Table 2.
Samples, characteristics of interventions and outcome measures of the included studies
| Acute/ chronic tendinopathy |
Tendon affected | Author | Sample, mean/median age, %F | Interventions | Treatment duration (follow-up) | Outcome measures |
| Acute | Rotator cuff | Berrazueta et al 13 | n=20; mean 37 years (2062 years); 50%. | GTN patch 5 mg/day (n=10) or placebo patch (n=10). | 3 days (24 hours, 48 hours, 15 days). | Pain: (A) VAS score. (B) Pain duration in last 24 hours (five-point scale). ROM: restriction of joint movement (five-point scale). Other: sleep hours (three-point scale). Treatment success: asymptomatic at 15 days. |
| Acute | Rotator cuff | Pons et al 32 | n=48; mean 61 years; 69%. | GTN patch 5 mg/day (n=24) or local corticosteroid injection (n=24). | 3 days; if no complete improvement, intervention was repeated up to 3 times at 15-day intervals (7 days, 22 days and 42 days). | Pain: at rest (changes in VAS score; described as three categories: decrease of >5 points=complete improvement, 3–5 points=partial improvement, <3 points= failure). |
| Chronic | Patellar | Steunebrink et al 35 | n=33; median age 31.9 years in GTN group and 33.8 years in control group; NA. | GTN patch 1.25 mg/day+tendon rehab (n=16) or placebo patch+tendon rehab (n=17). | 12 weeks (6 weeks, 12 weeks and 24 weeks). | Pain: VAS score during sports. Tendon specific: VISA-P questionnaire. Patient satisfaction. |
| Chronic | Rotator cuff | Giner-Pascual et al 33 | n=45; mean 54.3 years GTN and 42.2 years control; 37.8%. | GTN patch 1.25 mg/day (n=33) or placebo patch (n=12). | 6 months (6 months). | Pain: VAS score. ROM (degrees). Patient-group specific: (A) functional movement (SCIM). (B) Functional movement-induced pain (WUSPI). |
| Chronic | Rotator cuff | Paoloni et al 29 | n=53; mean 51 years, median 52 years (25–79 years); 55%. | GTN patch 1.25 mg/day+tendon rehab (n=26) or placebo patch+tendon rehab (n=27). | 24 weeks (2 weeks, 6 weeks, 12 weeks and 24 weeks). |
Pain: at rest, at night and with activity (five-point scale: 0–4). Subacromial tenderness (four-point scale: 0–3). ROM: passive (degrees). Force (N). Tendon specific: Clinical impingement tests in IR and ER (positive or negative). |
| Chronic | Achilles | Kane et al 30 | n=40; mean 40.5 years (22–68 years); %NA. | GTN patch 2.5 mg/day+tendon rehab (n=20) or tendon rehab only (n=20). Histology and immunohistochemistry of Achilles samples from surgery (control group n=3, GTN group n=4). |
6 months (6 months) |
Pain: AOS VAS for pain and disability. Other: (A) histology (neovascularisation, collagen synthesis and fibroblast activity). (B) Immunohistochemistry (NOS production). |
| Chronic | Achilles | Paoloni et al 28 | n=65; median 49 years (24–77 years); 38.5%. | GTN patch 1.25 mg/day+tendon rehab (n=32) or placebo patch+tendon rehab (n=33). | 24 weeks (2 weeks, 6 weeks, 12 weeks and 24 weeks). | Pain: (A) at rest, at night, with activity (five-point scale: 0–4). (B) After hop test (11-point scale: 0–10). Tenderness: four-point scale (0–3). Force: (A) plantar flexor peak force (N). (B) plantar flexor work (N). |
| Chronic | Wrist extensors | Ozden et al 34 | n=40; mean 43.2 years (19–74 years), 30%. | GTN patch 1.25 mg/day+tendon rehab (n=20) or placebo patch+tendon rehab (n=20). | 24 weeks (3 weeks and 6 months). | Pain: VAS score. Force: grip strength (N). Tendon specific: treatment outcomes as per Verhaar et al. |
| Chronic | Wrist extensors | Paoloni et al 31 | n=154; NA years (NA years), NA%. | GTN patch 0.72 mg/day+stretching (n=41) GTN patch 1.44 mg/day+stretching (n=34), GTN patch 3.6 mg/day+stretching (n=44), placebo patch+stretching (n=35). | 8 weeks (8 weeks) | Pain: at rest, with activity (VAS score). Force: (A) grip strength (kg) and (B) strength test using ORI-TETS (kg; tendon specific). Tendon specific: PRTEV. Other: SGAC in overall symptoms. |
| Chronic | Wrist extensors | Paoloni et al 27 | n=86; median 46 years (30–74 years), 51%. | GTN patch 1.25 mg/day+tendon rehab (n=43) or placebo patch+tendon rehab (n=43). | 24 weeks (2 weeks, 6 weeks, 12 weeks and 24 weeks). | Pain: at rest, at night, with activity (five-point scale: 0–4). Tenderness (four-point scale: none, mild, moderate and severe). Force: (A) Maudsley’s test (resisted third MCPJ extension force; N), (B) wrist extension peak force (chair pick up test - ORI-TETS; N; tendon specific) and (C) total work using ORI-TETS (N; tendon specific). |
AOS, Ankle Osteoarthritis Scale; ER, external rotation; GTN, glyceryl trinitrate; IR, internal rotation; MCPJ, metacarpophalangeal joint; NOS, nitric oxide synthase; ns, not stated; ORI-TETS, Orthopaedic Research Institute Tennis Elbow Testing System; PRTEV, Patient-Rated Tennis Elbow Evaluation; ROM, range of movement; SCIM, spinal cord injury measurement; SGAC, Subjective Global Assessment of Change; VAS, visual analogue scale; VISA-P, Victorian Institute of Sports Assessment – Patella; WUSPI, Wheelchair Users Shoulder Pain Index.