Cargando…

Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review

Tendinopathy can be resistant to treatment and often recurs, implying that current treatment approaches are suboptimal. Rehabilitation programmes that have been successful in terms of pain reduction and return to sport outcomes usually include strength training. Muscle activation can induce analgesi...

Descripción completa

Detalles Bibliográficos
Autores principales: Rio, Ebonie, Kidgell, Dawson, Moseley, G Lorimer, Gaida, Jamie, Docking, Sean, Purdam, Craig, Cook, Jill
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752665/
https://www.ncbi.nlm.nih.gov/pubmed/26407586
http://dx.doi.org/10.1136/bjsports-2015-095215
_version_ 1782415766811836416
author Rio, Ebonie
Kidgell, Dawson
Moseley, G Lorimer
Gaida, Jamie
Docking, Sean
Purdam, Craig
Cook, Jill
author_facet Rio, Ebonie
Kidgell, Dawson
Moseley, G Lorimer
Gaida, Jamie
Docking, Sean
Purdam, Craig
Cook, Jill
author_sort Rio, Ebonie
collection PubMed
description Tendinopathy can be resistant to treatment and often recurs, implying that current treatment approaches are suboptimal. Rehabilitation programmes that have been successful in terms of pain reduction and return to sport outcomes usually include strength training. Muscle activation can induce analgesia, improving self-efficacy associated with reducing one's own pain. Furthermore, strength training is beneficial for tendon matrix structure, muscle properties and limb biomechanics. However, current tendon rehabilitation may not adequately address the corticospinal control of the muscle, which may result in altered control of muscle recruitment and the consequent tendon load, and this may contribute to recalcitrance or symptom recurrence. Outcomes of interest include the effect of strength training on tendon pain, corticospinal excitability and short interval cortical inhibition. The aims of this concept paper are to: (1) review what is known about changes to the primary motor cortex and motor control in tendinopathy, (2) identify the parameters shown to induce neuroplasticity in strength training and (3) align these principles with tendon rehabilitation loading protocols to introduce a combination approach termed as tendon neuroplastic training. Strength training is a powerful modulator of the central nervous system. In particular, corticospinal inputs are essential for motor unit recruitment and activation; however, specific strength training parameters are important for neuroplasticity. Strength training that is externally paced and akin to a skilled movement task has been shown to not only reduce tendon pain, but modulate excitatory and inhibitory control of the muscle and therefore, potentially tendon load. An improved understanding of the methods that maximise the opportunity for neuroplasticity may be an important progression in how we prescribe exercise-based rehabilitation in tendinopathy for pain modulation and potentially restoration of the corticospinal control of the muscle-tendon complex.
format Online
Article
Text
id pubmed-4752665
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-47526652016-02-21 Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review Rio, Ebonie Kidgell, Dawson Moseley, G Lorimer Gaida, Jamie Docking, Sean Purdam, Craig Cook, Jill Br J Sports Med Review Tendinopathy can be resistant to treatment and often recurs, implying that current treatment approaches are suboptimal. Rehabilitation programmes that have been successful in terms of pain reduction and return to sport outcomes usually include strength training. Muscle activation can induce analgesia, improving self-efficacy associated with reducing one's own pain. Furthermore, strength training is beneficial for tendon matrix structure, muscle properties and limb biomechanics. However, current tendon rehabilitation may not adequately address the corticospinal control of the muscle, which may result in altered control of muscle recruitment and the consequent tendon load, and this may contribute to recalcitrance or symptom recurrence. Outcomes of interest include the effect of strength training on tendon pain, corticospinal excitability and short interval cortical inhibition. The aims of this concept paper are to: (1) review what is known about changes to the primary motor cortex and motor control in tendinopathy, (2) identify the parameters shown to induce neuroplasticity in strength training and (3) align these principles with tendon rehabilitation loading protocols to introduce a combination approach termed as tendon neuroplastic training. Strength training is a powerful modulator of the central nervous system. In particular, corticospinal inputs are essential for motor unit recruitment and activation; however, specific strength training parameters are important for neuroplasticity. Strength training that is externally paced and akin to a skilled movement task has been shown to not only reduce tendon pain, but modulate excitatory and inhibitory control of the muscle and therefore, potentially tendon load. An improved understanding of the methods that maximise the opportunity for neuroplasticity may be an important progression in how we prescribe exercise-based rehabilitation in tendinopathy for pain modulation and potentially restoration of the corticospinal control of the muscle-tendon complex. BMJ Publishing Group 2016-02 2015-09-25 /pmc/articles/PMC4752665/ /pubmed/26407586 http://dx.doi.org/10.1136/bjsports-2015-095215 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Review
Rio, Ebonie
Kidgell, Dawson
Moseley, G Lorimer
Gaida, Jamie
Docking, Sean
Purdam, Craig
Cook, Jill
Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review
title Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review
title_full Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review
title_fullStr Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review
title_full_unstemmed Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review
title_short Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review
title_sort tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752665/
https://www.ncbi.nlm.nih.gov/pubmed/26407586
http://dx.doi.org/10.1136/bjsports-2015-095215
work_keys_str_mv AT rioebonie tendonneuroplastictrainingchangingthewaywethinkabouttendonrehabilitationanarrativereview
AT kidgelldawson tendonneuroplastictrainingchangingthewaywethinkabouttendonrehabilitationanarrativereview
AT moseleyglorimer tendonneuroplastictrainingchangingthewaywethinkabouttendonrehabilitationanarrativereview
AT gaidajamie tendonneuroplastictrainingchangingthewaywethinkabouttendonrehabilitationanarrativereview
AT dockingsean tendonneuroplastictrainingchangingthewaywethinkabouttendonrehabilitationanarrativereview
AT purdamcraig tendonneuroplastictrainingchangingthewaywethinkabouttendonrehabilitationanarrativereview
AT cookjill tendonneuroplastictrainingchangingthewaywethinkabouttendonrehabilitationanarrativereview