Patients with rotator cuff tendinopathy can successfully self-manage, but with certain caveats: A qualitative study

Littlewood, Chris; Malliaras, Peter; Mawson, Sue; May, Stephen; Walters, Stephen

Abstract

Objectives: Evidence has emerged supporting the value of loaded exercises for rotator cuff tendinopathy but there are barriers that might prevent implementation of this intervention in the real-world. The purpose of this study was to explore these potential barriers with participants involved in a pilot randomised controlled trial (RCT) investigating a self-managed loaded exercise intervention.

Design: A qualitative study within the framework of a mixed methods design. Data were collected using individual interviews and analysed using the framework method.

Setting: One private physiotherapy clinic in northern England.

Participants: Six patients and two physiotherapists were purposively sampled from those allocated to the self-managed exercise group within the RCT.

Results: Three themes were generated: (1) Expectations and preferences, (2) characteristics of an unsuccessful outcome, (3) characteristics of a successful outcome. Most patients expressed expectations contrary to the philosophy of a self-managed approach. But this did not serve as a barrier when the intervention was offered within a positive and supporting environment where patients understood the reasons for undertaking the exercise, effectively self-monitored and engaged with pro-active follow-up. An early and appreciable response to therapy was also a key factor influencing continuing engagement with the exercise programme.

Conclusion: With certain caveats including the need to recognise and respond to individual characteristics, implement effective knowledge translation strategies and the need to engage with appropriately timed pro-active follow-up, the potential to implement programmes of self-managed loaded exercise for patients with rotator cuff tendinopathy in the real-world and in further research studies appears feasible but challenging.

Citation

Littlewood, C., Malliaras, P., Mawson, S., May, S., & Walters, S. (2014). Patients with rotator cuff tendinopathy can successfully self-manage, but with certain caveats: A qualitative study. Physiotherapy, 100(1), 80-85. https://doi.org/10.1016/j.physio.2013.08.003

• Journal Article Type: Article
• Online Publication Date: Nov 18, 2013
• Publication Date: 2014-03
• Deposit Date: Dec 19, 2024
• Journal: Physiotherapy (United Kingdom)
• Print ISSN: 0031-9406
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 100
• Issue: 1
• Pages: 80-85
• DOI: https://doi.org/10.1016/j.physio.2013.08.003
• Keywords: Qualitative research, Rotator cuff, Self-management, Tendinopathy
• Related Public URLs: https://eprints.whiterose.ac.uk/79599/