Comparative Effects of Heavy Slow Resistance Training and Eccentric Overload Training in Runners

March 10, 2025 updated by: Riphah International University

Comparative Effects of Heavy Slow Resistance Training and Eccentric Overload Training on Pain, Range of Motion, and Lower Extremity Functions in Runners With Patellar Tendinopathy

Patellar Tendinopathy (PT) also known as Jumper's knee, is characterized by multifaceted activity-related pathology causing anterior knee pain and patellar-tendon dysfunction. It most commonly affects athletic activities that involve jumping and running. Tendinopathy is most likely to be related to mechanical loading and overuse. Athletes suffer from insidious well-localized pain, typically as the athlete starts the activity. Conservative treatment is the first line of treatment in tendinopathy, however, there is no consensus regarding the best treatment. In acute conditions, relative rest rather than immobilization is preferred. The most popular non-operative treatment involves eccentric exercise (EE). It is commonly accepted that surgical treatment must be indicated in motivated patients if carefully followed conservative treatment (physical training, injections, ESWT) is unsuccessful after 3-6 months. In recent studies, isometric and heavy slow resistance (HSR) exercises have demonstrated potential for pain reduction and functional improvement in patellar tendinopathy.

A randomized controlled trial will be conducted at the Pakistan Sports Board (PSB) Coaching Center, Lahore. 18 Subjects will be randomized into two groups; Heavy slow resistance exercises plus eccentric exercises will be given to group A and exercises of 4 sets of 10-20 repetitions will be given. Group B will give Eccentric exercises in 3 sets of 10-20 repetitions. Pre-assessments will be taken through the Numeric Pain Rating Scale (NPRS) for pain, a goniometer for range of motion, Lower extremity function assessment scale to evaluate lower limb functional impairments, and a Visa-P scale for patellar dysfunction. Assessment will be done at baseline and post 4 weeks of training. Data will be analyzed using SPSS software version 21. The normality of data will be checked, and tests will be applied according to the normality of the data, either parametric or non-parametric tests will be used (within a group or between two groups).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The objective of the study is to compare the effects of heavy slow resistance training and eccentric overload training on pain, range of motion, and lower extremity functions in runners with patellar tendinopathy.

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Study Type

Interventional

Enrollment (Actual)

30

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab
      • Lahore, Punjab, Pakistan
        • Pakistan Sports Board coaching center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • anterior knee pain located on the inferior pole of the patella for at least 3 months while practicing sport;
  • age between 18 and 45 years old;
  • practicing any kind of sports at least 3 times a week
  • score less than 80 on the Victorian Institute of Sport Assessment-Patellar questionnaire (VISA-p).

Exclusion Criteria:

  • Knee surgery within the previous 6 months;
  • Chronic joint diseases;
  • Corticosteroid injection in the patellar tendon within the previous 3 months;
  • Anti-inflammatory, analgesic, or antibiotic medications within the previous 48 hours;
  • Any other concomitant treatment for PT

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group A (Heavy Slow Resistance exercises)
Other: Group A (Heavy Slow Resistance exercises)
Pre - assessment will be taken. Heavy slow resistance exercises will be given to group A and exercises of 4 sets of 10-20 repetitions will be given
Experimental: Group B (Eccentric exercises).
Other: : Group B (Eccentric exercises)
Sessions should be conducted 2 times per week, similar to Group A, in 3 sets of 10-20 repetitions. Exercises focus solely on eccentric loading, such as eccentric squats, eccentric leg presses, and step-down exercises.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire
Time Frame: 4 weeks
This brief questionnaire assesses (i) symptoms, (ii) simple tests of function and (in') ability to play sport. Six of the eight questions are scored on a visual analogue scale from 0-10 with 10 representing optimal health. The maximal VISA score for an asymptomatic, fully performing individual is 100 points and the theoretical minimum is 0 points. We found the VISA scale to have excellent short-term test retest, and inter-tester reliability both, r>0.95 as well as good short-term stability (r=0.87).(14)
4 weeks
NPRS
Time Frame: 4 weeks
For the NPRS, the intraclass correlation coefficient (ICC) for all subjects is .76 (p < .0001). The ICC, however, is .90 (p < .0001)(15)
4 weeks
Goniometer
Time Frame: 4 weeks
Goniometric measurements are used to quantify baseline limitations of motion, decide on appropriate therapeutic interventions, and document the effectiveness of these interventions
4 weeks
LEFS
Time Frame: 4 weeks
The Lower Extremity Functional Scale (LEFS) is a questionnaire containing 20 questions about a person's ability to perform everyday tasks. The LEFS can be used by clinicians as a measure of patients' initial function, ongoing progress and outcome, as well as to set functional goals. Internal consistency is α=.96 (N=107). Test-retest reliability estimates were R=.86 (95% lower limit CI=.80) for the entire sample (n=98) and R=.94 (95% lower limit CI=.89) for the subset of patients with more chronic conditions (n=31)
4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Aamir Gul Memon, MS, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2024

Primary Completion (Actual)

August 1, 2024

Study Completion (Actual)

September 30, 2024

Study Registration Dates

First Submitted

March 10, 2025

First Submitted That Met QC Criteria

March 10, 2025

First Posted (Actual)

March 25, 2025

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

March 10, 2025

Last Verified

March 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR & AHS/24/0417

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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