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Low socioeconomic status is associated with worse treatment outcomes in patients with Achilles tendinopathy.
Visser, Tjerk Sleeswijk; Brul, Stefano; Deng, Jie; Bonsel, Joshua; van Es, Eline; Eygendaal, Denise; de Vos, Robert-Jan.
Afiliación
  • Visser TS; Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands t.sleeswijkvisser@erasmusmc.nl.
  • Brul S; Department of Sports Medicine, Haaglanden Medisch Centrum, The Hague, The Netherlands.
  • Deng J; Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands.
  • Bonsel J; Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands.
  • van Es E; Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands.
  • Eygendaal D; Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands.
  • de Vos RJ; Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, The Netherlands.
Br J Sports Med ; 58(11): 579-585, 2024 May 28.
Article en En | MEDLINE | ID: mdl-38569849
ABSTRACT

OBJECTIVE:

To assess whether there is a difference in symptom severity at baseline and 24 weeks follow-up between conservatively managed patients with Achilles tendinopathy (AT) with low socioeconomic status (SES) compared with those with high SES.

METHODS:

In this prospective cohort study, 200 patients with AT were included and treated according to current guidelines. We linked a neighbourhood SES indicator based on income, employment and education level and divided the patient population into quintiles, with Q1 being the highest SES and Q5 the lowest. Symptom severity at baseline and follow-up was assessed using the Victorian Institute of Sports Assessment-Achilles (VISA-A) score. Treatment adherence was not measured. We used a general linear model and the mean VISA-A scores at baseline and at 6, 12 and 24 weeks follow-up were compared between Q1 (n=45) and Q5 (n=39), while adjusting for age, sex, body mass index (BMI), Ankle Activity Score, symptom duration and baseline VISA-A score.

RESULTS:

Patients had a median age of 51 years and median BMI of 25.4, 40% were female. 74%, 70% and 58% of the participants completed the VISA-A at 6, 12 and 24 weeks, respectively. VISA-A scores at baseline were similar for Q1 and Q5 (43.9 and 41.8, p=0.591). At 24 weeks, there was a mean (95% CI) difference of 11.2 (1.0 to 21.3, p=0.032) points in favour of Q1 on the VISA-A score.

CONCLUSION:

AT patients with low SES may have worse outcomes when treated using the current guidelines. The difference in VISA-A score at 24 weeks is larger than the minimal clinically important difference and might be clinically relevant, but comes with uncertainty due to the large dispersion in the data. Clinicians need to consider the impact of social inequality when developing and implementing treatment plans.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Clase Social / Tendón Calcáneo / Tendinopatía Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Sports Med Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Clase Social / Tendón Calcáneo / Tendinopatía Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Sports Med Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido