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      Oral Supplementation of Specific Collagen Peptides Combined with Calf-Strengthening Exercises Enhances Function and Reduces Pain in Achilles Tendinopathy Patients

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          Abstract

          The current pilot study investigates whether oral supplementation of specific collagen peptides improves symptoms and tendon vascularisation in patients with chronic mid-portion Achilles tendinopathy in combination with structured exercise. Participants were given a placebo or specific collagen peptides (TENDOFORTE ®) in combination with a bi-daily calf-strengthening program for 6 months. Group AB received specific collagen peptides for the first 3 months before crossing over to placebo. Group BA received placebo first before crossing over to specific collagen peptides. At baseline (T1), 3 (T2) and 6 (T3) months, Victorian Institute of Sports Assessment–Achilles (VISA-A) questionnaires and microvascularity measurements through contrast-enhanced ultrasound were obtained in 20 patients. Linear mixed modeling statistics showed that after 3 months, VISA-A increased significantly for group AB with 12.6 (9.7; 15.5), while in group BA VISA-A increased only by 5.3 (2.3; 8.3) points. After crossing over group AB and BA showed subsequently a significant increase in VISA-A of, respectively, 5.9 (2.8; 9.0) and 17.7 (14.6; 20.7). No adverse advents were reported. Microvascularity decreased in both groups to a similar extent and was moderately associated with VISA-A ( R c 2:0.68). We conclude that oral supplementation of specific collagen peptides may accelerate the clinical benefits of a well-structured calf-strengthening and return-to-running program in Achilles tendinopathy patients.

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          The VISA-A questionnaire: a valid and reliable index of the clinical severity of Achilles tendinopathy.

          There is no disease specific, reliable, and valid clinical measure of Achilles tendinopathy. To develop and test a questionnaire based instrument that would serve as an index of severity of Achilles tendinopathy. Item generation, item reduction, item scaling, and pretesting were used to develop a questionnaire to assess the severity of Achilles tendinopathy. The final version consisted of eight questions that measured the domains of pain, function in daily living, and sporting activity. Results range from 0 to 100, where 100 represents the perfect score. Its validity and reliability were then tested in a population of non-surgical patients with Achilles tendinopathy (n = 45), presurgical patients with Achilles tendinopathy (n = 14), and two normal control populations (total n = 87). The VISA-A questionnaire had good test-retest (r = 0.93), intrarater (three tests, r = 0.90), and interrater (r = 0.90) reliability as well as good stability when compared one week apart (r = 0.81). The mean (95% confidence interval) VISA-A score in the non-surgical patients was 64 (59-69), in presurgical patients 44 (28-60), and in control subjects it exceeded 96 (94-99). Thus the VISA-A score was higher in non-surgical than presurgical patients (p = 0.02) and higher in control subjects than in both patient populations (p<0.001). The VISA-A questionnaire is reliable and displayed construct validity when means were compared in patients with a range of severity of Achilles tendinopathy and control subjects. The continuous numerical result of the VISA-A questionnaire has the potential to provide utility in both the clinical setting and research. The test is not designed to be diagnostic. Further studies are needed to determine whether the VISA-A score predicts prognosis.
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            Heavy Slow Resistance Versus Eccentric Training as Treatment for Achilles Tendinopathy: A Randomized Controlled Trial.

            Previous studies have shown that eccentric training has a positive effect on Achilles tendinopathy, but few randomized controlled trials have compared it with other loading-based treatment regimens.
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              Identification of food-derived collagen peptides in human blood after oral ingestion of gelatin hydrolysates.

              In the present study, we identified several food-derived collagen peptides in human blood after oral ingestion of some gelatin hydrolysates. Healthy human volunteers ingested the gelatin hydrolysates (9.4-23 g) from porcine skin, chicken feet, and cartilage after 12 h of fasting. Negligible amounts of the peptide form of hydroxyproline (Hyp) were observed in human blood before the ingestion. After the oral ingestion, the peptide form of Hyp significantly increased and reached a maximum level (20-60 nmol/mL of plasma) after 1-2 h and then decreased to half of the maximum level at 4 h after the ingestion. Major constituents of food-derived collagen peptides in human serum and plasma were identified as Pro-Hyp. In addition, small but significant amounts of Ala-Hyp, Ala-Hyp-Gly, Pro-Hyp-Gly, Leu-Hyp, Ile-Hyp, and Phe-Hyp were contained.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                02 January 2019
                January 2019
                : 11
                : 1
                : 76
                Affiliations
                [1 ]Department of Sport Medicine, Australian Institute of Sport, Leverrier St, Bruce ACT 2617, Australia; marijke.welvaert@ 123456canberra.edu.au (M.W.); nicole.vlahovich@ 123456ausport.gov.au (N.V.); greglovell544@ 123456gmail.com (G.L.); silvia.manzanero@ 123456gmail.com (S.M.); david.hughes@ 123456ausport.gov.au (D.H.); gordon.waddington@ 123456canberra.edu.au (G.W.)
                [2 ]University of Canberra Research Institute for Sport and Exercise (UCRISE), Cnr Allawoona St & Ginninderra Drive Bruce, ACT 2617, Australia; jamie.gaida@ 123456canberra.edu.au
                [3 ]Department of Physiotherapy, Australian Institute of Sport, Leverrier St, Bruce ACT 2617, Australia; cpurdam@ 123456gmail.com
                [4 ]Department of Sports Nutrition, Australian Institute of Sport, Leverrier St, Bruce ACT 2617, Australia; louise.burke@ 123456ausport.gov.au
                [5 ]Discipline of Physiotherapy, University of Canberra, Building 1/11 Kirinari St, Bruce ACT 2617, Australia
                Author notes
                [* ]Correspondence: stephan.praet@ 123456canberra.edu.au ; Tel.:+61-2-6180-8500
                Author information
                https://orcid.org/0000-0001-6714-9027
                https://orcid.org/0000-0002-5294-7082
                Article
                nutrients-11-00076
                10.3390/nu11010076
                6356409
                30609761
                db85c072-acf3-40c9-a085-b3908bf2b9a0
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 03 December 2018
                : 24 December 2018
                Categories
                Article

                Nutrition & Dietetics
                achilles tendon,microvessels,contrast-enhanced ultrasound,hydrolysed collagen supplementation

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