AimTo evaluate the inter-rater reliability of measuring structural changes in the tendon of patients, clinically diagnosed with supraspinatus tendinopathy (cases) and healthy participants (controls), on ultrasound (US) images captured by standardised procedures.MethodsA total of 40 participants (24 patients) were included for assessing inter-rater reliability of measurements of fibrillar disruption, neovascularity, as well as the number and total length of calcifications and tendon thickness. Linear weighted κ, intraclass correlation (ICC), SEM, limits of agreement (LOA) and minimal detectable change (MDC) were used to evaluate reliability.Results‘Moderate—almost perfect’ κ was found for grading fibrillar disruption, neovascularity and number of calcifications (k 0.60–0.96). For total length of calcifications and tendon thickness, ICC was ‘excellent’ (0.85–0.90), with SEM(Agreement) ranging from 0.63 to 2.94 mm and MDC(group) ranging from 0.28 to 1.29 mm. In general, SEM, LOA and MDC showed larger variation for calcifications than for tendon thickness.ConclusionsInter-rater reliability was moderate to almost perfect when a standardised procedure was applied for measuring structural changes on captured US images and movie sequences of relevance for patients with supraspinatus tendinopathy. Future studies should test intra-rater and inter-rater reliability of the method in vivo for use in clinical practice, in addition to validation against a gold standard, such as MRI.Trial registration numberNCT01984203; Pre-results.
The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.
Objective: To evaluate whether psychomotor therapy (PMT) in combination with usual care active exercise (AE) rehabilitation for the shoulder is superior to merely AE. Design: The trial was a single-center, stratified (by corticosteroid injection [yes or no]), randomized, and controlled superiority trial. Setting: Shoulder unit of the orthopedic department at Hospital Lillebaelt, Vejle Hospital. Participants: Eligible participants (NZ87) were adults aged 18-75 years with shoulder complaints lasting for at least 3 months, in addition to a score equal to or below 3 on the Multidimensional Assessment of Interoceptive Awareness score. Furthermore, patients had at least a visual analog scale pain score of 2 at rest, 3 at night, and 5 in activity (range: 0-10). Interventions: Patients were randomized to 12 weeks of AE (control group) or in combination with 5 PMT sessions (intervention group). Main Outcome Measure: The primary outcome was the patient-reported outcome score Disability of the Arm, Shoulder and Hand questionnaire. The primary endpoint was 12 weeks after baseline. Results: There was no between-group difference in function between the intervention group and control group. Conclusions: Our results showed no additional benefit on patient-reported function and pain from PMT over usual care in patients with longlasting shoulder pain and low body awareness. This finding suggests that PMT adds no additional benefit to patients' recovery in relation to pain and active function in comparison to standard care.
resistance band mounted device offering objective measurement of adherence. It is valid and reliable for measuring exercise quality (time-under-tension (TUT)) and quantity (number of repetitions) (Rathleff et al., 2013a and b). The aim was to objectively evaluate adherence (repetitions and TUT) to an exercise intervention for RCRSP, and compare with self-report diaries. Materials and Methods Ethical approval was obtained.Adults (!18 years old) with RCRSP (!6 weeks) were eligible for inclusion. All participants provided written informed consent before being prescribed a 6 week home exercise programme. Participants were instructed to complete exercises daily, doing 10 repetitions per set with TUT of 8 s per repetition. Participants completed the NRS(pain) and SPADI questionnaire at baseline and 6 weeks. Results 17 participants were eligible, with 11 participant data sets included in the analysis. There was on average 52% adherence to the prescribed TUT. The adherence to repetitions was superior at 76%, comparable to self-reported adherence (79%). Half (6/11) of the participants reported changes in pain and disability scores which exceeded the minimal detectable change. Conclusion The BandCizer™ was effective in quantifying adherence to TUT and repetitions, with poor adherence to TUT noted. Despite varied adherence, the intervention still produced significant changes in pain and disability. These findings support the need for further research examining parameters of exercise dosage in relation to patient outcomes in RCRSP.
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