Extended Restitution Between Sessions Does Not Enhance the Benefits of 12 Weeks Exercise-Based Treatment for Patellar Tendinopathy: A Randomized Controlled Clinical Trial (The TEREX Trial).

Extended restitution between exercise sessions did not provide superior outcomes compared to shorter restitution for patellar tendinopathy treatment.

• 52 participants with chronic patellar tendinopathy were randomized to either short restitution (SR, 3 exercise days/week) or extended restitution (ER, 1 exercise day/week) groups.
• No statistically significant group differences were found for any of the primary or secondary outcomes.
• No group differences were found in self-reported improvement or satisfaction with function or treatment at week 12.
• Both groups performed the same resistance exercises (leg press and knee extension) with load progressing from ~60% to ~75% of 1 RM, plus restricted impact activities.

Both treatment groups achieved significant improvements in clinical outcomes and muscular strength over the 12-week intervention.

• Improvements were observed in function and symptoms as measured by the VISA-P questionnaire in both groups.
• Tendon pain during activity measured by NRS improved significantly in both groups.
• Muscular strength gains were attained in both the SR and ER groups.
• Functional test performance showed improvements in both groups without significant between-group differences.

Neither treatment group showed improvements in jumping height or tendon structure after 12 weeks of exercise-based rehabilitation.

• Jumping height did not improve in either the SR (3 days/week) or ER (1 day/week) group.
• Ultrasound assessments of tendon vascularization and tendon swelling showed no significant improvements in either group.
• Structural and functional jumping outcomes were assessed before and after the 12-week intervention.
• The lack of structural improvement occurred despite significant clinical and strength gains in both groups.

The study was designed to test whether restitution time between loading sessions influences the response to exercise-based tendinopathy treatment.

• The study hypothesized that longer restitution would yield greater improvements in clinical outcomes, tissue structure, and function compared to shorter restitution.
• Loading intervention is described as the predominant treatment strategy for tendinopathy.
• The trial was a randomized controlled clinical trial (the TEREX Trial) with 52 participants.
• Outcomes assessed included VISA-P, NRS pain, functional tests, ultrasound (vascularization and swelling), and self-reported improvement and satisfaction.