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Loading-based exercise has become the principal non-surgical choice for the treatment of AT; however, mechanistic evidence by which loading-based treatment may help to resolve tendon pain remains unclear. This systematic review aims to summarise the evidence of the neuromechanical changes produced by AT and by exercise-induced mechanical loading.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This systematic review protocol was informed and reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA-P) and the Cochrane Handbook for Systematic Reviews of Interventions. Pubmed, MEDLINE, EMBASE, CINAHL Plus, Web of Science and SPORTDiscus electronic databases will be searched from inception to February 2021. Additionally, grey literature and key journals will be reviewed. Risk of bias will be determined independently by two reviewers using the version 2 of the Cochrane risk-of-bias tool for randomised trials (RoB 2) and the risk of bias in non-randomised studies - of interventions (ROBINS-I) tool according to Cochrane recommendations. Quality of the cumulative evidence will be assessed with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines. If homogeneity exists between groups of studies, a random-effects meta-analysis will be conducted. If not, results will be synthesised narratively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Our findings will be disseminated through publication in a peer-reviewed journal and presented at conferences. No ethical approval was required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42021231933.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-050186","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T12:11:49Z","timestamp":1644322309000},"page":"e050186","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Neuromechanical changes in Achilles tendinopathy and the effects of exercise-induced mechanical tendon loading: a protocol for a systematic review"],"prefix":"10.1136","volume":"12","author":[{"given":"Ignacio","family":"Contreras-Hernandez","sequence":"first","affiliation":[{"name":"Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1689-6190","authenticated-orcid":false,"given":"Deborah","family":"Falla","sequence":"additional","affiliation":[{"name":"Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8411-2012","authenticated-orcid":false,"given":"Alessandro","family":"Schneebeli","sequence":"additional","affiliation":[{"name":"Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK"},{"name":"Rehabilitation Research Laboratory, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5790-7514","authenticated-orcid":false,"given":"Eduardo","family":"Martinez-Valdes","sequence":"additional","affiliation":[{"name":"Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,2,8]]},"reference":[{"key":"2025121510543854000_12.2.e050186.1","doi-asserted-by":"crossref","unstructured":"Millar NL , Silbernagel KG , Thorborg K , et al . 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