reduced in people with patellar tendinopathy (PT) compared to asymptomatic controls.MethodsThis study was a systematic review and meta-analysis of peer-reviewed, English language case-control studies. MEDLINE, PubMed, Scopus, and Web of Science were searched to identify all English-language studies published prior to the 26th of October 2022. Eligible studies included participants with a clinical diagnosis of PT, and asymptomatic controls, who had an objective measure of lower limb maximal strength. Random-effects models (Hedges' g) were used to calculate the pooled effect size (ES) of muscle strength according to the direction of joint movement and type of contraction.ResultsTwenty-three studies were included. Twenty studies reported knee strength, three reported hip strength, and one reported ankle strength. The pooled ESs (95%CI) for maximal voluntary isometric knee extension strength, concentric knee extension strength, and concentric knee flexion strength were 0.54 (0.27 – 0.80), 0.78 (0.30 – 1.33), and 0.41 (0.04 – 0.78), all favoring greater strength in the asymptomatic control group. Two studies reported maximal eccentric knee extensor strength with no differences between PT and asymptomatic controls. Three studies reported maximal hip strength (abduction, extension, and external rotation) and all within-study ESs favored greater strength in the asymptomatic control group.ConclusionIsometric and concentric knee extensor strength is reduced in people with PT compared to asymptomatic controls. In contrast there is limited and inconsistent evidence for reduced knee extension eccentric strength in PT, compared with asymptomatic controls. While there is emerging evidence that both knee flexion strength and hip strength may be reduced in PT more research is needed to confirm this observation.
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MEDLINE, PubMed, Scopus, and Web of Science were searched to identify all English-language studies published prior to the 26th of October 2022. Eligible studies included participants with a clinical diagnosis of PT, and asymptomatic controls, who had an objective measure of lower limb maximal strength. Random-effects models (Hedges' g) were used to calculate the pooled effect size (ES) of muscle strength according to the direction of joint movement and type of contraction.ResultsTwenty-three studies were included. Twenty studies reported knee strength, three reported hip strength, and one reported ankle strength. The pooled ESs (95%CI) for maximal voluntary isometric knee extension strength, concentric knee extension strength, and concentric knee flexion strength were 0.54 (0.27 – 0.80), 0.78 (0.30 – 1.33), and 0.41 (0.04 – 0.78), all favoring greater strength in the asymptomatic control group. Two studies reported maximal eccentric knee extensor strength with no differences between PT and asymptomatic controls. Three studies reported maximal hip strength (abduction, extension, and external rotation) and all within-study ESs favored greater strength in the asymptomatic control group.ConclusionIsometric and concentric knee extensor strength is reduced in people with PT compared to asymptomatic controls. In contrast there is limited and inconsistent evidence for reduced knee extension eccentric strength in PT, compared with asymptomatic controls. While there is emerging evidence that both knee flexion strength and hip strength may be reduced in PT more research is needed to confirm this observation.</description><identifier>ISSN: 1062-6050</identifier><identifier>EISSN: 1938-162X</identifier><identifier>DOI: 10.4085/1062-6050-0662.22</identifier><language>eng</language><publisher>Dallas: National Athletic Trainers Association</publisher><subject>Asymptomatic ; Clinical Diagnosis ; Control Groups ; Meta Analysis ; Muscular Strength ; Physical Fitness ; Systematic review</subject><ispartof>Journal of athletic training, 2023-04</ispartof><rights>Copyright National Athletic Trainers Association Apr 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2802687586/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2802687586?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,786,790,21406,21422,27957,27958,33646,33912,43768,43915,74578,74754</link.rule.ids></links><search><creatorcontrib>Obst, Steven J</creatorcontrib><creatorcontrib>Peterson, Benjamin</creatorcontrib><creatorcontrib>Heales, Luke J</creatorcontrib><title>Lower limb strength in patellar tendinopathy - A systematic review with meta-analysis</title><title>Journal of athletic training</title><description>ObjectiveThis review aimed to investigate whether lower limb strength is reduced in people with patellar tendinopathy (PT) compared to asymptomatic controls.MethodsThis study was a systematic review and meta-analysis of peer-reviewed, English language case-control studies. MEDLINE, PubMed, Scopus, and Web of Science were searched to identify all English-language studies published prior to the 26th of October 2022. Eligible studies included participants with a clinical diagnosis of PT, and asymptomatic controls, who had an objective measure of lower limb maximal strength. Random-effects models (Hedges' g) were used to calculate the pooled effect size (ES) of muscle strength according to the direction of joint movement and type of contraction.ResultsTwenty-three studies were included. Twenty studies reported knee strength, three reported hip strength, and one reported ankle strength. The pooled ESs (95%CI) for maximal voluntary isometric knee extension strength, concentric knee extension strength, and concentric knee flexion strength were 0.54 (0.27 – 0.80), 0.78 (0.30 – 1.33), and 0.41 (0.04 – 0.78), all favoring greater strength in the asymptomatic control group. Two studies reported maximal eccentric knee extensor strength with no differences between PT and asymptomatic controls. Three studies reported maximal hip strength (abduction, extension, and external rotation) and all within-study ESs favored greater strength in the asymptomatic control group.ConclusionIsometric and concentric knee extensor strength is reduced in people with PT compared to asymptomatic controls. In contrast there is limited and inconsistent evidence for reduced knee extension eccentric strength in PT, compared with asymptomatic controls. While there is emerging evidence that both knee flexion strength and hip strength may be reduced in PT more research is needed to confirm this observation.</description><subject>Asymptomatic</subject><subject>Clinical Diagnosis</subject><subject>Control Groups</subject><subject>Meta Analysis</subject><subject>Muscular Strength</subject><subject>Physical Fitness</subject><subject>Systematic review</subject><issn>1062-6050</issn><issn>1938-162X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ALSLI</sourceid><sourceid>CJNVE</sourceid><recordid>eNo1jk1LAzEYhIMoWKs_wFvAc2o-Ntl3j6WoFRa8VPBWsukbm7JfblKX_fcuqKeZYZjhIeRe8FXGQT8KbiQzXHPGjZErKS_IQhQKmDDy43L2__01uYnxxLmQujAL8l52Iw60Dk1FYxqw_UxHGlra24R1bQeasD2EtpvzcaKMrmmcYsLGpuDogN8BRzqGedNgssy2tp5iiLfkyts64t2fLsnu-Wm32bLy7eV1sy5ZnwvJwHuXZQenTOWEqoSvTCYLZ5QGDh4zNVMCcK8VOIm5yyCvFKDiugKvhVBL8vB72w_d1xlj2p-68zAzxL0ELg3kGoz6AVGQUlk</recordid><startdate>20230401</startdate><enddate>20230401</enddate><creator>Obst, Steven J</creator><creator>Peterson, Benjamin</creator><creator>Heales, Luke J</creator><general>National Athletic Trainers Association</general><scope>0-V</scope><scope>3V.</scope><scope>4U-</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88G</scope><scope>8A4</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0P</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope></search><sort><creationdate>20230401</creationdate><title>Lower limb strength in patellar tendinopathy - A systematic review with meta-analysis</title><author>Obst, Steven J ; 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MEDLINE, PubMed, Scopus, and Web of Science were searched to identify all English-language studies published prior to the 26th of October 2022. Eligible studies included participants with a clinical diagnosis of PT, and asymptomatic controls, who had an objective measure of lower limb maximal strength. Random-effects models (Hedges' g) were used to calculate the pooled effect size (ES) of muscle strength according to the direction of joint movement and type of contraction.ResultsTwenty-three studies were included. Twenty studies reported knee strength, three reported hip strength, and one reported ankle strength. The pooled ESs (95%CI) for maximal voluntary isometric knee extension strength, concentric knee extension strength, and concentric knee flexion strength were 0.54 (0.27 – 0.80), 0.78 (0.30 – 1.33), and 0.41 (0.04 – 0.78), all favoring greater strength in the asymptomatic control group. Two studies reported maximal eccentric knee extensor strength with no differences between PT and asymptomatic controls. Three studies reported maximal hip strength (abduction, extension, and external rotation) and all within-study ESs favored greater strength in the asymptomatic control group.ConclusionIsometric and concentric knee extensor strength is reduced in people with PT compared to asymptomatic controls. In contrast there is limited and inconsistent evidence for reduced knee extension eccentric strength in PT, compared with asymptomatic controls. While there is emerging evidence that both knee flexion strength and hip strength may be reduced in PT more research is needed to confirm this observation.</abstract><cop>Dallas</cop><pub>National Athletic Trainers Association</pub><doi>10.4085/1062-6050-0662.22</doi><oa>free_for_read</oa></addata></record>
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subjects Asymptomatic
Clinical Diagnosis
Control Groups
Meta Analysis
Muscular Strength
Physical Fitness
Systematic review
title Lower limb strength in patellar tendinopathy - A systematic review with meta-analysis
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