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Patient ratings in exercise therapy for the management of tendinopathy: a systematic review with meta-analysis.

Shim, J.; Pavlova, A.V.; Moss, R.A.; MacLean, C.; Brandie, D.; Mitchell, L.; Greig, L.; Parkinson, E.; Tzortziou Brown, V.; Morrissey, D.; Alexander, L.; Cooper, K.; Swinton, P.A.


R.A. Moss

C. MacLean

D. Brandie

L. Mitchell

V. Tzortziou Brown

D. Morrissey


The objective of this study was to synthesise exercise therapy intervention data investigating patient rating outcomes for the management of tendinopathy. A systematic review and meta-analysis of randomised controlled trials investigating exercise therapy interventions and reporting patient rating outcomes were undertaken. Eligible settings were considered to be any setting in any country listed as very high on the human development index. Eligible participants were considered to be people with a diagnosis of any tendinopathy of any severity or duration. Exercise therapy for the management of tendinopathy was considered for inclusion based on alignment with five different therapy classes: 1) resistance; 2) plyometric; 3) vibration; 4) flexibility; and 5) movement pattern retraining modalities. The main outcomes sought were those that measured patient rating of condition, including patient satisfaction and Global Rating of Change (GROC). From a total of 124 exercise therapy studies, 34 (Achilles: 41%; rotator cuff: 32%; patellar: 15%; elbow: 9%; and gluteal: 3%) provided sufficient information to be meta-analysed. The data were obtained across 48 treatment arms and 1246 participants. The pooled estimate for proportion of satisfaction was 0.63 [95% CrI: 0.53 to 0.73], and the pooled estimate for percentage of maximum GROC was 53 [95% CrI: 38 to 69%]. The proportion of patients reporting positive satisfaction and perception of change increased with longer follow-up periods from treatment onset. Patient satisfaction and GROC appear similar and are ranked moderately high demonstrating that patients generally perceive exercise therapies positively. Further research including greater consistency in measurement tools is required to explore and where possible, identify patient- and exercise-related moderating factors that can be used to improve person-centred care.


SHIM, J., PAVLOVA, A.V., MOSS, R.A., MACLEAN, C., BRANDIE, D., MITCHELL, L., GREIG, L., PARKINSON, E., TZORTZIOU BROWN, V., MORRISSEY, D., ALEXANDER, L., COOPER, K. and SWINTON, P.A. 2023. Patient ratings in exercise therapy for the management of tendinopathy: a systematic review with meta-analysis. Physiotherapy [online], 120, pages 78-94. Available from:

Journal Article Type Review
Acceptance Date May 26, 2023
Online Publication Date Jun 7, 2023
Publication Date Sep 30, 2023
Deposit Date Jun 8, 2023
Publicly Available Date Jun 8, 2023
Journal Physiotherapy
Print ISSN 0031-9406
Electronic ISSN 1873-1465
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 120
Pages 78-94
Keywords Exercise therapy; Tendinopathy; Patient satisfaction; Meta-analysis; Patient rating of condition; Global rating of change
Public URL
Related Public URLs (Protocol)


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