Monitoring, implementation and reporting of interventions in a selection of trials assessing exercise therapy for the management of shoulder subacromial pain: a cross-sectional investigation

• Published in: BMJ open 2021-02, Vol.11 (2), p.e044462
• Main Authors: Ribeiro, Daniel C, Spiers, Kate, Thomas, Laura, Leilua, Kiriffi, Wilkes, Matthew, Norton, Shontal, Lamb, Sarah E
• Format: Article
• Language: English
• Subjects: clinical trials; Cross-Sectional Studies; Exercise Therapy; Humans; musculoskeletal disorders; Musculoskeletal Manipulations; Rehabilitation Medicine; Shoulder; Shoulder Pain - therapy
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2020-044462

ObjectivesTo review the reporting of monitoring and implementation of interventions in a selection of trials that assessed the effectiveness of manual therapy and exercise in the management of shoulder subacromial pain.DesignA review of trials assessing the effectiveness of manual therapy and exercise in the management of patients with shoulder subacromial pain.MethodsWe included in our review a selection of 10 trials that were included in a Cochrane review and compared manual therapy and exercise intervention with another intervention. Trials were assessed independently by two reviewers using two checklists: the Template for Intervention Description and Replication (TIDieR) and the Health Behavior Change Consortium treatment fidelity (National Institutes of Health Behaviour Change Consortium/NIHBCC).ResultsTIDieR overall scores for individual trials ranged from 11.1% to 45% and fidelity scores ranged from 7% to 50%. On average, trials scored the following within each domain of NIHBCC: study design 51%; training of providers 8%; treatment delivery 15%; treatment receipt 14% and treatment enactment 2.5%.ConclusionsLittle information about the monitoring, implementation and reporting of interventions was provided by trials and that is a barrier for implementing or replicating these interventions. The lack of information regarding the implementation of interventions needs to be taken into account when assessing whether effectiveness of interventions was impacted by their design or due to deviations from the protocol within trials.