Effectiveness of fascial manipulation® versus eccentric training with static stretching on patellar tendinopathy – A randomized clinical trial

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.