ICON 2020—International Scientific Tendinopathy Symposium Consensus: A Systematic Review of Outcome Measures Reported in Clinical Trials of Achilles Tendinopathy

Abstract

Background Nine core domains for tendinopathy have been identified. For Achilles tendinopathy there is large variation in outcome measures used, and how these fit into the core domains has not been investigated. Objective To identify all available outcome measures outcome measures used to assess the clinical phenotype of Achilles tendinopathy in prospective studies and to map the outcomes measures into predefined health-related core domains. Design Systematic review. Data Sources Embase, MEDLINE (Ovid), Web of Science, CINAHL, The Cochrane Library, SPORTDiscus and Google Scholar. Eligibility Criteria for Selecting Studies Clinical diagnosis of Achilles tendinopathy, sample size ≥ ten participants, age ≥ 16 years, and the study design was a randomized or non-randomized clinical trial, observational cohort, single-arm intervention, or case series. Results 9376 studies were initially screened and 307 studies were finally included, totaling 13,248 participants. There were 233 (177 core domain) different outcome measures identified across all domains. For each core domain outcome measures were identified, with a range between 8 and 35 unique outcome measures utilized for each domain. The proportion of studies that included outcomes for predefined core domains ranged from 4% for the psychological factors domain to 72% for the disability domain. Conclusion 233 unique outcome measures for Achilles tendinopathy were identified. Most frequently, outcome measures were used within the disability domain. Outcome measures assessing psychological factors were scarcely used. The next step in developing a core outcome set for Achilles tendinopathy is to engage patients, clinicians and researchers to reach consensus on key outcomes measures. Prospero Registration CRD42020156763.

The effects of pain science education plus exercise on pain and function in chronic Achilles tendinopathy: a blinded, placebo-controlled, explanatory, randomized trial

“…Future clinical trials on noninvasive treatments should consider using the VISA-A as a primary outcome, which is more responsive and is commonly used by other exercise studies for the AT population. 21…”

Assessment and monitoring of Achilles tendinopathy in clinical practice: a qualitative descriptive exploration of the barriers clinicians face

“… 5 7–11 Examples include a patient’s self-reported pain with functional tasks, validated patient-reported outcome measures or an objective assessment of functional capacity. 12 13 However, not all tools have been validated, 14 thus it is valuable to find out what is being used (and how) in clinical practice regarding the assessment and monitoring of Achilles tendinopathy.…”

“…To address the confusion within the research, the Achilles Tendinopathy International Consensus Sub-Group has worked to identify all assessments used within clinical studies of Achilles tendinopathy and allocate them under the ICON core health domain of ‘best fit’. 14 This project involves further reviews and a Delphi study to determine which outcome measures are most valid and reliable and make recommendations regarding which assessments best represent each health domain. However, this body of work does not definitively indicate what current practice ‘at the coalface’ is for clinicians when diagnosing and monitoring Achilles tendinopathy.…”

Assessment and Monitoring of Achilles Tendinopathy in Clinical Practice: A Qualitative Exploration of the Barrier’s Clinicians Face.

“…5 7-11 Examples include a patients self-reported pain with functional tasks, validated patient-reported outcome measures or an objective assessment of functional capacity. 12 13 However, not all tools have been validated 14 thus it is valuable to nd out what is being used (and how) in clinical practice regarding the assessment and monitoring of Achilles tendinopathy.…”

“…To address the confusion within the research the Achilles Tendinopathy International Consensus Sub-Group has worked to identify all assessments used within clinical studies of Achilles tendinopathy and allocate them under the ICON Core health domain of 'best t.' 14…”