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The Effect of Isotonic Versus Isometric Strength Exercise for Pain and Strength in Proximal Hamstring Tendinopathy: A
Aidan L F Rich1,2, Jon J Ford1,3, Jillianne L Cook1
1School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
Objective:
The effect of isometric exercise on pain and strength for various tendinopathies has been investigated but there are no published studies on proximal hamstring tendinopathy (PHT). The objective of this trial was to determine the effectiveness of isometric versus isotonic exercise on pain and strength in people with PHT.
Design:
Prospective, crossover, assessor blinded randomized trial.
Setting:
Neuroplasticity laboratory at La Trobe University, Melbourne, Australia.
Participants:
A total of 20 participants with clinical features of PHT (greater than 3 months in duration) were included.
Interventions:
All participants completed 1 session of isometric and 1 session of isotonic exercise with a 3 to 7 days washout period between sessions. Participants were randomly allocated to the order of interventions.
Main Outcome Measures:
Primary outcomes were pain measured with a functional task (modified arabesque) assessed at 0 minutes, 45 minutes, and 24 hours postintervention, strength was measured with a dynamometer, assessed at 0 minutes and 45 minutes postintervention. A secondary outcome was pain with sitting assessed at 24 hours postintervention.
Results:
Of the 20 enrolled participants, 19 (95%) completed both intervention sessions. There were no statistically significant differences between groups at any timeframe for pain with a functional task, strength, or sitting symptoms. There was no significant difference in the number of participants who achieved a clinically relevant reduction in pain with a functional task or sitting symptoms.
Conclusion:
There were no differences between isometric and isotonic exercise for strength, pain with a functional task, or sitting symptoms in participants with PHT.
Key Points:
This is the first trial to evaluate the effect of isometric compared with isotonic exercise for pain and strength in PHT. No difference was found between groups. Selection of exercise type for PHT may be on a 'trial and error' basis and with consideration of long-term outcomes.
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