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Abstract
Aim
To undertake a pilot study looking at the addition of transverse friction massage (TFM) to an exercise programme in treatment of infrapatellar tendinopathy to test design feasibility and assess if it can improve outcomes of pain and function.
Design
Comparative clinical trial approach with convenient sampling.
Setting
A private physiotherapy clinic.
Participants
Fourteen participants were allocated to group A (exercise, n = 6, mean age 38 years) or group B (TFM and exercise, n = 8, mean age 43 years).
Outcome measures
A blinded assessor measured the visual analogue score (VAS) for pain and the Victorian Institute of Sport Assessment Patellar score (VISA-P) for function before the first treatment and after the last.
Intervention
Both groups attended twice a week for 3 weeks completing an exercise programme of eccentric exercise on a decline board and proprioceptive exercises. Group B received TFM prior to exercise. Exercises were also completed at home.
Results
An independent t-test demonstrated that the pre/post change in scores were significantly better in group B for pain (t(12) = 2.388, P = 0.034) and function (t(12) = 2.469, P = 0.030) with medium effect (r = 0.57). In group A, a dependent t-test demonstrated a significant difference for outcomes after treatment when compared with before treatment for pain (t(5) = 3.181, P = 0.025) and function (t(5) = 5.209, P = 0.003) with high effect (r = 0.82 (VAS) and 0.92 (VISA-P)). In group B, a dependent t-test demonstrated a significant difference for outcomes after treatment when compared with before for pain (t(7) = 7.342, P = 0.0001) and function (t(7) = −6.527, P = 0.0001) with high effect (r = 0.94 (VAS) and 0.93 (VISA-P)).
Conclusion
This study demonstrated that the design was feasible with both groups significantly improving pain/function but with significantly greater change in group B who received TFM prior to exercise. Future studies should use a larger sample size with a wider sampling population and long-term outcome measures to further test the efficacy of TFM in this setting.
Acknowledgements
The authors would like to thank the Society of Orthopaedic Medicine especially Elaine Atkins (programme leader) and Mr Ramesh Vaswani (clinical supervisor). They would also like to thank those at the University of Middlesex for their support through the M.Sc. programme. The authors would also like to thank Nuffield Health for their funding towards completing the M.Sc. programme.