Mallows, A, Debenham, J, Malliaras, P, Stace, R and Littlewood, C (2018) Cognitive and contextual factors to optimise clinical outcomes in tendinopathy. British Journal of Sports Medicine, 52 (13). pp. 822-823. ISSN 1473-0480

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Abstract

Tendinopathy, a clinical term used to describe ‘tendon-related pain’, is a heterogeneous clinical presentation, reflected by the wide-ranging pain presentations and functional deficits.1 For this population, load-based exercise is effective; however, the ‘optimal’ type of exercise, intensity, frequency and duration are not known.2 3

Substantial variety has been a feature of the exercise prescription used in tendinopathy research to date. However, this variation does not appear to have impacted the results. Exercise programmes as different as a concentric-eccentric heavy slow loading programme performed three times per week and eccentric only exercises performed twice daily, 7 days/week, have achieved similar results.4 While within-group mean severity scores improve, individual responses are wide ranging for the same exercise programme4 and success rates vary from 44% failing to improve5 to 100% success6 for a similar exercise intervention.

Here we discuss a novel consideration to explain such phenomena—cognitive and contextual factors that affect each individual therapeutic encounter. We acknowledge that heterogeneity in the research cohorts (eg, age, sex, chronicity, comorbidities) or variations in how the exercise programme was delivered and progressed likely play a role, but we focus on factors we feel have received little attention.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via BMJ Publishing Group at http://dx.doi.org/10.1136/bjsports-2017-098064 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: tendinopathy, education, knowledge transfer, rehabilitation, 5 intervention effectiveness
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 26 Sep 2017 12:43
Last Modified: 28 Aug 2018 13:42
URI: http://eprints.keele.ac.uk/id/eprint/4050

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