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Published in: Journal of Foot and Ankle Research 1/2018

Open Access 01-12-2018 | Research

What are patients’ knowledge, expectation and experience of radial extracorporeal shockwave therapy for the treatment of their tendinopathies? A qualitative study

Authors: Raymond Leung, Nikolaos Malliaropoulos, Vasileios Korakakis, Nat Padhiar

Published in: Journal of Foot and Ankle Research | Issue 1/2018

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Abstract

Background

Extracorporeal shockwave therapy (ESWT) is used to manage different tendinopathies and appears to be effective in some tendinopathies but not others. The reasons for this are unclear. There is evidence that patient outcomes can be influenced by a patient-centred approach. There is therefore a need to qualitatively evaluate patient experiences for a treatment like ESWT where uncertainties exist. The aim of this study was to understand patients’ overall perspective of ESWT to manage their tendinopathy.

Methods

A qualitative semi-structured face-to-face interview study design was used and the data was analysed thematically using ‘Framework Analysis’.

Results

Eleven participants that have had radial ESWT (rESWT) to treat a range of tendinopathies were recruited from a private London sports clinic and interviewed in person or via Skype™. Four main themes and 16 subthemes were identified. Subthemes included previous failed treatment, clinician factors, mechanisms of ESWT, positive aspects, negative aspects, responsibility over own health and perceived outcomes.

Conclusion

The participants understood the procedural aspects of rESWT, but were largely unaware of its mechanism of action and whether it was found to be effective for their condition or not. The participants felt that self-management measures were equally or more important than rESWT to help treat their tendinopathies. Recommendations would be for rESWT providers to offer patients written information, maintain continuity of care, address patients’ expectations, feedback on progress, and encourage self-management measures such as activity modification.
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Literature
1.
go back to reference Scott A, Backman LJ, Speed C. Tendinopathy: update on pathophysiology. J Orthop Sports Phys Ther. 2015;45(11):833–41.CrossRefPubMed Scott A, Backman LJ, Speed C. Tendinopathy: update on pathophysiology. J Orthop Sports Phys Ther. 2015;45(11):833–41.CrossRefPubMed
3.
go back to reference Maffulli N, Wong J, Almekinders LC. Types and epidemiology of tendinopathy. Clin Sports Med. 2003;22(4):675–92.CrossRefPubMed Maffulli N, Wong J, Almekinders LC. Types and epidemiology of tendinopathy. Clin Sports Med. 2003;22(4):675–92.CrossRefPubMed
4.
go back to reference Wilson JJ, Best TM. Common overuse tendon problems: a review and recommendations for treatment. Am Fam Physician. 2005;72(5):811–8.PubMed Wilson JJ, Best TM. Common overuse tendon problems: a review and recommendations for treatment. Am Fam Physician. 2005;72(5):811–8.PubMed
5.
6.
go back to reference Woodley BL, Newsham-West RJ, Baxter GD. Chronic tendinopathy: effectiveness of eccentric exercise. Br J Sports Med. 2007;41(4):188–98. discussion 99CrossRefPubMed Woodley BL, Newsham-West RJ, Baxter GD. Chronic tendinopathy: effectiveness of eccentric exercise. Br J Sports Med. 2007;41(4):188–98. discussion 99CrossRefPubMed
7.
go back to reference Ioppolo F, Rompe JD, Furia JP, Cacchio A. Clinical application of shock wave therapy (SWT) in musculoskeletal disorders. Eur J Phys Rehabil Med. 2014;50(2):217–30.PubMed Ioppolo F, Rompe JD, Furia JP, Cacchio A. Clinical application of shock wave therapy (SWT) in musculoskeletal disorders. Eur J Phys Rehabil Med. 2014;50(2):217–30.PubMed
9.
go back to reference Speed C. A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence. Br J Sports Med. 2014;48(21):1538–42.CrossRefPubMed Speed C. A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence. Br J Sports Med. 2014;48(21):1538–42.CrossRefPubMed
13.
go back to reference Notarnicola A, Moretti B. The biological effects of extracorporeal shock wave therapy (eswt) on tendon tissue. Muscles Ligaments Tendons J. 2012;2(1):33–7.PubMedPubMedCentral Notarnicola A, Moretti B. The biological effects of extracorporeal shock wave therapy (eswt) on tendon tissue. Muscles Ligaments Tendons J. 2012;2(1):33–7.PubMedPubMedCentral
14.
go back to reference Yürük Z, Kirdi N. The effects of radial extracorporeal shock wave therapy on subjective pain and functionality in patients with lateral epicondylitis. Fizyoterapi Rehabilitasyon. 2014;25(1). Yürük Z, Kirdi N. The effects of radial extracorporeal shock wave therapy on subjective pain and functionality in patients with lateral epicondylitis. Fizyoterapi Rehabilitasyon. 2014;25(1).
15.
go back to reference Haake M, Buch M, Schoellner C, Goebel F, Vogel M, Mueller I, et al. Extracorporeal shock wave therapy for plantar fasciitis: randomised controlled multicentre trial. BMJ. 2003;327(7406):75.CrossRefPubMedPubMedCentral Haake M, Buch M, Schoellner C, Goebel F, Vogel M, Mueller I, et al. Extracorporeal shock wave therapy for plantar fasciitis: randomised controlled multicentre trial. BMJ. 2003;327(7406):75.CrossRefPubMedPubMedCentral
16.
go back to reference Mani-Babu S, Morrissey D, Waugh C, Screen H, Barton C. The effectiveness of extracorporeal shock wave therapy in lower limb tendinopathy: a systematic review. Am J Sports Med. 2015;43(3):752–61.CrossRefPubMed Mani-Babu S, Morrissey D, Waugh C, Screen H, Barton C. The effectiveness of extracorporeal shock wave therapy in lower limb tendinopathy: a systematic review. Am J Sports Med. 2015;43(3):752–61.CrossRefPubMed
17.
go back to reference Buchbinder R, Green SE, Youd JM, Assendelft WJ, Barnsley L, Smidt N. Shock wave therapy for lateral elbow pain. Cochrane Database Syst Rev. 2005;4:CD003524. Buchbinder R, Green SE, Youd JM, Assendelft WJ, Barnsley L, Smidt N. Shock wave therapy for lateral elbow pain. Cochrane Database Syst Rev. 2005;4:CD003524.
18.
go back to reference Little P, Everitt H, Williamson I, Warner G, Moore M, Gould C, et al. Preferences of patients for patient centred approach to consultation in primary care: observational study. BMJ. 2001;322(7284):468–72.CrossRefPubMedPubMedCentral Little P, Everitt H, Williamson I, Warner G, Moore M, Gould C, et al. Preferences of patients for patient centred approach to consultation in primary care: observational study. BMJ. 2001;322(7284):468–72.CrossRefPubMedPubMedCentral
19.
go back to reference Kinnersley P, Stott N, Peters TJ, Harvey I. The patient-centredness of consultations and outcome in primary care. Br J Gen Pract. 1999;49(446):711–6.PubMedPubMedCentral Kinnersley P, Stott N, Peters TJ, Harvey I. The patient-centredness of consultations and outcome in primary care. Br J Gen Pract. 1999;49(446):711–6.PubMedPubMedCentral
20.
21.
go back to reference Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;3(1). Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;3(1).
22.
go back to reference Ritchie J, Lewis J, McNaughton CN, et al. Qualitative research practice : a guide for social science students and researchers. 2nd ed. London: SAGE Publications Ltd; 2014. Ritchie J, Lewis J, McNaughton CN, et al. Qualitative research practice : a guide for social science students and researchers. 2nd ed. London: SAGE Publications Ltd; 2014.
23.
go back to reference Carnes D, Anwer Y, Underwood M, Harding G, Parsons S, Team TS, et al. Influences on older people's decision making regarding choice of topical or oral NSAIDs for knee pain: qualitative study. Br Med J. 2008;336(7636):142.CrossRef Carnes D, Anwer Y, Underwood M, Harding G, Parsons S, Team TS, et al. Influences on older people's decision making regarding choice of topical or oral NSAIDs for knee pain: qualitative study. Br Med J. 2008;336(7636):142.CrossRef
24.
go back to reference Gustafsson M, Ekholm J, Ohman A. From shame to respect: musculoskeletal pain patients’ experience of a rehabilitation programme, a qualitative study. J Rehabil Med. 2004;36(3):97–103.CrossRefPubMed Gustafsson M, Ekholm J, Ohman A. From shame to respect: musculoskeletal pain patients’ experience of a rehabilitation programme, a qualitative study. J Rehabil Med. 2004;36(3):97–103.CrossRefPubMed
25.
go back to reference Vahdat S, Hamzehgardeshi L, Hessam S, Hamzehgardeshi Z. Patient involvement in health care decision making: a review. Iran Red Crescent Med J. 2014;16(1):e12454.CrossRefPubMedPubMedCentral Vahdat S, Hamzehgardeshi L, Hessam S, Hamzehgardeshi Z. Patient involvement in health care decision making: a review. Iran Red Crescent Med J. 2014;16(1):e12454.CrossRefPubMedPubMedCentral
26.
go back to reference Cacchio A, Rompe JD, Furia JP, Susi P, Santilli V, De Paulis F. Shockwave therapy for the treatment of chronic proximal hamstring tendinopathy in professional athletes. Am J Sports Med. 2011;39(1):146–53.CrossRefPubMed Cacchio A, Rompe JD, Furia JP, Susi P, Santilli V, De Paulis F. Shockwave therapy for the treatment of chronic proximal hamstring tendinopathy in professional athletes. Am J Sports Med. 2011;39(1):146–53.CrossRefPubMed
27.
go back to reference Cormier S, Lavigne GL, Choinière M, Rainville P. Expectations predict chronic pain treatment outcomes. Pain. 2016;157(2):329–38.CrossRefPubMed Cormier S, Lavigne GL, Choinière M, Rainville P. Expectations predict chronic pain treatment outcomes. Pain. 2016;157(2):329–38.CrossRefPubMed
28.
go back to reference Schmitz C, Császár NB, Milz S, Schieker M, Maffulli N, Rompe JD, et al. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database. Br Med Bull. 2015;116:115–38.PubMedPubMedCentral Schmitz C, Császár NB, Milz S, Schieker M, Maffulli N, Rompe JD, et al. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database. Br Med Bull. 2015;116:115–38.PubMedPubMedCentral
31.
go back to reference Maffulli G, Hemmings S, Maffulli N. Assessment of the effectiveness of extracorporeal shock wave therapy (ESWT) for soft tissue injuries (ASSERT): an online database protocol. Transl Med UniSa. 2014;10:46–51.PubMedPubMedCentral Maffulli G, Hemmings S, Maffulli N. Assessment of the effectiveness of extracorporeal shock wave therapy (ESWT) for soft tissue injuries (ASSERT): an online database protocol. Transl Med UniSa. 2014;10:46–51.PubMedPubMedCentral
32.
33.
go back to reference Malliaropoulos N, Crate G, Meke M, Korakakis V, Nauck T, Lohrer H, et al. Success and recurrence rate after radial extracorporeal shock wave therapy for plantar Fasciopathy: a retrospective study. Biomed Res Int. 2016;2016:9415827.CrossRefPubMedPubMedCentral Malliaropoulos N, Crate G, Meke M, Korakakis V, Nauck T, Lohrer H, et al. Success and recurrence rate after radial extracorporeal shock wave therapy for plantar Fasciopathy: a retrospective study. Biomed Res Int. 2016;2016:9415827.CrossRefPubMedPubMedCentral
34.
go back to reference Rio E, Kidgell D, Moseley GL, Gaida J, Docking S, Purdam C, et al. Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review. Br J Sports Med. 2016;50(4):209–15.CrossRefPubMed Rio E, Kidgell D, Moseley GL, Gaida J, Docking S, Purdam C, et al. Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review. Br J Sports Med. 2016;50(4):209–15.CrossRefPubMed
35.
go back to reference Galloway MT, Lalley AL, Shearn JT. The role of mechanical loading in tendon development, maintenance, injury, and repair. J Bone Joint Surg Am. 2013;95(17):1620–8.CrossRefPubMedPubMedCentral Galloway MT, Lalley AL, Shearn JT. The role of mechanical loading in tendon development, maintenance, injury, and repair. J Bone Joint Surg Am. 2013;95(17):1620–8.CrossRefPubMedPubMedCentral
36.
go back to reference Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence? Clin Sports Med. 2012;31(2):329–50.CrossRefPubMed Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence? Clin Sports Med. 2012;31(2):329–50.CrossRefPubMed
Metadata
Title
What are patients’ knowledge, expectation and experience of radial extracorporeal shockwave therapy for the treatment of their tendinopathies? A qualitative study
Authors
Raymond Leung
Nikolaos Malliaropoulos
Vasileios Korakakis
Nat Padhiar
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2018
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/s13047-018-0254-5

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