Banca de DEFESA: EDUARDO HENRIQUE DIAS ARAÚJO

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : EDUARDO HENRIQUE DIAS ARAÚJO
DATE: 11/11/2025
TIME: 14:00
LOCAL: Banca Remota, realizada em plataforma Google Meet
TITLE:

Evaluation and Treatment of Athletes with Patellar Tendinopathy with a Focus on the Kinetic Chain

KEY WORDS:

Tendon, tendinitis, knee, rehabilitation.

PAGES: 180
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Patellar tendinopathy is one of the most common causes of knee pain in athletes and causes significant functional limitation, which can culminate in abandonment of sports practice. Traditional protocols, such as Heavy Slow Resistance Training (HSR), have already been consolidated as effective for the rehabilitation of athletes with patellar tendinopathy, but do not contemplate relevant kinetic chain factors that can be important sources of knee overload. Objectives: Study 1 – To compare strength, flexibility and landing mechanics between athletes with patellar tendinopathy and healthy controls; Studies 2 and 3 – To evaluate the effects of an intervention based on kinetic chain factors compared to HSR on short- and long-term clinical and functional outcomes in athletes with patellar tendinopathy. Methods: Study 1 – Cross-sectional study with 32 athletes (16 with tendinopathy and 16 controls), evaluated for isometric hip, knee and ankle strength, quadriceps and hamstring flexibility, dorsiflexion range of motion (ROM) and landing mechanics [Landing Error Scoring System (LESS)]; Studies 2 and 3 – Double-blind randomized controlled trial with 28 athletes, allocated to Kinetic Chain Group (KCG, n=14) and HSR Group (HSRG, n=14), submitted to 12 weeks of supervised intervention (3x/week). Symptom severity [(Victorian Institute of Sport Assessment-Patella (VISA-P)], pain (numerical pain scale), global perception of change, isometric torque (handheld dynamometer), ankle dorsiflexion ROM (lunge test) and jump landing mechanics (LESS) were assessed and were assessed by a blinded researcher at baseline, after 12 weeks and after 6 months. The data were analyzed with generalized estimation equation tests, with intention-to-treat analysis. Results: Study 1 – Athletes with tendinopathy had significantly lower strength in all muscle groups [mean differences (MD) between 0.59 and 3.16 N·m/kg/m; p<0.01), lower dorsiflexion ROM [MD=8.35°; 95% confidence interval (95%CI)=5.95–10.73; p<0.001) and hamstring flexibility (MD=10.50°; 95%CI=1.75–19.25; p=0.005), in addition to a higher LESS score (MD=–5.18; 95%CI=–5.74 to –4.63; p<0.001). Studies 2 and 3 – The KCG showed a greater improvement in symptom severity (VISA-P) when compared to HSRG after 12 weeks (MD=14.14 points; 95%CI=0.92 to 27.35; p=0.02) and after 6 months (MD=14.28 points; 95%CI=3.56 to 25.00; p<0.001). The KCG also showed greater improvement in ankle dorsiflexion ROM (MD=3.70°; 95%CI=1.42 to 5.97; p<0.001) and in jump landing mechanics (MD=4.14 points; 95%CI=3.37 to 4.91; p<0.001) when compared to the HSRG. Isometric torque increased in all muscle groups with no differences between the groups (p>0.05). Conclusion: Athletes with patellar tendinopathy exhibit deficits in strength and flexibility in the lower limb, as well as changes in the movement pattern on the jump landing compared to healthy athletes. An intervention targeting kinetic chain factors produced a significantly greater improvement than the classical HSR protocol in symptom severity immediately after 12 weeks of intervention and 6 months after the end of interventions in athletes with patellar tendinopathy. These results highlight the importance of a comprehensive intervention in the rehabilitation of patellar tendinopathy, including not only progressive exercises for the patellar tendon, but also potential causative factors of overload in athletes.

COMMITTEE MEMBERS:
Presidente - 2316237 - RODRIGO SCATTONE DA SILVA
Interno - 2275864 - CAIO ALANO DE ALMEIDA LINS
Externo à Instituição - DANIEL FERREIRA MOREIRA LOBATO - UFTM
Externo à Instituição - GLAUKO ANDRE DE FIGUEIREDO DANTAS - UFDPar
Externo à Instituição - RODRIGO RIBEIRO DE OLIVEIRA - UFC