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25 Are patients satisfied? A systematic review and meta-analysis of exercise therapy in the management of tendinopathy
  1. Joanna Shim1,
  2. Anastasia Pavlova1,
  3. Rachel Moss1,
  4. Colin MacLean2,
  5. David Brandie3,
  6. Laura Mitchell4,
  7. Eva Parkinson1,
  8. Leon Greig1,
  9. Dylan Morrissey5,
  10. Lyndsay Alexander1,
  11. Kay Cooper1,
  12. Paul Swinton1
  1. 1School of Health Sciences, Robert Gordon University, UK
  2. 2Library Services, Robert Gordon University, UK
  3. 3Sport UK
  4. 4NHS Grampian, UK
  5. 5Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, UK


Introduction Patient satisfaction is consistently associated with improved health outcomes and higher quality of life. However, its relationship to tendinopathy outcomes is under-explored. The purpose of this systematic review and meta-analysis was to synthesise intervention data investigating patient satisfaction and self-perceived improvement or deterioration following engagement in exercise therapy for the management of tendinopathy.

Materials and Methods A search of controlled trials investigating exercise therapy interventions across all tendinopathies was made extracting data assessing patient rating of overall condition. Outcomes were split into those measuring satisfactions (binary) and those measuring global rating of change (GROC). Bayesian hierarchical models were used to meta-analyse proportions and mean effect size (percentage of maximum) for the two outcome categories.

Results From a total of 218 studies investigating exercise therapy for tendinopathy, 22 studies (Achilles: 40.9%, patellar: 22.7%, rotator cuff: 18.2%, elbow: 13.6% and gluteal: 4.5%) provided sufficient information to be meta-analysed. The data comprised of 35 treatment arms and 796 participants. The pooled estimate of the proportion of positive satisfaction (43 outcomes from 19 studies) was equal to 61.3% [95%CrI: 55.3–77.2], and the pooled estimate of percentage of maximum GROC (17 outcomes from 4 studies) was equal to 52.1% [95%CrI: 39.1–65.2].

Conclusion Patient satisfaction is not commonly reported in tendinopathy research, and in those studies where it is reported, satisfaction and GROC appear similar and are ranked moderately high demonstrating patients generally perceive exercise therapy for tendinopathy positively. Further research investigating satisfaction and GROC is required to identify moderating factors and improve patient-centred care.

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