PT Unknown
AU Niering, M
TI Physical, psychological, and injury-related parameters in male youth soccer players with patellar tendinopathy: aspects of assessment and training
PD 08
PY 2024
DI 10.17185/duepublico/82281
LA en
DE Überlastungsschaden; Sportverletzung; Jugendsport
AB Background and objectives Many adolescent soccer players suffer from patellar tendinopathy, which can result in periods of absence over many months, or even years, and even giving up the sport. Since conventional therapy programmes often do not lead to complete remission of symptoms, many athletes often return to competition before full recovery. This can lead not only to increased susceptibility to injury but also to reduced performance. The aim of this dissertation was therefore to investigate physical and psychological performance as well as injury- and pain-related parameters after therapy. The cross-sectional study (STUDY I) examined the difference between healthy and affected players, the meta-analysis (STUDY II) summarized the state of treatment methods and the intervention study (STUDY III) investigated the effects of a novel therapeutic intervention. Methods Physical, psychological, and injury-related parameters were analysed as part of a systematic review with meta-analysis, a cross-sectional study, and an intervention study. The cross-sectional study (STUDY I) examined differences between healthy (n = 17, age: 15.0 ± 1.0 years) and post-treatment soccer players with patellar tendinopathy (n = 18, age: 15.1 ± 0.8 years). Regarding the meta-analysis (STUDY II), a computerised systematic literature search was conducted in the electronic databases PubMed, Medline, and Web of Science from January 1960 to July 2020 examining 277 subjects (mean age 16–32 years). The intervention study (STUDY III) investigated the results of a conventional (n = 18, age: 15.1 ± 0.8 years) compared to a novel (n = 16, age: 15.4 ± 1.0 years) therapy program. In the cross-sectional and intervention study (STUDY I and III) muscle power (drop jump, jump-and-reach), change of direction speed (modified agility T-test), linear speed (30-m linear sprint, tapping test), endurance (Yo-Yo intermittent recovery test level 1), achievement motivation (Achievement Motive Scale-Sport), and injury-/pain-related data were assessed at four time points over 20 weeks after completion of therapy to measure long-term outcomes. The interventions carried out included a conventional eccentric strength training programme with a pain-adapted rest before starting, as well as a novel intervention programme that started immediately regardless of pain level and added additional cognitive tasks and instability strength training to the eccentric training. Results Regarding the cross-sectional study (STUDY I), athletes with patellar tendinopathy following treatment showed significantly worse physical performance over the entire measurement period, as well as inferior psychological performance in the first six weeks, compared to healthy players. In addition, there were significantly higher rates of injury to the lower limbs, as well as training interruptions due to injury and pain, indicating relevant long-term impairments. The meta-analysis (STUDY II) revealed that only three out of eleven studies conducted follow-up measurements after the end of therapy, which highlights the research gap in long-term treatment results. The heterogeneous results indicate that physical exercise is an effective therapy for improving pain intensity and symptom severity, but not physical performance. Concerning the intervention study (STUDY III), the alternative approach achieved greater improvements in physical performance, the same enhancements in psychological measures, and better values for injury-related or pain-related correlates. The novel intervention required a shorter duration of therapy compared to the conventional programme and significantly improved change of direction speed as well as injury- and pain-related parameters. Conclusions The cross-sectional study (STUDY I) showed that youth players with patellar tendinopathy exhibit physical and psychological performance impairments even after completing therapy, which increases the risk of injury and compromises career development. The results of the meta-analysis (STUDY II) highlighted that various methods of exercise therapy are effective, but little is known about the long-term effects on sport-specific performance. The intervention study (STUDY III) demonstrated that complex pathogenesis requires a multimodal therapeutic intervention characterised by increased complexity and intensity. Further research should investigate the effects of patellar tendinopathy on other psychological parameters and adapt the interventions more individually to the performance-determining factors of the sport.
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