ICON 2023: International Scientific Tendinopathy Symposium Consensus - the core outcome set for Achilles tendinopathy (COS-AT) using a systematic review and a Delphi study of professional participants and patients.
de Vos, Robert-Jan; Gravare Silbernagel, Karin; Malliaras, Peteret al.
2024 • In British Journal of Sports Medicine, 58 (20), p. 1175 - 1186
Achilles Tendon; Consensus; Review; Tendinopathy; Humans; Outcome Assessment, Health Care; Surveys and Questionnaires; Tendinopathy/therapy; Delphi Technique; Physical Therapy, Sports Therapy and Rehabilitation; Orthopedics and Sports Medicine
Abstract :
[en] To develop a core outcome set for Achilles tendinopathy (COS-AT) for use in clinical trials we performed a five-step process including (1) a systematic review of available outcome measurement instruments, (2) an online survey on truth and feasibility of the available measurement instruments, (3) an assessment of the methodological quality of the selected outcome measurement instruments, (4) an online survey on the outcome measurement instruments as COS and (5) a consensus in-person meeting. Both surveys were completed by healthcare professionals and patients. The Outcome Measures in Rheumatology guidelines with a 70% threshold for consensus were followed. We identified 233 different outcome measurement instruments from 307 included studies; 177 were mapped within the International Scientific Tendinopathy Symposium Consensus core domains. 31 participants (12 patients) completed the first online survey (response rate 94%). 22/177 (12%) outcome measurement instruments were deemed truthful and feasible and their measurement properties were evaluated. 29 participants (12 patients) completed the second online survey (response rate 88%) and three outcome measurement instruments were endorsed: the Victorian Institute of Sports Assessment-Achilles questionnaire, the single-leg heel rise test and evaluating pain after activity using a Visual Analogue Scale (VAS, 0-10). 12 participants (1 patient) attended the final consensus meeting, and 1 additional outcome measurement instrument was endorsed: evaluating pain during activity/loading using a VAS (0-10). It is recommended that the identified COS-AT will be used in future clinical trials evaluating the effectiveness of an intervention. This will facilitate comparing outcomes of intervention strategies, data pooling and further progression of knowledge about AT. As COS-AT is implemented, further evidence on measurement properties of included measures and new outcome measurement instruments should lead to its review and refinement.
Disciplines :
Orthopedics, rehabilitation & sports medicine
Author, co-author :
de Vos, Robert-Jan ; Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
Gravare Silbernagel, Karin; Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
Malliaras, Peter; Physiotherapy Department, Monash University Faculty of Medicine Nursing and Health Sciences, Melbourne, Victoria, Australia
Visser, Tjerk Sleeswijk ; Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, The Netherlands t.sleeswijkvisser@erasmusmc.nl ; Department of Sports Medicine, HMC Antoniushove Stichting Haaglanden Medisch Centrum, Leidschendam, The Netherlands
Alfredson, Hakan ; Department of Community Medicine and Rehabilitation, Sports Medicine, Umea University Faculty of Medicine, Umea, Sweden
Akker-Scheek, Inge van den ; Department of Orthopedics, University Medical Centre, Groningen, The Netherlands
van Ark, Mathijs; Physiotherapy Department, School of Health Care Studies, Hanze University of Applied Sciences, Groningen, The Netherlands
Brorsson, Annelie; Department of Orthopedics, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
Chimenti, Ruth ; Department of Physical Therapy and Rehabilitation Sciences, The University of Iowa, Iowa City, Iowa, USA
Docking, Sean; Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
Eliasson, Pernilla; Department of Orthopedics, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
Farnqvist, Kenneth; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
Haleem, Zubair; Sports and Exercise Medicine, Queen Mary University, London, UK ; Arsenal Football Club, London, UK
Hanlon, Shawn L ; Department of Kinesiology, California State University Fullerton, Fullerton, California, USA
Kaux, Jean-François ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation > Médecine physique, réadaptation et traumatologie du sport ; FIMS Collaborative Centre of Sports Medicine, FIFA Medical Centre of Excellence, Dubai, UAE
Kearney, Rebecca Samantha; Bristol Trials Centre, University of Bristol, Bristol, UK
Kirwan, Paul D ; Discipline of Physiotherapy, School Of Medicine, Trinity College Dublin, Dublin, Ireland ; Physiotherapy Dept, Connolly Hospital Blanchardstown, Blanchardstown, Ireland
Kulig, Kornelia; Musculoskeletal Biomechanics Research Laboratory, Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA
Kumar, Bhavesh; Fortius Clinic, London, UK
Lewis, Trevor; Liverpool Foundation Trust, Aintree University Hospital, Liverpool, UK
Lui, Tun Hing; Department of Orthopaedic and Traumatology, North District Hospital, Hong Kong, Hong Kong
Maffulli, Nicola; Department of Trauma and Orthopaedics, School of Medicine and Psychology, University of Rome La Sapienza, Rome, Italy
Mallows, Adrian James; School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
Masci, Lorenzo; Institute of Sport Exercise and Health (ISEH), University College London, London, UK
McGonagle, Dennis; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds Leeds, Leeds, UK ; Leeds Biomedical Research Centre, Leeds, UK
Morrissey, Dylan; Sport and Exercise Medicine, Queen Mary University, London, UK ; Physiotherapy Department, Barts Health NHS Trust, London, UK
Murphy, Myles Calder ; Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia ; School of Health Sciences, The University of Notre Dame, Fremantle, Western Australia, Australia
Newsham-West, Richard; Australian Physiotherapy Association, Hawthorn, Victoria, Australia
Nilsson-Helander, Katarina Maria; Department of Orthopaedics, Sahlgrenska University Hospital, Goteborg, Sweden
Norris, Richard; Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK ; The Physiotherapy Centre, Liverpool, UK
Oliva, Francesco; Department of Human Sciences and Promotion of the Quality of Life, University of Rome La Sapienza, Rome, Italy
O'Neill, Seth; School of Healthcare, College of Life Sciences, University of Leicester, Leicester, UK
Peers, Koen; Department of Development and Regeneration, KU Leuven - University, Leuven, Belgium
Rio, Ebonie Kendra; La Trobe Sport and Exercise Medicine Research Centre, The Australian Ballet, The Victorian Institute of Sport, La Trobe University, Bundoora, Victoria, Australia
Sancho, Igor; Deusto Physical TherapIker, Physiotherapy Department, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
Scott, Alex ; Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
Seymore, Kayla D ; Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
Soh, Sze-Ee; Department of Physiotherapy and Rehabilitation, Monash University Rehabilitation Ageing and Independent Living Research Centre, Frankston, Victoria, Australia
Vallance, Patrick; Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Clayton, Victoria, Australia
Verhaar, Jan A N; Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
van der Vlist, Arco C ; Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
Weir, Adam; Aspetar Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar ; Sport Medicine and Exercise Clinic (SBK), Haarlem, The Netherlands
Zellers, Jennifer Ann ; Program in Physical Therapy & Department of Orthopaedic Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
Vicenzino, Bill ; Physiotherapy, The University of Queensland School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia
ICON 2023: International Scientific Tendinopathy Symposium Consensus - the core outcome set for Achilles tendinopathy (COS-AT) using a systematic review and a Delphi study of professional participants and patients.
The authors from the steering group (R-JdV, KGS, PM and BV) have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Within this 5-year project, multiple authors have been supported by specific research fellowships and/or grants that were not directly related to the COS-AT development. One author (DM) mentioned indirect support by the National Institute for Health Research Barts Biomedical Research Centre (NIHR203330).
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