Content reporting of exercise interventions in rotator cuff disease trials: results from application of the Consensus on Exercise Reporting Template (CERT)

Abstract

BackgroundExercise interventions are frequently recommended for patients with rotator cuff disease, but poor content reporting in clinical trials of exercise limits interpretation and replication of trials and clinicians’ ability to deliver effective exercise protocols. The Consensus on Exercise Reporting Template (CERT) was developed to address this problem.ObjectiveTo assess completeness of content reporting of exercise interventions in randomised controlled trials for patients with rotator cuff disease and the inter-rater reliability of the CERT.DesignCritical appraisal.MethodsIndependent pairs of reviewers applied the CERT to all 34 exercise trials from the most recent Cochrane Review evaluating the effect of manual therapy and exercise for patients with rotator cuff disease. We used the CERT Explanation and Elaboration Statement to guide assessment of whether each of the 19-item criteria were clearly described (score 0–19; higher scores indicate better reporting). Percentage agreement and the prevalence and bias adjusted kappa (PABAK) coefficient were used to measure inter-rater reliability.ResultsThe median CERT score was 5 (range 0–16). Percentage agreement was high for 15 items and acceptable for 4 items. The PABAK coefficient indicated excellent (5 items), substantial (11 items) and moderate (3 items) inter-rater agreement.ConclusionThe description of exercise interventions for patients with rotator cuff disease in published trials is poorly reported. Overall, the inter-rater reliability of the CERT is high/acceptable. We strongly encourage journals to mandate use of the CERT for papers reporting trial protocols and results investigating exercise interventions.

If exercise is medicine, why don’t we know the dose? An overview of systematic reviews assessing reporting quality of exercise interventions in health and disease

“…We identified 7804 studies and included 28 systematic reviews18–20 22 24 34 35 37–57 (figure 1). These 28 reviews included 1467 studies comprised of 1724 interventions.…”

“…A list of the studies excluded during full-text assessment, with reasons, is provided in online supplemental appendix 5. Ten reviews only used CERT,35 38 41 42 44 48 52–54 56 11 reviews only used TIDieR,18–20 24 39 45–47 50 51 55 and 6 reviews22 34 37 40 43 57 used both CERT and TIDieR (table 2). One review38 used a hybrid tool comprised of items 1–5, 7, and 9–12 from TIDieR, complemented and expanded upon by items 6 and 8 of CERT.…”

Adherence to self-managed exercises for patients with persistent subacromial pain: the Ad-Shoulder feasibility study

“…There is also moderate quality evidence that behaviour change techniques, such as social support, goal setting, demonstration of behaviour, graded tasks and self-monitoring of behaviour, may improve exercise adherence among patients with persistent musculoskeletal pain [ 18 , 19 ]. Despite this, behavioural frameworks to enhance adherence to home exercise programmes have been little implemented in current trials on shoulder pain [ 20 ].…”

Adherence to Self-managed Exercises for Patients with Persistent Subacromial Pain: The Ad-Shoulder Feasibility Study

“…There is also moderate quality evidence that behaviour change techniques, such as social support, goal setting, demonstration of behaviour, graded tasks and self-monitoring of behaviour, may improve exercise adherence among patients with persistent musculoskeletal pain (20,21). Despite this, behavioural frameworks to enhance adherence to home exercise programs have been little implemented in current trials on shoulder pain (18).…”