Abstract
Objective
To synthesise exercise therapy intervention data investigating patient rating outcomes for the management of tendinopathy.
Design
A systematic review and meta-analysis of randomized controlled trials investigating exercise therapy interventions and reporting patient rating outcomes.
Setting
Any setting in any country listed as very high on the human development index.
Participants
People with a diagnosis of any tendinopathy of any severity or duration.
Interventions
Exercise therapy for the management of tendinopathy comprising five different therapy classes: 1) resistance; 2) plyometric; 3) vibration; 4) flexibility, and 5) movement pattern retraining modalities, were considered for inclusion.
Main outcome measures
Outcomes measuring patient rating of condition, including patient satisfaction and Global Rating of Change (GROC).
Results
From a total of 124 exercise therapy studies, 34 (Achilles: 41%, rotator cuff: 32%, patellar: 15%, elbow: 9% and gluteal: 3%) provided sufficient information to be meta-analysed. The data were obtained across 48 treatment arms and 1246 participants. The pooled estimate for proportion of satisfaction was 0.63 [95%CrI: 0.53–0.73], and the pooled estimate for percentage of maximum GROC was 53 [95%CrI: 38–69%]. The proportion of patients reporting positive satisfaction and perception of change increased with longer follow-up periods from treatment onset.
Conclusion
Patient satisfaction and GROC appear similar and are ranked moderately high demonstrating that patients generally perceive exercise therapies positively. Further research including greater consistency in measurement tools is required to explore and where possible, identify patient- and exercise-related moderating factors that can be used to improve person-centred care.
Systematic Review Registration Number
PROSPERO ID=CRD42020168187
Contribution of paper
- Patient rating of condition is one of the least measured core outcome domains in studies investigating exercise therapy.
Patients are generally satisfied and report positive perceptions of change with exercise therapy for the management of tendinopathies.