{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:16:40Z","timestamp":1788542200791,"version":"build-2803163510"},"reference-count":46,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Funct. Morphol. Kinesiol.","JFMK"],"abstract":"<jats:p>Background: Patellar tendinopathy is a persistent load-related condition in athletes, and exercise is recommended as first-line care; however, the comparative value of specific tendon-loading prescriptions remains uncertain. This systematic review aimed to synthesize exercise-based interventions for adults with patellar tendinopathy, map reported loading prescription parameters, and estimate comparative effects when sufficiently comparable active-loading data were available. Methods: We conducted a PROSPERO-registered systematic review following PRISMA 2020. MEDLINE\/PubMed, Web of Science Core Collection, Scopus, SPORTDiscus, and CENTRAL via Ovid\/EBMR Reviews were searched. Two reviewers independently screened studies, extracted data, and assessed risk of bias. The primary outcome was VISA-P\/VISA final score. Randomized active exercise\/loading comparisons with extractable final-score data were pooled as mean differences on the original 0\u2013100 scale using random-effects restricted maximum likelihood models with Hartung\u2013Knapp adjustment. Results: The searches identified 942 records; 96 full-text reports were assessed and 40 reports were retained for qualitative synthesis. Six active exercise\/loading comparisons contributed to the primary comparative synthesis. The pooled mean difference was 5.16 VISA-P\/VISA points (95% CI 2.39 to 7.93) in favour of the first-listed intervention, with negligible statistical heterogeneity (tau2 = 0.000; I2 = 0.0%; Q = 3.50, p = 0.624). All contributing studies had some concerns in RoB 2, and GRADE certainty was low. Conclusions: Structured tendon-loading exercise remains central to rehabilitation. The pooled estimate should be interpreted as a small average comparative signal across clinically distinct active-loading contrasts, not as evidence that one specific loading strategy is universally superior.<\/jats:p>","DOI":"10.3390\/jfmk11030348","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:19:26Z","timestamp":1788232766000},"page":"348","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exercise Loading Strategies for Patellar Tendinopathy: A Systematic Review and Meta-Analysis of Clinical Outcomes"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7697-419X","authenticated-orcid":false,"given":"Alejandro","family":"Bruna-Mejias","sequence":"first","affiliation":[{"name":"Departamento de Ciencias y Geograf\u00eda, Facultad de Ciencias Naturales y Exactas, Universidad de Playa Ancha, Valpara\u00edso 2360072, Chile"},{"name":"Departamento de Morfolog\u00eda, Facultad de Medicina, Universidad Andr\u00e9s Bello, Vi\u00f1a del Mar 2520000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Ca\u00f1as-Jamett","sequence":"additional","affiliation":[{"name":"Physiology Laboratory, Department of Biological Sciences, Faculty of Life Sciences, Universidad Andres Bello, Vi\u00f1a del Mar 2520000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jos\u00e9","family":"Valenzuela Fuenzalida","sequence":"additional","affiliation":[{"name":"Departamento de Morfolog\u00eda, Facultad de Medicina, Universidad Andr\u00e9s Bello, Vi\u00f1a del Mar 2520000, Chile"},{"name":"Departamento de Ciencias Qu\u00edmica y Biol\u00f3gicas, Facultad de Ciencias de la Salud, Universidad Bernardo O\u2019Higgins, Santiago 8370993, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2889-3667","authenticated-orcid":false,"given":"Mar\u00eda P.","family":"Moya-Daza","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Universidad Aut\u00f3noma de Chile, Santiago 8910060, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9092-3469","authenticated-orcid":false,"given":"Gustavo","family":"Oyanedel","sequence":"additional","affiliation":[{"name":"Faculty of Health and Social Sciences, University of the Americas, Santiago 8370040, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6497-3480","authenticated-orcid":false,"given":"Gloria","family":"Cifuentes-Suazo","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Carrera de Odontolog\u00eda, Universidad Cat\u00f3lica de la Sant\u00edsima Concepci\u00f3n, Av. Alonso de Ribera 2850, Concepci\u00f3n 4090541, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Villaroel","sequence":"additional","affiliation":[{"name":"Vicerrectoria Acad\u00e9mica, Universidad Mayor, Santiago 7500000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1781-062X","authenticated-orcid":false,"given":"Mathias","family":"Orellana Donoso","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad Finis Terrae, Santiago 7501015, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Mateluna-Valls","sequence":"additional","affiliation":[{"name":"Carrera de Kinesiolog\u00eda, Departamento de Salud, Comunidad y Gesti\u00f3n, Facultad de Ciencias de la Salud, Universidad de Playa Ancha, Valpara\u00edso 2340000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jose","family":"Cabeza-Salgado","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Cat\u00f3lica del Maule, Talca 3460000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8130-6460","authenticated-orcid":false,"given":"Jos\u00e9 E.","family":"Le\u00f3n-Rojas","sequence":"additional","affiliation":[{"name":"Cerebro, Emoci\u00f3n y Conducta (CEC) Research Group, Escuela de Medicina, Universidad de las Am\u00e9ricas (UDLA), Quito 170521, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2599-8474","authenticated-orcid":false,"given":"Juan","family":"Sanchis-Gimeno","sequence":"additional","affiliation":[{"name":"GIAVAL Research Group, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Valencia, 46001 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1177\/0363546504270454","article-title":"Prevalence of jumper\u2019s knee among elite athletes from different sports: A cross-sectional study","volume":"33","author":"Lian","year":"2005","journal-title":"Am. 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