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Patellar TendinopathyNCT06729437

Transcranial Direct Current Stimulation on Functionality and Pain in Individuals With Patellar Tendinopathy

A study testing tDCS + Therapeutic eccentric exercise in people with Patellar Tendinopathy, run by University of Valencia at 1 site in Spain.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The aim of the present study is to investigate the effectiveness of transcranial direct current stimulation (tDCS) prior to a therapeutic eccentric exercise program on parameters related to pain and functionality in individuals with patellar tendinopathy. Read more about this study

Who is it for?
Ages 18 to 50 yearsHealthy volunteers can take part
Conditions the study is for
Patellar Tendinopathy
What is being tested?
tDCS + Therapeutic eccentric exercise
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
42 participants
Where
1 siteSpain
Study dates
1 Jul 2024to 1 Jul 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 50 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Age between 18 and 50 years.
  • Diagnosis of patellar tendinopathy (VISA-P score of 80 or lower).
  • Pain lasting more than 3 months.

Who cannot join

  • Previous knee surgery.
  • Corticosteroid injection in the previous 6 weeks.
  • Systemic inflammatory, autoimmune, or rheumatic diseases.
  • Cognitive or behavioural issues that hinder comprehension and adherence to the intervention.
  • Any neurological disease.
  • Neoplastic disease.
  • Subjects presenting contraindications for tDCS (Thair et al., 2017), including: personal and family history of epilepsy, metallic implants in the head, implanted medication pump, pacemaker, recurrent headaches, skin conditions (psoriasis, eczema), or major head surgeries, pregnancy, heart diseases, and various medications (psychotropic or antihistamines).
  • Subjects must not have undergone pharmacological treatment or knee physical rehabilitation programs for a period of 1 year.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Marta Inglés, Dr contact

963 98 38 55

marta.ingles@uv.es

Elena Muñoz-Gómez, Dr contact

963 98 38 55

elena.munoz-gomez@uv.es

Spain1 site, 1 recruiting
  • Faculty of Physiotherapy, University of Valencia

    Valencia, Valencia, 46022

    Marta Inglés, PhD, (+34) 96 398 38 55

    Recruiting

Other trials in Spain

About this study

Official title: Effectiveness of Transcranial Direct Current Stimulation on Functionality and Pain in Individuals With Patellar Tendinopathy: Randomized Clinical Trial

The aim of the present study is to investigate the effectiveness of transcranial direct current stimulation (tDCS) prior to a therapeutic eccentric exercise program on parameters related to pain and functionality in individuals with patellar tendinopathy. For this purpose, participants will be randomly divided into two groups: i) experimental group, receiving tDCS prior to a therapeutic exercise program; and ii) control group, receiving sham tDCS and a therapeutic exercise program. The interventions will last for 8 weeks. Additionally, four assessments will be conducted (baseline, week 4, week 8 and week 12). The variables studied are related to pain, functionality, muscle activity and strength, proprioception, and quality of life.

Read the detailed description

Patellar tendinopathy is a painful condition affecting the anterior portion of the knee, commonly exacerbated by activities putting pressure on the patellofemoral joint. It remains a challenge for the healthcare system, not only due to its high prevalence, but also because of its high persistence and negative consequences. Although therapeutic exercise has been widely studied as a treatment strategy, eccentric exercise protocols, while effective, often require long application periods, which may affect treatment adherence. Additionally, eccentric exercise is pain-provoking and its therapeutic benefits for pain relief and functional improvement are controversial when used during the competitive season. More adaptable and personalized treatment strategies could enhance clinical outcomes and treatment adherence in patients with patellar tendinopathy. In this context, interventions combining exercise with other techniques have been proposed. However, existing evidence does not definitively determine the optimal approach for combining conservative treatment options to maximize benefits.

An emerging therapeutic approach combines Transcranial Direct Current Stimulation (tDCS) with therapeutic exercise protocols. tDCS involves the application of weak direct current to specific cortical areas, aiming to modulate brain excitability. This non-invasive method offers painless, selective, and focal stimulation with minimal side effects. Research increasingly supports the effectiveness of integrating tDCS with exercise for patellar tendinopathy, offering the potential to amplify exercise effects by modulating brain excitability. However, to date, no study has investigated the impact of tDCS combined with eccentric exercise on variables related to function and pain in patellar tendinopathy individuals.

Therefore, the aim of this study is to investigate the effectiveness of tDCS prior to a therapeutic eccentric exercise program on parameters related to pain and functionality in individuals with patellar tendinopathy.

This study is a randomized clinical trial in which two groups will participate, with different interventions: i) Experimental group: tDCS + Therapeutic eccentric exercise; and ii) Control group: Sham tDCS + Therapeutic eccentric exercise. The interventions will last for 8 weeks. Participants will be evaluated in four moments, at baseline, week 4, week 8 and week 12. The variables studied are related to pain, functionality, muscle strength and activity, proprioception, and quality of life.

Being tested
tDCS + Therapeutic eccentric exercise, Sham tDCS + Therapeutic eccentric exercise
Keywords
patellar tendinopathy, transcranial direct current stimulation, therapeutic exercise, eccentric exercise

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • tDCS + Therapeutic eccentric exerciseOther

    A direct current of 1.5 mA will be applied for 20 minutes to the primary motor cortex (M1) during each session of eccentric exercises.

  • Sham tDCS + Therapeutic eccentric exerciseOther

    The current will be interrupted after 30 seconds.

Study groups in NCT06729437
Study groupRoleWhat they receive
Experimental groupExperimentalParticipants will undergo an 8-week intervention of supervised eccentric exercise by a physiotherapist (3 sessions/week). During the first 4 weeks, real tDCS will be administered at a rate of 3 sessions per week (12 in total) as an adjunct to exercise . A direct current of 1.5 mA will be applied for 20 minutes to the primary motor cortex (M1) during each session of eccentric exercises. Additionally, all participants will perform the eccentric exercise program on the remaining weekdays at home unsupervised.
Receives: Other: tDCS + Therapeutic eccentric exercise
Sham groupPlacebo comparatorParticipants will undergo an 8-week intervention of supervised eccentric exercise by a physiotherapist (3 sessions/week). During the first 4 weeks, sham tDCS will be administered at a rate of 3 sessions per week (12 in total) as an adjunct to exercise. The current will be interrupted after 30 seconds. Additionally, all participants will perform the eccentric exercise program on the remaining weekdays at home unsupervised.
Receives: Other: Sham tDCS + Therapeutic eccentric exercise

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Knee functionality

    The Victorian Institute of Sport Assessment-Patella (VISA-P) is a questionnaire to assess the severity of patellar tendinopathies. It consists of 8 items with a rating range from 0 to 100. The optimal state would correspond to a score of 100.

    Measured: 5 minutes

Secondary outcomes (8)
  1. Pain intensity

    The single-leg squat pain provocation test is used to monitor the response to previous loading in athletes with patella tendinopathy. A visual analogue scale (VAS) will be used to determine pain intensity during the test. A score of 0 points indicates no pain and 10 points is the worst imaginable pain.

    Measured: 2 minutes

  2. Health-related quality of life

    The EuroQol 5 dimensions (EQ-5D) test is an instrument which evaluates the generic quality of life. Scores range from 0 (worst imaginable health state) to 100 (best imaginable health state).

    Measured: 2 minutes

  3. Muscle strength

    Maximum voluntary isometric contraction of the quadriceps, hamstrings, and hip abductors will be measured using a force sensor connected to the corresponding software (Chronojump Boscosystem). Higher values indicate greater muscle strength.

    Measured: 10 minutes

  4. Electromyographic activity of lower limb muscles

    Electromyographic activity during maximum voluntary isometric contraction of the rectus femoris, vastus lateralis, vastus medialis, biceps femoris, and semitendinosus muscles, using electromyography, will be registered.

    Measured: 5 minutes

  5. Muscle flexibility

    Knee joint range of motion will be measured in flexion and extension using a goniometer. Higher values indicate greater muscle flexibility.

    Measured: 5 minutes

  6. Muscle tone

    The biomechanical and viscoelastic properties of the muscle tissue will be evaluated using a non-invasive myometer, MyotonPRO (Myoton AS, Tallinn, Estonia). The patellar tendon, rectus femoris, vastus medialis, vastus lateralis, semitendinosus, and biceps femoris will be assessed. Higher values may indicate greater muscle stiffness or tone.

    Measured: 5 minutes

  7. Proprioception

    Proprioception will be assessed using the active knee repositioning test with an inclinometer. The difference between the target angle and the obtained angle will be registered. A smaller difference between the angles indicates better knee proprioception.

    Measured: 5 minutes

  8. Patient global perception of change

    The Patient Global Impression of Change Scale (PGIC) will be filled out. It consists of 7 points, with options ranging from "1=much better" to "7=much worse".

    Measured: 1 minute

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Dec 2024
  2. Study start1 Jul 2024
  3. Primary completion1 Jul 2027 (estimated)
  4. Study completion1 Jul 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
42 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06729437
Sponsor's protocol ID
2023-FIS-3100133
Status last verified
Jun 2026
First submitted
7 Dec 2024
Last updated
25 Jun 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Breda SJ, Oei EHG, Zwerver J, Visser E, Waarsing E, Krestin GP, de Vos RJ. Effectiveness of progressive tendon-loading exercise therapy in patients with patellar tendinopathy: a randomised clinical trial. Br J Sports Med. 2021 May;55(9):501-509. doi: 10.1136/bjsports-2020-103403. Epub 2020 Nov 20.

    PubMed 33219115
  • Cosca DD, Navazio F. Common problems in endurance athletes. Am Fam Physician. 2007 Jul 15;76(2):237-44.

    PubMed 17695568
  • Hedayatpour N, Falla D. Physiological and Neural Adaptations to Eccentric Exercise: Mechanisms and Considerations for Training. Biomed Res Int. 2015;2015:193741. doi: 10.1155/2015/193741. Epub 2015 Oct 12.

    PubMed 26543850
  • Hernandez-Sanchez S, Hidalgo MD, Gomez A. Cross-cultural adaptation of VISA-P score for patellar tendinopathy in Spanish population. J Orthop Sports Phys Ther. 2011 Aug;41(8):581-91. doi: 10.2519/jospt.2011.3613. Epub 2011 Jul 12.

    PubMed 21765223
  • Bikson M, Grossman P, Thomas C, Zannou AL, Jiang J, Adnan T, Mourdoukoutas AP, Kronberg G, Truong D, Boggio P, Brunoni AR, Charvet L, Fregni F, Fritsch B, Gillick B, Hamilton RH, Hampstead BM, Jankord R, Kirton A, Knotkova H, Liebetanz D, Liu A, Loo C, Nitsche MA, Reis J, Richardson JD, Rotenberg A, Turkeltaub PE, Woods AJ. Safety of Transcranial Direct Current Stimulation: Evidence Based Update 2016. Brain Stimul. 2016 Sep-Oct;9(5):641-661. doi: 10.1016/j.brs.2016.06.004. Epub 2016 Jun 15.

    PubMed 27372845
  • Peers KH, Lysens RJ. Patellar tendinopathy in athletes: current diagnostic and therapeutic recommendations. Sports Med. 2005;35(1):71-87. doi: 10.2165/00007256-200535010-00006.

    PubMed 15651914
  • Teixeira PEP, Alawdah L, Alhassan HAA, Guidetti M, Priori A, Papatheodorou S, Fregni F. The Analgesic Effect of Transcranial Direct Current Stimulation (tDCS) combined with Physical Therapy on Common Musculoskeletal Conditions: A Systematic Review and Meta-Analysis. Princ Pract Clin Res. 2020 Jan-Apr;6(1):23-26. doi: 10.21801/ppcrj.2020.61.5. Epub 2020 May 21.

    PubMed 32766451
  • Thair H, Holloway AL, Newport R, Smith AD. Transcranial Direct Current Stimulation (tDCS): A Beginner's Guide for Design and Implementation. Front Neurosci. 2017 Nov 22;11:641. doi: 10.3389/fnins.2017.00641. eCollection 2017.

    PubMed 29213226
  • Vander Doelen T, Jelley W. Non-surgical treatment of patellar tendinopathy: A systematic review of randomized controlled trials. J Sci Med Sport. 2020 Feb;23(2):118-124. doi: 10.1016/j.jsams.2019.09.008. Epub 2019 Sep 13.

    PubMed 31606317
  • Visnes H, Hoksrud A, Cook J, Bahr R. No effect of eccentric training on jumper's knee in volleyball players during the competitive season: a randomized clinical trial. Clin J Sport Med. 2005 Jul;15(4):227-34. doi: 10.1097/01.jsm.0000168073.82121.20.

    PubMed 16003036
  • Young MA, Cook JL, Purdam CR, Kiss ZS, Alfredson H. Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. Br J Sports Med. 2005 Feb;39(2):102-5. doi: 10.1136/bjsm.2003.010587.

    PubMed 15665207

Questions about this trial

What is this clinical trial studying?

A study testing tDCS + Therapeutic eccentric exercise in people with Patellar Tendinopathy, run by University of Valencia at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 25 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Marta Inglés, Dr (963 98 38 55, marta.ingles@uv.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Knee functionality (time frame: 5 minutes). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06729437, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Jun 2026.

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