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Objectives: The primary purpose of this systematic review is to examine the literature on resistance training interventions for lower limb tendinopathy to evaluate the proportion of interventions that implemented key resistance training principles (specificity, progression, overload, individualisation) and reported relevant prescription components (frequency, intensity, sets, repetitions) and reported intervention adherence. Design: Two reviewers performed a qualitative systematic review after screening titles and abstracts based on eligibility criteria. Identified papers were obtained in full text, with data extracted regarding the implementation of resistance training principles. Included articles were evaluated by the Cochrane risk of bias tool, with a scoring tool out of 10 used for implementation and reporting of the 5 key principles. Scientific databases were searched in November 2020 and included Medline, CINAHL, AMED, and Sportsdiscus.Results: 52 randomised controlled trials investigating resistance training in five different lower limb tendinopathies were included. Although most studies considered the principles of progression (92%) and individualisation (88%), only 19 studies (37%) appropriately described how this progression in resistance was achieved, and only 18 studies (35%) reported specific instruction on how individualisation was applied. Adherence was considered in 27 studies (52%), with only 17 studies (33%) reporting the levels of adherence. In the scoring criteria, only 5 studies (10%) achieved a total maximum score of 10, with 17 studies (33%) achieving a maximum score of 8 for implementing and reporting the principles of specificity, overload, progression and individualisation.Conclusion: There is meaningful variability and methodological concerns regarding the application and reporting of resistance training principles, particularly progression and individualisation, along with intervention adherence throughout studies. Collectively, these findings have important implications for the prescription of current resistance training interventions, including the design and implementation of future interventions for populations with lower limb tendinopathies.

Background: Plantar heel pain (PHP) is a common musculoskeletal disorder, with both extracorporeal shockwave therapy (ESWT) and specific exercise such as plantar fascia specific stretching shown to be effective treatments. This review aimed to evaluate the effectiveness of combined ESWT and exercise interventions versus other interventions in treating PHP. Methods: A systematic review of effectiveness was conducted, adhering to the PRISMA guidelines. Five databases were searched for studies published between January 2000 and March 2020, with 12 studies meeting the inclusion criteria. The Grading of Recommendations Assessment Development and Evaluation (GRADE) framework was used to determine quality of recommendations. Results: The 12 included studies (n = 861) compared ESWT and stretching with various other treatments. Due to clinical and methodological heterogeneity, pooling of data was not possible, and a narrative synthesis of findings was provided. There was high quality evidence that combined ESWT and stretching interventions are more effective than those using either alone or botulinum toxin injections, and low-quality evidence of superiority versus ultrasound and stretching. There was moderate quality evidence that combined ESWT and stretching is no more effective than corticosteroid injection (CSI), and high quality evidence that the combination is no more effective than blood-derived injection therapies, custom orthotics or low-level laser therapy (LLLT) combined with stretching. There is high quality evidence that the use of topical corticosteroid or laser therapy in combination with ESWT and stretching increases effectiveness compared to ESWT and stretching alone, and moderate quality evidence for the additive effective of dry needling. Conclusions: Combined ESWT and stretching treatments are effective and may be recommended where they are available and practical to implement. Further high-quality studies with larger sample sizes and longer follow-up durations comparing combined interventions for PHP, including different exercise types such as resistance training are required.

Background: Plantar heel pain (PHP) is considered a tendinopathy and it affects up to 10% of the population. Both heavy slow resistance training (HSRT) and extracorporeal shockwave therapy (ESWT) have shown effectiveness for treating PHP in isolation. However more comprehensive exercise protocols and progression methods are needed due to poor long-term outcomes, and better standardization of ESWT protocols are required. Autoregulation of resistance training involves self-selecting exercise dosage based on individual factors. Although autoregulation has proven effective for strength gains in athletes, it has not been investigated in tendinopathy. It is recommended that PHP not be treated by one treatment in isolation, with there being a need to investigate feasibility and effectiveness of combined treatments in PHP. Currently, no studies have investigated autoregulated HSRT combined with ESWT, despite their individual efficacy. The optimal treatment protocol for PHP is unknown, and there is a need to ascertain whether the addition of ESWT to autoregulated HSRT leads to better outcomes compared to either alone. Methods: A three-arm randomised controlled trial (RCT) comparing these groups would be the ideal way to investigate this question, with a pilot RCT testing trial procedures and process evaluation required prior to a definitive RCT. Patients expectations, feasibility and acceptability of combined ESWT and exercise for PHP also remain unknown. Therefore, the addition of qualitative interviews in a mixed methods pilot RCT would help ascertain acceptability and help explain the intervention outcomes.

Background: Musculoskeletal disorders such as tendinopathy are having an increasing burden on society and health systems. Plantar heel pain (PHP) is considered a tendinopathy and it affects up to 10% of the population, having a high incidence in running athletes. Although resistance training has shown short-term effectiveness for treating PHP, more comprehensive exercise protocols and progression methods are needed due to poor long-term outcomes. Combining heavy slow resistance training with other types of exercise, such as plyometric exercise could lead to superior outcomes. It is recommended that PHP not be treated by one exercise type in isolation. However, studies often use only one type of exercise, with there being a need to investigate feasibility and effectiveness of comprehensive exercise programs in PHP. Resistance training programs in PHP are currently not achieving required intensity and dosage, leading to high recurrence rates. Therefore, better methods for progressing resistance training are required to improve outcomes. One potential method is autoregulation, which allows individuals to progress at their own rate, taking individual factors into account. Despite being found effective in increasing strength in healthy athletes, autoregulation methods have not been investigated in tendinopathy. Methods: A feasibility cohort study investigating a comprehensive exercise program for PHP could test feasibility and acceptability, prior to conducting a larger-scale study. A feasibility study would also help to determine if specific autoregulation progression methods for resistance training is feasible and acceptable for use with PHP patients. Patients expectations, and views on feasibility and acceptability of different types of exercise as well as autoregulation progression methods for PHP are unknown. Therefore, the addition of qualitative interviews in a mixed methods format would help ascertain acceptability of these methods and exercise interventions for the first time and help explain the intervention outcomes, allowing for design of a larger-scale study to determine effectiveness.

Musculoskeletal disorders, such as tendinopathy, are placing an increasing burden on society and health systems. Tendinopathy accounts for up to 30% of musculoskeletal disorders, with a high incidence in athletes and the general population. Although resistance training has shown short-term effectiveness in the treatment of lower limb tendinopathy, more comprehensive exercise protocols and progression methods are required due to poor long-term outcomes. The most common resistance training protocols are predetermined and standardized, which presents significant limitations. Current standardized protocols do not adhere to scientific resistance training principles, consider individual factors, or take the importance of individualized training into account. Resistance training programs in case of tendinopathy are currently not achieving the required intensity and dosage, leading to high recurrence rates. Therefore, better methods for individualizing and progressing resistance training are required to improve outcomes. One potential method is autoregulation, which allows individuals to progress training at their own rate, taking individual factors into account. Despite the finding of their effectiveness in increasing the strength of healthy athletes, autoregulation methods have not been investigated in case of tendinopathy. The purpose of this narrative review was 3-fold: firstly, to give an overview and a critical analysis of the individual factors involved in tendinopathy and current resistance training protocols and their limitations. Secondly, to give an overview of the history, methods, and application of autoregulation strategies both in sports performance and physiotherapy. Finally, a theoretical adaptation of a current tendinopathy resistance training protocol using autoregulation methods is presented, providing an example of how the method could be implemented in clinical practice or future research.

Introduction: Breast cancer and its treatments lead to several physical and psychological repercussions in the short and long term. Furthermore, breast cancer survivors (BCS) tend to present sedentary behavior, which worsens the aforementioned breast cancer treatment side effects. Physical exercise has been demonstrated to be effective for improving physical and psychological BCS aspects. Therefore, the purpose of this study is to investigate the effects of 24 weeks of supervised Mat Pilates on force production, flexibility, postural control, gait, body composition, pain, cancer related fatigue (CRF), body image, physical activity level, quality of life, and nutritional status in BCS undergoing hormone therapy. Methods and design: The HAPiMat Study is a randomized controlled clinical intervention trial comparing Mat Pilates with a control group. The primary outcomes are force production in different muscle groups, upper and lower limb flexibility, and gait and balance parameters. The secondary outcomes are quality of life, pain, cancer related fatigue, body image, sedentary behavior, functional capacity, physical activity level, nutritional intake, anthropometric measurements, and body composition. The safety of the Mat Pilates intervention and physical assessments are monitored throughout the intervention. Discussion: The strengths of this study are that the Pilates Method is mind-body training, which might ameliorate the side effects of breast cancer treatments, and that our intervention is systematized into sets, with the number of repetitions increased every eight weeks, enabling better results in the physical variables. Moreover, to date, no Pilates studies have focused on BCS undergoing hormone therapy only.

Review Objective: To synthesize the best available evidence on the effectiveness of interventions that have used autoregulated and individualised resistance training versus pre-determined and standardised resistance training in treating any tendinopathy. Introduction: Recent evidence suggests that individualised exercise may be more effective than standardised exercise for musculoskeletal disorders such as tendinopathy. However, no systematic reviews have been conducted on the topic and optimal treatment protocols and clinical recommendations are lacking.Inclusion criteria: Randomised controlled trials assessing the effectiveness of autoregulated and individualised resistance training versus pre-determined and standardised resistance training for tendinopathy in adults will be included. Methods: The authors will search for a wide range of sources to find both published and unpublished studies via EBSCOhost, including, but not limited to, MEDLINE, SPORTDiscus, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and Allied and Complementary Medicine Database (AMED). Studies published in a language other than English will only be considered if a translation is available. The JBI systematic review methodology will be followed when conducting the review. Data synthesis will be conducted using meta-analysis or narrative synthesis, where appropriate.

Background: Low physical activity levels and poor physical functioning are strongly associated with poor clinical outcomes and mortality in adult End Stage Kidney Disease (ESKD) patients, regardless of treatment modality. Compared to the general population, individuals with chronic kidney disease are physically inactive, have reduced physical abilities and difficulties performing routine daily tasks, lower health-related quality of life, higher cardiovascular morbidity and mortality. In addition, frail ESKD patients have higher hospitalization and mortality rates than other ESKD patients. Evidence suggests that assessment and recommendations for physical activity should be part of standard care for ESKD patients. Structured exercise can improve physical function and quality of life in frail older adults and may be used specifically for management of frailty in ESKD. However, research is needed to determine best practices for implementation of physical function measurements and physical activity promotion in standard ESKD care. Objective: The proposed Move More study will assess the feasibility of a physical activity intervention offered to the ESKD inpatients in Calgary, Alberta. Specifically, this study is designed to examine the effects of an early physical activity/mobility intervention led by a kinesiologist (KT), and supported by the clinical care team including physiotherapists (PT) and nurse clinicians.Methods: The Move More study is a single-arm pilot intervention examining feasibility and preliminary efficacy. ESKD inpatients at the Foothills Medical Centre will be recruited to participate. Patients will receive an individualized in-hospital physical activity/mobility intervention. Frailty and physical function will be assessed at baseline and post-intervention prior to hospital discharge. Conclusions: Evidence needed to support the inclusion of mobility and physical activity as part of standard care will be gathered, with knowledge gained used to help direct future physical activity programming for ESKD inpatients.

Physical activity is considered a strategy to improve health. This reasoning implies that physical inactivity is the reference behavior, which is not the case. In health, the gold standard is a state of complete physical, mental and social well-being.1 Physical inactivity involves a higher risk of cardiovascular disease2, hypertension3, diabetes2,4, cancer5, depression6, and obesity7. Moreover, 6 to 10% of all deaths from non-communicable diseases worldwide can be attributed to physical inactivity.8 Therefore, physically active individuals appear to be closer to the health gold standard than inactive individuals. Physical activity – not inactivity – should be the standard reference behavior. In this reversed framework, physical inactivity becomes a clinically significant disturbance in an individual's behavior, which is the definition of a behavioral disorder.9 Therefore, physical inactivity should be treated as such.

Background: Plantar heel pain (PHP) is considered a tendinopathy and it affects up to 10% of the population. Both heavy slow resistance training (HSRT) and extracorporeal shockwave therapy (ESWT) have shown effectiveness for treating PHP in isolation. However more comprehensive exercise protocols and progression methods are needed due to poor long-term outcomes, and better standardization of ESWT protocols are required. Autoregulation of resistance training involves self-selecting exercise dosage based on individual factors. Although autoregulation has proven effective for strength gains in athletes, it has not been investigated in tendinopathy. It is recommended that PHP not be treated by one treatment in isolation, with there being a need to investigate feasibility and effectiveness of combined treatments in PHP. Currently, no studies have investigated autoregulated HSRT combined with ESWT, despite their individual efficacy. The optimal treatment protocol for PHP is unknown, and there is a need to ascertain whether the addition of ESWT to autoregulated HSRT leads to better outcomes compared to either alone. Methods: A three-arm randomised controlled trial (RCT) comparing these groups would be the ideal way to investigate this question, with a pilot RCT testing trial procedures and process evaluation required prior to a definitive RCT. Patients expectations, feasibility and acceptability of ESWT and exercise for PHP also remain unknown. Therefore, the addition of qualitative interviews in a mixed methods pilot RCT would help ascertain acceptability and help explain the intervention outcomes.

Review Objective: To synthesize the best available evidence on the effectiveness of interventions that have used a combination of extracorporeal shockwave therapy and any type of exercise to treat plantar heel pain compared to any other treatment intervention. Introduction: Recent evidence suggests combining shockwave therapy and exercise may be more effective than other treatments for plantar heel pain. However, no systematic reviews have been conducted on the topic and optimal treatment protocols and clinical recommendations are lacking.Inclusion criteria: Randomised controlled trials assessing the effectiveness of combined shockwave therapy and exercise for plantar heel pain in adults will be included. Methods: The authors will search for a wide range of sources to find both published and unpublished studies via EBSCOhost, including, but not limited to, MEDLINE, SPORTDiscus, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and Allied and Complementary Medicine Database (AMED). Studies published in a language other than English will only be considered if a translation is available. The JBI systematic review methodology will be followed when conducting the review. Data synthesis will be conducted using meta-analysis or narrative synthesis, where appropriate. Systematic review registration number: CRD42020213286