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Effectiveness of fascial manipulation® versus eccentric training with static stretching on patellar tendinopathy - A
Rajasekar Sannasi1, K V N Dinesh2, Parth H Patel3
1Institute of Physiotherapy, Srinivas University, Mangalore, 575 001, Karnataka, India; Department of Physiotherapy, College of Health Sciences, Gulf Medical Unviersity, Ajman, UAE.
Objective:
To compare the effectiveness of Fascial Manipulation® (FM) and eccentric training (ET) with static stretching in patellar tendinopathy.
Methods:
This randomized clinical trial was conducted at an outpatient physiotherapy department. A total of 88 patients with patellar tendinopathy were recruited and randomly allocated to either a 4-week ET program with static stretching or a once-weekly FM treatment for 4 weeks. The primary outcome measure was the Victorian Institute of Sport Assessment-Patella Kannada (VISA-P-K) questionnaire. Secondary outcomes included the Numerical Pain Rating Scale (NPRS), Pressure Pain Threshold (PPT), patellar tendon thickness assessed using colour Doppler ultrasonography, and a 6-point Likert scale to measure patient satisfaction. Paired and independent t-tests, along with repeated measures ANOVA, were used to analyse differences within and between groups. Post hoc analysis was applied to minimize familywise error.
Results:
Of the 88 subjects, 86 completed the study follow-up. The mean scores for VISA-P, NPRS, and PPT showed significant improvement (p < .001) in both groups at 4 weeks, 3 months, 6 months, and 1-year follow-up. The thickness of the hypoechoic area in the patellar tendon was reduced at 4 weeks in both groups. On the 6-point Likert scale, 80 % of patients in the FM group and 39 % in the ET group reported complete recovery. Both groups demonstrated a significant Effect Size Index (ESI) across all outcome measures at 4 weeks.
Conclusion:
While both Fascial Manipulation® and Eccentric Training with stretching led to similar improvements, Fascial Manipulation® appears to be superior in terms of the number of treatment sessions required and patient satisfaction.
