BackgroundShear wave tensiometry is a recent promising technology which can be used to evaluate tendon loading. Knowing the clinimetric features (e.g., reliability) of this technology is important for use in clinical and research settings. ObjectivesTo evaluate the inter-session reliability of a novel shear wave tensiometer for the assessment of Achilles tendon loading. A further aim was to test the construct validity of this device by evaluating its precision in detecting Achilles tendon loading changes induced by a plantar flexor isometric contraction of increasing intensity. MethodTen healthy participants were recruited. Five measurements were performed at different time points to evaluate inter-session reliability. Shear wave speed along the Achilles tendon was evaluated during different isometric contractions using a shear wave tensiometer composed of an array of four accelerometers fixed on the tendon, ranging from 4 to 8.5 cm from the calcaneal insertion of the tendon. Test-retest, intra- and inter-session reliability were determined using intraclass correlation coefficient (ICC3.1). Absolute reliability was calculated using the standard error of measurement and minimal detectable change. ResultsTest-retest reliability was good to excellent (ICC3.1 0.87–0.99) for each of the contraction levels examined. Intra-session reliability was good to excellent (ICC3.1 0.85–0.96) and inter-session reliability was also good to excellent (ICC3.1 0.75–0.93) for each of the contraction levels. ConclusionsThis study confirms the reliability of this novel device. Future studies analyzing participants with Achilles tendinopathy are needed to evaluate the capability of shear wave tensiometry to detect transient changes in loading due to pathology.

BackgroundConservative treatments are beneficial for people with hand osteoarthritis (OA). ObjectiveIt was the purpose of this study to develop and internally validate both a basic model and a more complex model that could predict responders to conservative treatments in people with hand OA. DesignThis was a secondary analysis of a single-centre, randomised feasibility study. MethodsFifty-nine participants (34 responders) with hand osteoarthritis were recruited from the general population. Participants were randomised to receive either advice alone, or advice in combination with blood flow restriction training (BFRT), or traditional high intensity training (HIT). Participants underwent supervised hand exercises three times per week for six weeks. The OMERACT-OARSI criteria were utilised to determine responders vs non responders to treatment at the end of six weeks. A basic logistic regression model (treatment type, expectations, adherence) and a more complex logistic regression model (basic model variables plus pain catastrophising and neuropathic pain features) were created. Discrimination ability, and calibration were assessed. Internal model validation through bootstrapping (200 repetitions) was utilised to calculate the prediction model optimism. ResultsThe results showed that the basic model presented with acceptable discrimination (optimism corrected c-statistic: 0.72, 95% CI 0.71–0.73) and calibration (slope = 1.41; intercept = 0.68). The more complex model had better discrimination but poorer calibration. ConclusionA prediction tool was created to provide an individualised estimate of treatment response in people with hand OA. Future studies will need to validate this model in other groups of patients. Trial registrationhttps://www.anzctr.org.au/- ACTRN12617001270303.

BackgroundNon-traumatic complaints of the arm, neck and/or shoulder (CANS) are difficult-to-treat musculoskeletal conditions. CANS treatment has varying degrees of success, particularly in the working population. ObjectivesTo evaluate the experiences and needs of physiotherapists (PTs) and exercise therapists (ETs) regarding the treatment of working patients with CANS. DesignAn exploratory qualitative focus group study was conducted. MethodQualitative data were collected from 27 therapists who were purposefully recruited for their broad range of experience and qualifications. The data was analysed using thematic analysis. ResultsBoth PTs and ETs assess CANS extensively by exploring their patients' psychosocial factors, work-related factors, illness beliefs, and working conditions. Therapists apply hands-off treatment interventions, such as coaching the patient to make behavioural changes and providing self-management support. However, therapists experience many difficulties in these areas, resulting in a need to learn more about coaching techniques for behavioural change, engaging in meaningful conversations about the patient's perspective, supporting patients in building a strong social network in the workplace, and creating a professional network for collaboration. ConclusionsThe treatment of working people with CANS is difficult for PTs and ETs. Therapists express a need to learn more about supporting self-management, applying coaching techniques and engaging in meaningful conversations. Moreover, therapists indicate a need to establish a professional multidisciplinary network to support collaborations with other disciplines to treat working patients with CANS.