{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:01:20Z","timestamp":1791853280291,"version":"4.3.4"},"reference-count":60,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Musculoskeletal disorders (MSDs) are a major contributor to global disability. Exercise-based rehabilitation is widely recommended as first-line management; however, in clinical practice, it is frequently combined with adjunct therapeutic modalities, and the incremental effectiveness of these approaches remains unclear. The present review addressed the research question: Do adjunct modalities provide additional benefits beyond exercise-based rehabilitation alone in individuals with musculoskeletal disorders? Methods: This systematic review was conducted according to PRISMA 2020 guidelines and prospectively registered in the PROSPERO database (registration number CRD420261309183). Electronic searches were performed in PubMed\/MEDLINE, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials to identify controlled clinical trials evaluating exercise-based rehabilitation delivered alone or combined with adjunct modalities. Outcomes included pain, functional disability, physical performance, strength, structural or imaging-based measures, biomechanical variables, injury risk, and work-related outcomes. Due to methodological heterogeneity across studies, a structured narrative and tabular synthesis were performed. Results: Twenty-one controlled clinical trials were included, encompassing tendinopathies (n = 7), knee osteoarthritis (n = 5), post-ACL reconstruction (n = 2), chronic spinal pain (n = 3), sarcopenia (n = 2), low bone mass (n = 2), and occupational musculoskeletal conditions (n = 1), with sample sizes ranging from 22 to 823 participants. Pain outcomes were reported in 18 studies (86%) and functional outcomes in 16 studies (76%). Exercise-based rehabilitation consistently produced clinically meaningful improvements across studies, whereas adjunct modalities demonstrated short-term advantages in a limited number of trials but rarely showed sustained long-term superiority. Conclusions: Evidence from controlled clinical trials indicates that exercise-based rehabilitation is an effective primary intervention for improving pain, functional capacity, and physical performance across diverse musculoskeletal conditions. Adjunct modalities may provide condition-specific or short-term benefits but do not consistently enhance long-term outcomes beyond structured exercise programs.<\/jats:p>","DOI":"10.3390\/life16040608","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T09:40:31Z","timestamp":1775554831000},"page":"608","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Is Exercise Enough? Evidence from Controlled Clinical Trials on Rehabilitation with and Without Adjunct Modalities for Musculoskeletal Disorders"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2452-8764","authenticated-orcid":false,"given":"Bindiya","family":"Rawat","sequence":"first","affiliation":[{"name":"Department of Liberal Arts and Social Sciences, Manipal University Jaipur, Jaipur 303007, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0331-705X","authenticated-orcid":false,"given":"Yajuvendra Singh","family":"Rajpoot","sequence":"additional","affiliation":[{"name":"Department of Sports Management & Coaching, Lakshmibai National Institute of Physical Education, Gwalior 474002, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9438-1554","authenticated-orcid":false,"given":"Sohom","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Sport Psychology, Lakshmibai National Institute of Physical Education, Gwalior 474002, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4357-0882","authenticated-orcid":false,"given":"Vasile-C\u0103t\u0103lin","family":"Ciocan","sequence":"additional","affiliation":[{"name":"Faculty of Movement, Sports, and Health Sciences, \u201dVasile Alecsandri\u201d University of Bacau, 600115 Bacau, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2928-2844","authenticated-orcid":false,"given":"Alina-Mihaela","family":"Cristuta","sequence":"additional","affiliation":[{"name":"Faculty of Movement, Sports, and Health Sciences, \u201dVasile Alecsandri\u201d University of Bacau, 600115 Bacau, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7491-5404","authenticated-orcid":false,"given":"Suchishrava","family":"Choudhary","sequence":"additional","affiliation":[{"name":"Department of Physical Education Pedagogy, Lakshmibai National Institute of Physical Education, Gwalior 474002, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6163-8065","authenticated-orcid":false,"given":"Prashant Kumar","family":"Choudhary","sequence":"additional","affiliation":[{"name":"Department of Physical Education Pedagogy, Lakshmibai National Institute of Physical Education, Gwalior 474002, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0598-8180","authenticated-orcid":false,"given":"Carmina-Mihaela","family":"Gorgan","sequence":"additional","affiliation":[{"name":"Faculty of Movement, Sports, and Health Sciences, \u201dVasile Alecsandri\u201d University of Bacau, 600115 Bacau, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8923-8653","authenticated-orcid":false,"given":"Constantin","family":"Sufaru","sequence":"additional","affiliation":[{"name":"Faculty of Movement, Sports, and Health Sciences, \u201dVasile Alecsandri\u201d University of Bacau, 600115 Bacau, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7576-3497","authenticated-orcid":false,"given":"Nicolae Lucian","family":"Voinea","sequence":"additional","affiliation":[{"name":"Faculty of Movement, Sports, and Health Sciences, \u201dVasile Alecsandri\u201d University of Bacau, 600115 Bacau, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Belluzzi, E., Pozzuoli, A., and Ruggieri, P. (2023). Musculoskeletal Diseases: From Molecular Basis to Therapy. Biomedicines, 12.","DOI":"10.3390\/biomedicines12010032"},{"key":"ref_2","unstructured":"(2023). GBD 2021 Other Musculoskeletal Disorders Collaborators. Global, regional, and national burden of other musculoskeletal disorders, 1990\u20132020, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol., 5, e670\u2013e682."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3455","DOI":"10.2147\/JPR.S488133","article-title":"From Pain to Progress: Comprehensive Analysis of Musculoskeletal Disorders Worldwide","volume":"17","author":"Zhou","year":"2024","journal-title":"J. Pain Res."},{"key":"ref_4","first-page":"e85532","article-title":"Musculoskeletal Disorders a Universal Source of Pain and Disability Misunderstood and Mismanaged: A Critical Analysis Based on the U.S. Model of Care","volume":"8","author":"Malik","year":"2018","journal-title":"Anesthesiol. Pain Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.pcad.2023.02.006","article-title":"Musculoskeletal exercise: Its role in promoting health and longevity","volume":"77","author":"Kirschner","year":"2023","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"De la Corte-Rodriguez, H., Roman-Belmonte, J.M., Resino-Luis, C., Madrid-Gonzalez, J., and Rodriguez-Merchan, E.C. (2024). The Role of Physical Exercise in Chronic Musculoskeletal Pain: Best Medicine\u2014A Narrative Review. Healthcare, 12.","DOI":"10.3390\/healthcare12020242"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/s40279-023-01966-2","article-title":"The Impact of Exercise Prescription Variables on Intervention Outcomes in Musculoskeletal Pain: An Umbrella Review of Systematic Reviews","volume":"54","author":"Arora","year":"2024","journal-title":"Sports Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Castillo-Bellot, I., Peir\u00f3, A.M., and Zandonai, T. (2025). The Effect of Physical Exercise on Non-Oncological Musculoskeletal Chronic Pain and Its Associated Biomarkers: Systematic Review on Randomized Controlled Trials. Life, 15.","DOI":"10.3390\/life15091413"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.17309\/tmfv.2025.6.12","article-title":"Identifying Biomechanical Risk Factors for Lower Limb Injuries in High Jump Athletes Using Penalised Logistic Regression","volume":"25","author":"Choudhary","year":"2025","journal-title":"Phys. Educ. Theory Methodol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Choudhary, P.K., Choudhary, S., Saha, S., Rajpoot, Y.S., Ciocan, V.-C., Nicolae-Lucian, V., Pavel, S.-I., and \u0218ufaru, C. (2026). Lower-Limb Biomechanical Adaptations to Exercise-Induced Fatigue During Running: A Systematic Review of Injury-Relevant Mechanical Changes. Life, 16.","DOI":"10.3390\/life16020272"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s40798-022-00456-5","article-title":"Extracorporeal Shockwave Therapy for Mid-portion and Insertional Achilles Tendinopathy: A Systematic Review of Randomized Controlled Trials","volume":"8","author":"Paantjens","year":"2022","journal-title":"Sports Med.-Open"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e50616","DOI":"10.2196\/50616","article-title":"Effects of Digital Physical Health Exercises on Musculoskeletal Diseases: Systematic Review with Best-Evidence Synthesis","volume":"12","author":"Nagel","year":"2024","journal-title":"JMIR mHealth uHealth"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"372","DOI":"10.5606\/tftrd.2022.8113","article-title":"A comparison between the efficacy of eccentric exercise and extracorporeal shock wave therapy on tendon thickness, vascularity, and elasticity in Achilles tendinopathy: A randomized controlled trial","volume":"68","author":"Benli","year":"2022","journal-title":"Turk. J. Phys. Med. Rehabil."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1177\/1941738121991791","article-title":"Line- and Point-Focused Extracorporeal Shock Wave Therapy for Achilles Tendinopathy: A Placebo-Controlled RCT Study","volume":"13","author":"Gatz","year":"2021","journal-title":"Sports Heal. A Multidiscip. Approach"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s10103-015-1840-4","article-title":"Photobiomodulation and eccentric exercise for Achilles tendinopathy: A randomized controlled trial","volume":"31","author":"Tumilty","year":"2016","journal-title":"Lasers Med. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"975","DOI":"10.2519\/jospt.2015.6015","article-title":"The Incremental Effects of Manual Therapy or Booster Sessions in Addition to Exercise Therapy for Knee Osteoarthritis: A Randomized Clinical Trial","volume":"45","author":"Abbott","year":"2015","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/j.joca.2016.03.001","article-title":"Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: A multi-center, factorial randomized clinical trial","volume":"24","author":"Fitzgerald","year":"2016","journal-title":"Osteoarthr. Cartil."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Ford, K.R., Taylor, J.B., Westbrook, A.E., Paterno, M.V., Huang, B., and Nguyen, A.-D. (2025). Outcomes of a randomized controlled trial of neuromuscular training with real-time biofeedback in young female athletes. BMC Musculoskelet. Disord., 26.","DOI":"10.1186\/s12891-025-08647-3"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1002\/jbmr.3284","article-title":"High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women with Osteopenia and Osteoporosis: The LIFTMOR Ran-domized Controlled Trial","volume":"33","author":"Watson","year":"2018","journal-title":"J. Bone Miner Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1038\/s41746-023-00870-3","article-title":"Randomized-controlled trial assessing a digital care program versus conventional physiotherapy for chronic low back pain","volume":"6","author":"Cui","year":"2023","journal-title":"npj Digit. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1001\/jamainternmed.2021.0991","article-title":"Effects of a Self-directed Web-Based Strengthening Exercise and Physical Activity Program Supported by Automated Text Messages for People with Knee Osteoarthritis: A Randomized Clinical Trial","volume":"181","author":"Nelligan","year":"2021","journal-title":"JAMA Intern. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"100411","DOI":"10.1016\/j.apunsm.2023.100411","article-title":"Efficacy of perturbation-based balance training in anterior cruciate ligament tears. A systematic review","volume":"58","year":"2023","journal-title":"Apunt. Sports Med."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Stergiou, M., Calvo, A.L., and Forelli, F. (2025). Effectiveness of Neuromuscular Training in Preventing Lower Limb Soccer Injuries: A Systematic Review and Meta-Analysis. J. Clin. Med., 14.","DOI":"10.3390\/jcm14051714"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"100313","DOI":"10.1016\/j.arrct.2023.100313","article-title":"Exercise and Musculoskeletal Health in Men with Low Bone Mineral Density: A Systematic Review","volume":"6","author":"Hu","year":"2024","journal-title":"Arch. Rehabilitation Res. Clin. Transl."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1136\/bjsports-2015-095424","article-title":"Exercise for osteoarthritis of the knee: A Cochrane systematic review","volume":"49","author":"Fransen","year":"2015","journal-title":"Br. J. Sports Med."},{"key":"ref_26","first-page":"CD009790","article-title":"Exercise therapy for chronic low back pain","volume":"9","author":"AHayden","year":"2021","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"876","DOI":"10.2519\/jospt.2015.5885","article-title":"A Proposed Return-to-Sport Program for Patients with Midportion Achilles Tendinopathy: Rationale and Implementation","volume":"45","author":"Silbernagel","year":"2015","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"611","DOI":"10.26603\/ijspt20200611","article-title":"A TEN TASK-BASED PROGRESSION IN REHABILITATION AFTER ACL RECONSTRUCTION: FROM POST-SURGERY TO RETURN TO PLAY\u2014A CLINICAL COMMENTARY","volume":"15","author":"Buckthorpe","year":"2020","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1249\/MSS.0000000000001944","article-title":"Effects of Physical Activity in Knee and Hip Osteoarthritis: A Systematic Umbrella Review","volume":"51","author":"Kraus","year":"2019","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1002\/jbmr.3865","article-title":"Effects of a 12-Month Supervised, Community-Based, Multimodal Exercise Program Followed by a 6-Month Research-to-Practice Transition on Bone Mineral Density, Trabecular Microarchitecture, and Physical Function in Older Adults: A Randomized Controlled Trial","volume":"35","author":"Daly","year":"2020","journal-title":"J. Bone Miner. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"S309","DOI":"10.1016\/j.jcot.2020.02.004","article-title":"Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine","volume":"11","author":"Simplicio","year":"2020","journal-title":"J. Clin. Orthop. Trauma"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jshs.2020.06.006","article-title":"Risk factors for overuse injuries in short- and long-distance running: A systematic review","volume":"10","author":"Slabbekoorn","year":"2021","journal-title":"J. Sport Health Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.bjpt.2018.12.002","article-title":"Clinical and scientific recommendations for the use of photobiomodulation therapy in exercise performance enhancement and post-exercise recovery: Current evidence and future directions","volume":"23","author":"Bjordal","year":"2019","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e70150","DOI":"10.1002\/ejp.70150","article-title":"Evaluating Manual Therapy in Musculoskeletal Pain: Why Certain Trial Designs May Overestimate Effectiveness\u2014A Scoping Review","volume":"29","author":"Grenier","year":"2025","journal-title":"Eur. J. Pain"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e41917","DOI":"10.1016\/j.heliyon.2025.e41917","article-title":"The impact of biofeedback in enhancing chronic pain rehabilitation: A systematic review of mechanisms and outcomes","volume":"11","author":"Calderone","year":"2025","journal-title":"Heliyon"},{"key":"ref_37","first-page":"8","article-title":"The assessment of musculoskeletal pain","volume":"107","author":"Hawker","year":"2017","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.ptsp.2021.02.002","article-title":"Many physiotherapists lack preparedness to prescribe physical activity and exercise to people with musculoskeletal pain: A multi-national survey","volume":"49","author":"Barton","year":"2021","journal-title":"Phys. Ther. Sport"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"40","DOI":"10.7326\/M17-0046","article-title":"For the CONSORT NPT Group* CONSORT Statement for Randomized Trials of Nonpharmacologic Treatments: A 2017 Update and a CONSORT Extension for Nonpharmacologic Trial Abstracts","volume":"167","author":"Boutron","year":"2017","journal-title":"Ann. Intern. Med."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2019). Cochrane Handbook for Systematic Reviews of Interventions, Wiley. [1st ed.]. Available online: https:\/\/onlinelibrary.wiley.com\/doi\/book\/10.1002\/9781119536604.","DOI":"10.1002\/9781119536604"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s13643-021-01626-4","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"10","author":"Page","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.23736\/S1973-9087.24.08361-8","article-title":"Randomized controlled trials as a source of evidence in rehabilitation: A critical analysis","volume":"60","author":"Schmitz","year":"2024","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.2147\/CIA.S473081","article-title":"Graded Progressive Home-Based Resistance Combined with Aerobic Exercise in Community-Dwelling Older Adults with Sarcopenia: A Randomized Controlled Trial","volume":"19","author":"Liu","year":"2024","journal-title":"Clin. Interv. Aging"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.physio.2016.09.001","article-title":"Comparison of three types of exercise in the treatment of rotator cuff tendinopa-thy\/shoulder impingement syndrome: A randomized controlled trial","volume":"103","author":"Heron","year":"2017","journal-title":"Physiotherapy"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"37","DOI":"10.4103\/jrms.JRMS_413_16","article-title":"Effectiveness of extracorporeal shockwave therapy for chronic Achilles tendinopathy: A randomized clinical trial","volume":"23","author":"Vahdatpour","year":"2018","journal-title":"J. Res. Med Sci."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Seo, M.-W., Jung, S.-W., Kim, S.-W., Lee, J.-M., Jung, H.C., and Song, J.-K. (2021). Effects of 16 Weeks of Resistance Training on Muscle Quality and Muscle Growth Factors in Older Adult Women with Sarcopenia: A Randomized Controlled Trial. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18136762"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"42","DOI":"10.5271\/sjweh.3760","article-title":"The impact of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion interventions on office worker productivity: A cluster-randomized trial","volume":"45","author":"Pereira","year":"2019","journal-title":"Scand. J. Work. Environ. Heal."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2242","DOI":"10.1001\/jama.2022.21893","article-title":"Effect of Diet and Exercise on Knee Pain in Patients with Osteoarthritis and Overweight or Obesity: A Randomized Clinical Trial","volume":"328","author":"Messier","year":"2022","journal-title":"JAMA"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.12669\/pjms.38.8.5730","article-title":"Neuromuscular Training following Anterior Cruciate Ligament reconstruction\u2014Pain, Function, Strength, Power & Quality of Life Perspective: A Randomized Control Trial","volume":"38","author":"Khalid","year":"2022","journal-title":"Pak. J. Med Sci."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Centeno, C.J., Fausel, Z., Dodson, E., Berger, D.R., and Steinmetz, N.J. (2024). Percutaneous bone marrow concentrate and platelet products versus exercise therapy for the treatment of rotator cuff tears: A randomized controlled, crossover trial with 2-year follow-up. BMC Musculoskelet. Disord., 25.","DOI":"10.1186\/s12891-024-07519-6"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1080\/09593985.2018.1430876","article-title":"Effects of the craniocervical flexion and isometric neck exercise compared in patients with chronic neck pain: A randomized controlled trial","volume":"34","author":"Chung","year":"2018","journal-title":"Physiother. Theory Pr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e967","DOI":"10.7717\/peerj.967","article-title":"Astym treatment vs. eccentric exercise for lateral elbow tendinopathy: A randomized controlled clinical trial","volume":"3","author":"Sevier","year":"2015","journal-title":"PeerJ"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.1007\/s00167-016-4223-x","article-title":"Eccentric versus conventional exercise therapy in patients with rotator cuff tendinopathy: A randomized, single blinded, clinical trial","volume":"25","author":"Dejaco","year":"2017","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"115362","DOI":"10.1016\/j.bone.2020.115362","article-title":"Effects of supervised high-intensity resistance and impact training or machine-based isometric training on regional bone geometry and strength in middle-aged and older men with low bone mass: The LIFTMOR-M semi-randomised controlled trial","volume":"136","author":"Harding","year":"2020","journal-title":"Bone"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.clinbiomech.2018.09.016","article-title":"Quadriceps-strengthening exercise and quadriceps and knee biomechanics during walking in knee osteoarthritis: A two-centre randomized controlled trial","volume":"59","author":"DeVita","year":"2018","journal-title":"Clin. Biomech."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1136\/bjsports-2020-103403","article-title":"Effectiveness of progressive tendon-loading exercise therapy in patients with patellar tendinopathy: A randomised clinical trial","volume":"55","author":"Breda","year":"2021","journal-title":"Br. J. Sports Med."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Prud\u00eancio, D.A., Maffulli, N., Migliorini, F., Serafim, T.T., Nunes, L.F., Sanada, L.S., and Okubo, R. (2023). Eccentric exercise is more effective than other exercises in the treatment of mid-portion Achilles tendinopathy: Systematic review and meta-analysis. BMC Sports Sci. Med. Rehabil., 15.","DOI":"10.1186\/s13102-023-00618-2"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.17309\/tmfv.2025.6.06","article-title":"Analyzing the Effects of a 12-Week Yoga and Elastic-Band Resistance Training Program on Functional Fitness in Intermediate-Level Male Tennis Athletes: A Randomised Controlled Trial","volume":"25","author":"Choudhary","year":"2025","journal-title":"Phys. Educ. Theory Methodol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1136\/bjsports-2015-094639","article-title":"Neuromuscular training injury prevention strategies in youth sport: A systematic review and meta-analysis","volume":"49","author":"AEmery","year":"2015","journal-title":"Br. J. Sports Med."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Vecchiato, M., Duregon, F., Zanardo, E., Baioccato, V., Quinto, G., Livio, A., Mazzucato, B., Sarri, C., Bellis, L., and Carella, C. (2024). Tailored exercise with telehealth monitoring improves adherence and global health in kidney transplant recipients. Front. Sports Act. Living, 6.","DOI":"10.3389\/fspor.2024.1436742"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/4\/608\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T09:59:05Z","timestamp":1775555945000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/4\/608"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":60,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["life16040608"],"URL":"https:\/\/doi.org\/10.3390\/life16040608","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]}}}