Patient perspectives on participation in exercise-based rehabilitation for Achilles tendinopathy: A qualitative study. (December 2021)

• Record Type: Journal Article
• Authors: Mallows, Adrian; Head, John; Goom, Tom; Malliaras, Peter; O'Neill, Seth; Smith, Benjamin
• Is Part Of: Musculoskeletal science and practice. Volume 56(2021)
• Publication Date: 2021-12
• Subjects: Achilles tendinopathy -- Exercise -- Patient perspectives -- Qualitative research; Manipulation (Therapeutics) -- Periodicals; Physical therapy -- Periodicals; Neuromuscular diseases -- Treatment -- Periodicals; Musculoskeletal system -- Diseases -- Periodicals; Manipulation (Therapeutics); Neuromuscular diseases -- Treatment; Physical therapy; Manipulation, Orthopedic; Musculoskeletal Diseases -- therapy; Neuromuscular Diseases -- therapy; Physical Therapy Modalities; Electronic journals; Periodicals; 615.82
• DOI: 10.1016/j.msksp.2021.102450
• Languages: English
• ISSNs: 2468-8630

Abstract

Abstract: Background: Achilles tendinopathy (AT) is common, and can be traumatic or insidious in onset and short-lasting or persistent in nature. Factors influencing the experience of pain are poorly understood; little is known about mechanisms driving pain and the response (or lack of) to rehabilitation. Despite this, there is a growing body of evidence supporting the use of exercise to manage AT. Interestingly, variation in exercise approach does not appear to significantly impact outcome. Patients' perceptions of factors related to rehabilitation that may influence outcome could provide a valuable addition to help guide future research and practice. Objectives: The aim of this study is to gain an insight into patients' experiences of participating in an exercise-based rehabilitation programme for AT. Method: A qualitative interpretive description design. Data generated from semi-structured interviews were analysed thematically using the guidelines set out by Braun and Clarke. Findings: This is the first study to use a qualitative method of inquiry to gain data on the experiences of people undertaking exercise-based rehabilitation for AT. The four major themes that were identified from the data were: (1) 'understanding the impact' (2) 'expectations' (3) 'what matters' and (4) 'the burden of exercise'. Conclusions: Given the uncertainty surrounding the mechanisms of effect of our treatments, the insights provide a platform from which researchers and clinicians can consider further in the management of people with Achilles tendinopathy. Specifically, it has highlighted that patients value a flexible, supportive approach embracing the biopsychosocial impact of AT on the individual. Highlights: Participants evaluated treatment in relation to expected timeframes for recovery. Education was highly valued in treatment. Treatment was seen as time consuming and frustrating. A strong therapeutic alliance underpinned shared decision making. Further insight into how treatment may help is needed.