Sports Physical TherapyNCT06877741
Comparative Effects of Heavy Slow Resistance Training and Eccentric Overload Training in Runners
A study testing Group A (Heavy Slow Resistance exercises) and : Group B (Eccentric exercises) in people with Sports Physical Therapy, run by Riphah International University at 1 site in Pakistan.
Trial summary
Patellar Tendinopathy (PT) also known as Jumper's knee, is characterized by multifaceted activity-related pathology causing anterior knee pain and patellar-tendon dysfunction. It most commonly affects athletic activities that involve jumping and running. Read more about this study
- Who is it for?
- Ages 18 to 45 years, men onlyHealthy volunteers can take part
- Conditions the study is for
- Sports Physical Therapy
- What is being tested?
- Group A (Heavy Slow Resistance exercises) and : Group B (Eccentric exercises)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Apr 2024to 30 Sep 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
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 45 years
- Men only
- Healthy volunteers accepted
- Adult
Who may be able to join
- anterior knee pain located on the inferior pole of the patella for at least 3 months while practicing sport;
- age between 18 and 45 years old;
- practicing any kind of sports at least 3 times a week
- score less than 80 on the Victorian Institute of Sport Assessment-Patellar questionnaire (VISA-p).
Who cannot join
- Knee surgery within the previous 6 months;
- Chronic joint diseases;
- Corticosteroid injection in the patellar tendon within the previous 3 months;
- Anti-inflammatory, analgesic, or antibiotic medications within the previous 48 hours;
- Any other concomitant treatment for PT
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Comparative Effects of Heavy Slow Resistance Training and Eccentric Overload Training on Pain, Range of Motion, and Lower Extremity Functions in Runners With Patellar Tendinopathy
Patellar Tendinopathy (PT) also known as Jumper's knee, is characterized by multifaceted activity-related pathology causing anterior knee pain and patellar-tendon dysfunction. It most commonly affects athletic activities that involve jumping and running. Tendinopathy is most likely to be related to mechanical loading and overuse. Athletes suffer from insidious well-localized pain, typically as the athlete starts the activity. Conservative treatment is the first line of treatment in tendinopathy, however, there is no consensus regarding the best treatment. In acute conditions, relative rest rather than immobilization is preferred. The most popular non-operative treatment involves eccentric exercise (EE). It is commonly accepted that surgical treatment must be indicated in motivated patients if carefully followed conservative treatment (physical training, injections, ESWT) is unsuccessful after 3-6 months. In recent studies, isometric and heavy slow resistance (HSR) exercises have demonstrated potential for pain reduction and functional improvement in patellar tendinopathy.
A randomized controlled trial will be conducted at the Pakistan Sports Board (PSB) Coaching Center, Lahore. 18 Subjects will be randomized into two groups; Heavy slow resistance exercises plus eccentric exercises will be given to group A and exercises of 4 sets of 10-20 repetitions will be given. Group B will give Eccentric exercises in 3 sets of 10-20 repetitions. Pre-assessments will be taken through the Numeric Pain Rating Scale (NPRS) for pain, a goniometer for range of motion, Lower extremity function assessment scale to evaluate lower limb functional impairments, and a Visa-P scale for patellar dysfunction. Assessment will be done at baseline and post 4 weeks of training. Data will be analyzed using SPSS software version 21. The normality of data will be checked, and tests will be applied according to the normality of the data, either parametric or non-parametric tests will be used (within a group or between two groups).
Read the detailed description
The objective of the study is to compare the effects of heavy slow resistance training and eccentric overload training on pain, range of motion, and lower extremity functions in runners with patellar tendinopathy.
.
- Conditions
- Sports Physical Therapy
- Being tested
- Group A (Heavy Slow Resistance exercises), : Group B (Eccentric exercises)
- Keywords
- Exercise, Heavy slow resistance, Jumper's knee, Pain, Patellar tendinopathy
- Medical subject headings
- Motor Activity, Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Group A (Heavy Slow Resistance exercises)Other
Pre - assessment will be taken. Heavy slow resistance exercises will be given to group A and exercises of 4 sets of 10-20 repetitions will be given
: Group B (Eccentric exercises)Other
Sessions should be conducted 2 times per week, similar to Group A, in 3 sets of 10-20 repetitions. Exercises focus solely on eccentric loading, such as eccentric squats, eccentric leg presses, and step-down exercises.
| Study group | Role | What they receive |
|---|---|---|
| Group A (Heavy Slow Resistance exercises) | Experimental | Not described Receives: Other: Group A (Heavy Slow Resistance exercises) |
| Group B (Eccentric exercises). | Experimental | Not described Receives: Other: : Group B (Eccentric exercises) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire
This brief questionnaire assesses (i) symptoms, (ii) simple tests of function and (in') ability to play sport. Six of the eight questions are scored on a visual analogue scale from 0-10 with 10 representing optimal health. The maximal VISA score for an asymptomatic, fully performing individual is 100 points and the theoretical minimum is 0 points. We found the VISA scale to have excellent short-term test retest, and inter-tester reliability both, r>0.95 as well as good short-term stability (r=0.87).(14)
Measured: 4 weeks
NPRS
For the NPRS, the intraclass correlation coefficient (ICC) for all subjects is .76 (p < .0001). The ICC, however, is .90 (p < .0001)(15)
Measured: 4 weeks
Goniometer
Goniometric measurements are used to quantify baseline limitations of motion, decide on appropriate therapeutic interventions, and document the effectiveness of these interventions
Measured: 4 weeks
LEFS
The Lower Extremity Functional Scale (LEFS) is a questionnaire containing 20 questions about a person's ability to perform everyday tasks. The LEFS can be used by clinicians as a measure of patients' initial function, ongoing progress and outcome, as well as to set functional goals. Internal consistency is α=.96 (N=107). Test-retest reliability estimates were R=.86 (95% lower limit CI=.80) for the entire sample (n=98) and R=.94 (95% lower limit CI=.89) for the subset of patients with more chronic conditions (n=31)
Measured: 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Mar 2025
- Study start1 Apr 2024
- Primary completion1 Aug 2024
- Study completion30 Sep 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (17)Papers the sponsor has linked to this study.
- Other trials for Sports Physical TherapyStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- 30 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Aamir Gul Memon, MS, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06877741
- Sponsor's protocol ID
- REC/RCR & AHS/24/0417
- Status last verified
- Mar 2025
- First submitted
- 10 Mar 2025
- Last updated
- 14 Mar 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Muaidi QI. Rehabilitation of patellar tendinopathy. J Musculoskelet Neuronal Interact. 2020 Dec 1;20(4):535-540.
PubMed 33265081Lee WC, Ng GY, Zhang ZJ, Malliaras P, Masci L, Fu SN. Changes on Tendon Stiffness and Clinical Outcomes in Athletes Are Associated With Patellar Tendinopathy After Eccentric Exercise. Clin J Sport Med. 2020 Jan;30(1):25-32. doi: 10.1097/JSM.0000000000000562.
PubMed 31855909Schwartz A, Watson JN, Hutchinson MR. Patellar Tendinopathy. Sports Health. 2015 Sep-Oct;7(5):415-20. doi: 10.1177/1941738114568775. Epub 2015 Jan 23.
PubMed 26502416Rudavsky A, Cook J. Physiotherapy management of patellar tendinopathy (jumper's knee). J Physiother. 2014 Sep;60(3):122-9. doi: 10.1016/j.jphys.2014.06.022. Epub 2014 Aug 3. No abstract available.
PubMed 25092419Visnes H, Bahr R. The evolution of eccentric training as treatment for patellar tendinopathy (jumper's knee): a critical review of exercise programmes. Br J Sports Med. 2007 Apr;41(4):217-23. doi: 10.1136/bjsm.2006.032417. Epub 2007 Jan 29.
PubMed 17261559Rodriguez-Merchan EC. The treatment of patellar tendinopathy. J Orthop Traumatol. 2013 Jun;14(2):77-81. doi: 10.1007/s10195-012-0220-0. Epub 2012 Dec 28.
PubMed 23271268van Rijn D, van den Akker-Scheek I, Steunebrink M, Diercks RL, Zwerver J, van der Worp H. Comparison of the Effect of 5 Different Treatment Options for Managing Patellar Tendinopathy: A Secondary Analysis. Clin J Sport Med. 2019 May;29(3):181-187. doi: 10.1097/JSM.0000000000000520.
PubMed 31033610Lin PC, Hsu WY, Lee PY, Hsu SH, Chiou SS. Insights into Hepatocellular Carcinoma in Patients with Thalassemia: From Pathophysiology to Novel Therapies. Int J Mol Sci. 2023 Aug 10;24(16):12654. doi: 10.3390/ijms241612654.
PubMed 37628834Ghosh S, Cotta KB, Hande AA, Fernandes M, Mehra S. PNA-mediated efflux inhibition as a therapeutic strategy towards overcoming drug resistance in Mycobacterium smegmatis. Microb Pathog. 2021 Feb;151:104737. doi: 10.1016/j.micpath.2021.104737. Epub 2021 Jan 13.
PubMed 33453316Chung H, Lee S, Kim GA, Kim WH. Down-expression of klotho in canine mammary gland tumors and its prognostic significance. PLoS One. 2022 Jun 6;17(6):e0265248. doi: 10.1371/journal.pone.0265248. eCollection 2022.
PubMed 35666743Caradu C, Dubourg AP, Colacchio EC, Midy D, Berard X, Ducasse E. Endovascular Treatment of Complex Aneurysms with the Use of Covera Stent Grafts. J Vasc Interv Radiol. 2019 Dec;30(12):1942-1948.e1. doi: 10.1016/j.jvir.2019.05.004. Epub 2019 Sep 14.
PubMed 31530494Shen J, Li X, Yan X. Mechanical and Acoustic Properties of Jute Fiber-Reinforced Polypropylene Composites. ACS Omega. 2021 Nov 13;6(46):31154-31160. doi: 10.1021/acsomega.1c04605. eCollection 2021 Nov 23.
PubMed 34841157Martindale S, Mableson H, Bodimeade C, Hume H, Badia X, Karim J, Mahmood ASMS, Chiphwanya J, Rimal P, Boko-Collins P, Bougma R, Agyemang D, Alomatu B, Cisse A, Bathiri SA, Shu'aibu J, Betts H, Kelly-Hope LA, Riches N. The development and roll-out of a new hydrocoele surgery facility assessment tool for the elimination of lymphatic filariasis. Int Health. 2022 Sep 21;14(Suppl 2):ii55-ii63. doi: 10.1093/inthealth/ihac020.
PubMed 36130253Visentini PJ, Khan KM, Cook JL, Kiss ZS, Harcourt PR, Wark JD. The VISA score: an index of severity of symptoms in patients with jumper's knee (patellar tendinosis). Victorian Institute of Sport Tendon Study Group. J Sci Med Sport. 1998 Jan;1(1):22-8. doi: 10.1016/s1440-2440(98)80005-4.
PubMed 9732118Pearce L. Recovery through suggestion. Nurs Stand. 2013 Jul 3-9;27(44):20. doi: 10.7748/ns2013.07.27.44.20.s28.
PubMed 23940935
Study at a glance
From the registry record, last updated by the sponsor on 14 Mar 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Heavy Slow Resistance Training and Eccentric Overload Training on Pain, Range of Motion, and Lower Extremity Functions in Runners With Patellar Tendinopathy
- ClinicalTrials.gov ID
- NCT06877741
- Acronym / sponsor ID
- REC/RCR & AHS/24/0417
- Conditions
- Sports Physical Therapy
- Keywords
- Exercise, Heavy slow resistance, Jumper's knee, Pain, Patellar tendinopathy
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 30 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 1 Apr 2024 (actual)
- Primary completion
- 1 Aug 2024 (actual)
- Study completion
- 30 Sep 2024 (actual)
- First posted
- 14 Mar 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Patellar Tendinopathy (PT) also known as Jumper's knee, is characterized by multifaceted activity-related pathology causing anterior knee pain and patellar-tendon dysfunction. It most commonly affects athletic activities that involve jumping and running. Tendinopathy is most likely to be related to mechanical loading and overuse. Athletes suffer from insidious well-localized pain, typically as the athlete starts the activity. Conservative treatment is the first line of treatment in tendinopathy, however, there is no consensus regarding the best treatment. In acute conditions, relative rest rather than immobilization is preferred. The most popular non-operative treatment involves eccentric exercise (EE). It is commonly accepted that surgical treatment must be indicated in motivated patients if carefully followed conservative treatment (physical training, injections, ESWT) is unsuccessful after 3-6 months. In recent studies, isometric and heavy slow resistance (HSR) exercises have demonstrated potential for pain reduction and functional improvement in patellar tendinopathy.
A randomized controlled trial will be conducted at the Pakistan Sports Board (PSB) Coaching Center, Lahore. 18 Subjects will be randomized into two groups; Heavy slow resistance exercises plus eccentric exercises will be given to group A and exercises of 4 sets of 10-20 repetitions will be given. Group B will give Eccentric exercises in 3 sets of 10-20 repetitions. Pre-assessments will be taken through the Numeric Pain Rating Scale (NPRS) for pain, a goniometer for range of motion, Lower extremity function assessment scale to evaluate lower limb functional impairments, and a Visa-P scale for patellar dysfunction. Assessment will be done at baseline and post 4 weeks of training. Data will be analyzed using SPSS software version 21. The normality of data will be checked, and tests will be applied according to the normality of the data, either parametric or non-parametric tests will be used (within a group or between two groups).
Detailed description
The objective of the study is to compare the effects of heavy slow resistance training and eccentric overload training on pain, range of motion, and lower extremity functions in runners with patellar tendinopathy.
.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group A (Heavy Slow Resistance exercises) | Experimental | Other: Group A (Heavy Slow Resistance exercises) |
| Group B (Eccentric exercises). | Experimental | Other: : Group B (Eccentric exercises) |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- Male only
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- anterior knee pain located on the inferior pole of the patella for at least 3 months while practicing sport;
- age between 18 and 45 years old;
- practicing any kind of sports at least 3 times a week
- score less than 80 on the Victorian Institute of Sport Assessment-Patellar questionnaire (VISA-p).
Key exclusion criteria (5 listed)
- Knee surgery within the previous 6 months;
- Chronic joint diseases;
- Corticosteroid injection in the patellar tendon within the previous 3 months;
- Anti-inflammatory, analgesic, or antibiotic medications within the previous 48 hours;
- Any other concomitant treatment for PT
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Group A (Heavy Slow Resistance exercises)Pre - assessment will be taken. Heavy slow resistance exercises will be given to group A and exercises of 4 sets of 10-20 repetitions will be given | Other | Group A (Heavy Slow Resistance exercises) |
| : Group B (Eccentric exercises)Sessions should be conducted 2 times per week, similar to Group A, in 3 sets of 10-20 repetitions. Exercises focus solely on eccentric loading, such as eccentric squats, eccentric leg presses, and step-down exercises. | Other | Group B (Eccentric exercises). |
Primary outcome
Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire
Time frame: 4 weeks
This brief questionnaire assesses (i) symptoms, (ii) simple tests of function and (in') ability to play sport. Six of the eight questions are scored on a visual analogue scale from 0-10 with 10 representing optimal health. The maximal VISA score for an asymptomatic, fully performing individual is 100 points and the theoretical minimum is 0 points. We found the VISA scale to have excellent short-term test retest, and inter-tester reliability both, r>0.95 as well as good short-term stability (r=0.87).(14)
NPRS
Time frame: 4 weeks
For the NPRS, the intraclass correlation coefficient (ICC) for all subjects is .76 (p < .0001). The ICC, however, is .90 (p < .0001)(15)
Goniometer
Time frame: 4 weeks
Goniometric measurements are used to quantify baseline limitations of motion, decide on appropriate therapeutic interventions, and document the effectiveness of these interventions
LEFS
Time frame: 4 weeks
The Lower Extremity Functional Scale (LEFS) is a questionnaire containing 20 questions about a person's ability to perform everyday tasks. The LEFS can be used by clinicians as a measure of patients' initial function, ongoing progress and outcome, as well as to set functional goals. Internal consistency is α=.96 (N=107). Test-retest reliability estimates were R=.86 (95% lower limit CI=.80) for the entire sample (n=98) and R=.94 (95% lower limit CI=.89) for the subset of patients with more chronic conditions (n=31)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Mar 2025.
- Background: PubMed 33265081Muaidi QI. Rehabilitation of patellar tendinopathy. J Musculoskelet Neuronal Interact. 2020 Dec 1;20(4):535-540.
- Background: PubMed 31855909Lee WC, Ng GY, Zhang ZJ, Malliaras P, Masci L, Fu SN. Changes on Tendon Stiffness and Clinical Outcomes in Athletes Are Associated With Patellar Tendinopathy After Eccentric Exercise. Clin J Sport Med. 2020 Jan;30(1):25-32. doi: 10.1097/JSM.0000000000000562.
- Background: PubMed 26502416Schwartz A, Watson JN, Hutchinson MR. Patellar Tendinopathy. Sports Health. 2015 Sep-Oct;7(5):415-20. doi: 10.1177/1941738114568775. Epub 2015 Jan 23.
- Background: PubMed 25092419Rudavsky A, Cook J. Physiotherapy management of patellar tendinopathy (jumper's knee). J Physiother. 2014 Sep;60(3):122-9. doi: 10.1016/j.jphys.2014.06.022. Epub 2014 Aug 3. No abstract available.
- Background: PubMed 17261559Visnes H, Bahr R. The evolution of eccentric training as treatment for patellar tendinopathy (jumper's knee): a critical review of exercise programmes. Br J Sports Med. 2007 Apr;41(4):217-23. doi: 10.1136/bjsm.2006.032417. Epub 2007 Jan 29.
- Background: PubMed 23271268Rodriguez-Merchan EC. The treatment of patellar tendinopathy. J Orthop Traumatol. 2013 Jun;14(2):77-81. doi: 10.1007/s10195-012-0220-0. Epub 2012 Dec 28.
- Background: PubMed 31033610van Rijn D, van den Akker-Scheek I, Steunebrink M, Diercks RL, Zwerver J, van der Worp H. Comparison of the Effect of 5 Different Treatment Options for Managing Patellar Tendinopathy: A Secondary Analysis. Clin J Sport Med. 2019 May;29(3):181-187. doi: 10.1097/JSM.0000000000000520.
- Background: PubMed 37628834Lin PC, Hsu WY, Lee PY, Hsu SH, Chiou SS. Insights into Hepatocellular Carcinoma in Patients with Thalassemia: From Pathophysiology to Novel Therapies. Int J Mol Sci. 2023 Aug 10;24(16):12654. doi: 10.3390/ijms241612654.
- Background: PubMed 33453316Ghosh S, Cotta KB, Hande AA, Fernandes M, Mehra S. PNA-mediated efflux inhibition as a therapeutic strategy towards overcoming drug resistance in Mycobacterium smegmatis. Microb Pathog. 2021 Feb;151:104737. doi: 10.1016/j.micpath.2021.104737. Epub 2021 Jan 13.
- Background: PubMed 35666743Chung H, Lee S, Kim GA, Kim WH. Down-expression of klotho in canine mammary gland tumors and its prognostic significance. PLoS One. 2022 Jun 6;17(6):e0265248. doi: 10.1371/journal.pone.0265248. eCollection 2022.
- Background: PubMed 31530494Caradu C, Dubourg AP, Colacchio EC, Midy D, Berard X, Ducasse E. Endovascular Treatment of Complex Aneurysms with the Use of Covera Stent Grafts. J Vasc Interv Radiol. 2019 Dec;30(12):1942-1948.e1. doi: 10.1016/j.jvir.2019.05.004. Epub 2019 Sep 14.
- Background: PubMed 34841157Shen J, Li X, Yan X. Mechanical and Acoustic Properties of Jute Fiber-Reinforced Polypropylene Composites. ACS Omega. 2021 Nov 13;6(46):31154-31160. doi: 10.1021/acsomega.1c04605. eCollection 2021 Nov 23.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Aamir Gul Memon, MS principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Group A (Heavy Slow Resistance exercises) and : Group B (Eccentric exercises) in people with Sports Physical Therapy, run by Riphah International University at 1 site in Pakistan.
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 4 inclusion and 5 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: finished, as of the sponsor's last update on 14 Mar 2025. 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 Pakistan. 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. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire (time frame: 4 weeks). The study lists 4 primary outcomes in all. 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 NCT06877741, which also lists 17 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 14 Mar 2025.