Table 2.
Description of samples, interventions and outcome measures
| First author | Tendon affected | Min duration of symptoms | Sample, mean/median age (range), %F | Interventions | Supervision? (physio only) | Follow-up | Outcome measures |
| Brox36 | Rotator cuff | 3 m | N=125; mean 48 y (18–66 y); 47% | Arthroscopic surgery (n=45) or physiotherapy (n=50) or detuned laser (placebo) (n=30) |
Yes, 3–6 m | 3 m, 6 m, 2.5 y | (a) Neer shoulder score (pain during previous week 0–35, function tests (muscle tests, reaching ability, stability 0–30 and active ROM 0–25), anatomical/radiological evaluation 0–10), (b) pain at rest, at night, during activity during previous week (1–9), (c) emotional distress with Hopkins symptom checklist (0–25), (d) costs |
| Rahme37 | Rotator cuff | 12 m | N=42; mean 42 y (28–63 y); 55% | Open surgery (n=21) or physiotherapy (n=21) |
Yes, not stated | 6 m, 12 m | (a) VAS for pain at rest plus VAS for pain during ‘pour out of pot’ manoeuvre (treatment success if >50% improvement compared with baseline) |
| Rompe30 | Rotator cuff | 12 m | N=79; mean 50.8 y (31–68 y); 61% | ESWT 3000 impulses, 0.6 mJ/mm2(n=50) or open surgery (n=29) |
12 m, 24 m | (a) UCLA rating for pain and function of the shoulder (Kay and Amstutz): max score 35 points; pain 1–10, function 1–10, active range forward flexion 0–5, strength in forward flexion 0–5, patient satisfaction 0–5, (b) Outcomes score (>33 excellent, 29–33 good,<29 poor), (c) radiological evaluation: AP radiograph 1 day before surgery or ESWT and at 12 m; resorption graded as none, partial or complete | |
| Haahr35
Hahr (2009) |
Rotator cuff | 6 m | N=90; mean 44.4 y(; 69% | Arthroscopic surgery (n=45) or physiotherapy (n=45) |
Yes, 12 w | 3 m, 6 m, 12 m, >4 y | (a) Constant score (primary outcome; 0–100; includes VAS for pain, limitations in ADLs, active ROM of glenohumeral joint in four directions, isometric shoulder strength measurement), (b) Likert scale (0–9, numerical box complaint scale), (c) employment within last 3 m, (d) sick leave, (e) labour compensation claims |
| Ketola29 | Rotator cuff | 3 m | N=140; mean 47.1 y (23–60 y); 63% | Arthroscopic surgery +physiotherapy (n=70) or physiotherapy (n=70) |
Yes, mean 6.5 visits | 3 m, 6 m, 12 m, 24 m, 60 m | (a) VAS for pain (0–10; primary measure), (b) VAS for disability (0–10), (c) VAS for working ability (0–10), (d) VAS for pain at night (0–10), (e) SDQ score, (f) number of painful days in previous 3 m, (g) proportion of pain-free patients (VAS for pain <4), (h) health-related QoL (15-day tool) at 5 y |
| Farfaras28, Farfaras (2018) | Rotator cuff | 6 m | N=87; mean 49.3 y (41–78); 51% | Arthroscopic surgery +physiotherapy (n=29) or open surgery +physiotherapy (n=24) or physiotherapy (n=34) |
Yes, 3–6 m | 2.5 y, >10 y | (a) Constant score (0–100; includes VAS for pain, limitations in ADLs, active ROM of glenohumeral joint in four directions, isometric shoulder strength measurement), (b) SF-36 (general health), (c) Watson & Sonnabend score (0–3, 14 questions), (d) ROM active elevation and internal rotation, (e) abduction strength, (f) USS and X-ray both shoulders |
| Beard34 | Rotator cuff | 3 m | N=313; mean 53 y 50% | Arthroscopic surgery (n=106) or sham surgery (n=103) or no treatment (n=104) |
6 m, 12 m | (a) OSS (primary outcome; 0–48), (b) modified Constant-Murley Shoulder Score (for function and ROM), (c) Pain DETECT (questionnaire for neuropathic pain), (d) Quantitative sensory testing, (e) adverse events, (f) QoL life (EQ-5D-3L), (g) EQ VAS, (h) treatment expectations, (i) patient perception or satisfaction, (j) anxiety and depression (HADS score). | |
| Bahr27 | Patellar | 3 m | N=35 (40 tendons); mean 31 y (19–49 y); 14% | Open surgery +physiotherapy (n=20 tendons) or physiotherapy (n=20 tendons) |
Yes, 12 w | 3 m, 6 m, 12 m | (a) VISA score (0–100), (b) global evaluation score (−5 to +5), (c) treatment satisfaction (4-grade scale), (d) functional tests (standing jumps, counter-movement jumps and leg extension strength), (e) VAS score for pain after each functional test (0–10) |
| Alfredson33 | Achilles | 6 m | N=20; mean 46 y; 55% | Open surgery (n=10) or polidocanol injection (n=10) |
12 w, 6 m | (a) VAS for pain (0–100) during activity, (b) patient satisfaction (satisfied or not satisfied) | |
| Radwan31 | Wrist extensors | 6 m | N=56; mean 40 y (22–60 y); 41% | ESWT 1800 impulses, 0.22 mJ/mm2 (n=29) or open surgery (n=27) |
3 w, 6 w, 12 w, 1 y | (a) Pain (at night, at rest) with VAS score (0–100), (b) residual pain at 12 m based on criteria by Roles & Maudsley (excellent, good, acceptable, poor), (c) tenderness with VAS score (0–100), (d) grip strength (scale 1–4), (e) treatment success: asymptomatic at 15 days | |
| Kroslak22 | Wrist extensors | 6 m | N=26 mean 51.5 y (41–77 y); 68% | Open surgery (n=13) or sham surgery (n=13) |
2 w, 6 w, 12 w, 26 w, >1 y | (a) Pain (frequency and severity) with Likert-based verbal descriptor scale with activity, at rest and during sleep, (b) Self-rated function (picking up objects, twisting motions, elbow stiffness, overall elbow rating), (c) point tenderness (Likert verbal descriptor pain scale), (d) elbow stiffness and ROM, (e) Maximal force of wrist extension during chair pick-up test using ORI-TETS, (f) maximal grip strength |
ADLs, activities of daily living; AP, antero-posterior; EQ-5D-3L, EuroQoL 5 Dimensions 3 Level index; ESWT, extracorporeal shock wave therapy; HADS, Hospital Anxiety and Depression Score; ORI-TETS, Orthopaedic Research Institute Tennis Elbow Testing System; OSS, Oxford Shoulder Score; QoL, quality of life; ROM, range of movement; SDQ, Strengths and Difficulties Questionnaire; SF-36, Short Form Health Survey; UCLA, University of California Los Angeles score; USS, ultrasound scan; VAS, Visual Analogue Scale; VISA, Victorian Institute of Sport Assessment; m, months; w, weeks; y, years.