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The efficacy of education as an intervention for improving core outcome domains in people with tendinopathy: a systematic review with meta-analysis [with consumer summary]
Townsend L, Neal BS, Carter H, Cuff A, Mallows A
The Journal of Orthopaedic and Sports Physical Therapy 2025 Aug;55(8):1-15
systematic review

OBJECTIVE: To evaluate the efficacy of standalone education for people with tendinopathy. DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: MEDLINE, CINAHL, SPORTDiscus, and EMBASE (from inception to June 2024). STUDY SECTION CRITERIA: Randomized controlled trials (RCTs) comparing standalone education to another intervention for adults with tendinopathy. DATA SYNTHESIS: Outcome (success/no success), pain, and function data were extracted in the short (<= 3 months), medium (3 to 6 months), and long term (>= 12 months). Homogeneous data were pooled using random effects and subgrouped by tendinopathy. Continuous and dichotomous data were used to calculate standardized mean differences and odds ratios (ORs) with 95% confidence intervals (CIs), respectively. RESULTS: Eleven RCTs involving 2094 people with tendinopathy were included. Education delivery mode and content varied substantially. There was very low- to low-certainty evidence that education was equivalent to physiotherapy management for short- (OR 0.56; 95% CI 0.31 to 1.01), medium- (OR 0.42; 95% CI 0.12 to 1.53), and long-term (OR 0.56; 95% CI 0.21 to 1.51) treatment success. There was very low- to low-certainty evidence that education was equivalent to corticosteroid injection for short- (OR 0.32; 95% CI 0.14 to 2.31), medium- (OR 1.76; 95% CI 0.18 to 17.54), and long-term (OR 1.86; 95% CI 0.71 to 4.84) treatment success. There was very low-certainty evidence that education combined with physiotherapy management offered no additional benefit for short- (OR 0.54; 95% CI 0.07 to 4.16), medium- (OR 0.47; 95% CI 0.12 to 1.81), and long-term (OR 0.56; 95% CI 0.21 to 1.46) treatment success. CONCLUSION: The short-term benefits of additional treatment to standalone education were not carried through into the medium- and long-term. Education as a standalone treatment could be considered as part of shared decision making for adults with tendinopathy.

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