Karen Mccreesh

Karen Mccreesh
University of Limerick | UL · School of Allied Health

PhD, MSc Manip Ther, BSc Physio, PgC Diagnostic Imag

About

89
Publications
28,596
Reads
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1,218
Citations
Additional affiliations
August 2003 - present
University of Limerick
Position
  • Lecturer

Publications

Publications (89)
Article
Synopsis The hallmark characteristics of rotator cuff (RC) tendinopathy are pain and weakness experienced most commonly during shoulder external rotation and elevation. Assessment is complicated by non-specific clinical tests and the poor correlation between structural failure and symptoms. As such, diagnosis is best reached by exclusion of other p...
Article
Introduction Loading leads to multiple changes in tendon morphological and mechanical properties, which can be altered in tendinopathy. Reductions in tendon thickness are generally reported after loading in lower limb tendons, with some studies suggesting a reduced response in painful tendons. However, no such studies exist for the rotator cuff (RC...
Article
Full-text available
Objective. This study aimed to describe the interrater and intrarater reliability of the flexicurve index, flexicurve angle, and manual inclinometer in swimmers. A secondary objective was to determine the level of agreement between the inclinometer angle and the flexicurve angle and to provide an equation to approximate one angle from the other. Me...
Article
Chronic tendon pathology is a common and often disabling condition, the causes of which remain poorly understood. The continuum model of tendon pathology was proposed to provide a model for the staging of tendon pathology and to assist clinicians in managing this often complex condition (Br. J. Sports Med., 43, 2009, 409). The model presents clinic...
Article
Full-text available
Narrowing of the subacromial space has been noted as a common feature of rotator cuff (RC) tendinopathy. It has been implicated in the development of symptoms and forms the basis for some surgical and rehabilitation approaches. Various radiological methods have been used to measure the subacromial space, which is represented by a two-dimensional me...
Article
Objective: To identify and describe the psychological and psychosocial constructs and outcome measures used in tendinopathy research. Design: Scoping review. Literature search: We searched the PubMed, EMBASE, Scopus, Web of Science, PEDro, CINAHL, and APA PsychNet databases on July 10, 2021, for all published studies of tendinopathy population...
Article
Questions To report the characteristics of exercise interventions and ascertain their effectiveness compared to surgery on quality of life, disability, and pain for people with large to massive rotator cuff tendon tears (L-MRCTTs). Design Systematic review with meta-analysis of randomised controlled trials (RCTs). Participants Adults with L-MRCTT...
Article
Introduction: Many inconsistencies have been identified in the translation of evidence-based treatment recommendations for musculoskeletal shoulder pain into healthcare services, with little known about factors influencing decision-making. The objective of this study was to explore the views and experiences of healthcare providers (HCPs) and peopl...
Article
Shoulder pain accounts for a large proportion of musculoskeletal disorders and years lived with disability. Musculoskeletal shoulder pain is challenging to manage and while research evidence suggests that exercise should be a cornerstone of shoulder pain rehabilitation, the exact type and dosage of exercise is unclear. Adherence is a barrier to suc...
Article
Full-text available
Background In response to issues with timely access and high non-attendance rates for Emergency Department (ED) physiotherapy, a telephone assessment and advice service was evaluated as part of a quality improvement project. This telehealth option requires minimal resources, with the added benefit of allowing the healthcare professional streamline...
Article
Objective The purpose of this study is to identify the training load (TL) monitoring practices employed in real-world competitive swimming environments. The study explores data collection, analysis and barriers to TL monitoring. Design Cross-sectional. Setting Online survey platform. Participants Thirty-one responders working in competitive swim...
Article
Full-text available
Background: Chronic non-traumatic rotator cuff tendon tears are inextricably linked with the natural process of aging often resulting in severe disability, poor quality of life and an added burden to the health care system. The occurrence of rotator cuff tendon tears increases exponentially with every decade of life to approximately 60% in individu...
Article
Full-text available
Background: Rotator cuff tendon tears are inextricably linked with the natural process of aging often resulting in severe disability, poor quality of life and an added burden to the health care system. The occurrence of rotator cuff tendon tears increases exponentially with every decade of life to approximately 60% in individuals over 80 years of a...
Article
Full-text available
Background Virtual Reality (VR) is an immersive technology, which transports the user to a three-dimensional ‘virtual world’ and is increasingly used as an innovative treatment modality in various aspects of healthcare. The use of immersive VR in the management of musculoskeletal conditions is relatively new and research is required to demonstrate...
Article
Shoulder pain accounts for a large proportion of musculoskeletal disorders and years lived with disability. Musculoskeletal shoulder pain is challenging to manage and while research evidence suggests that exercise should be a cornerstone of shoulder pain rehabilitation, the exact type and dosage of exercise is unclear. Adherence is a barrier to suc...
Article
Objective: To review and synthesize qualitative research studies exploring the experiences of Healthcare Providers (HCPs) of managing shoulder pain. Methods: A meta-ethnographic approach was adopted to review and synthesize eligible studies. The findings from each included study were translated into one another using Noblit and Hares' seven-stag...
Conference Paper
Full-text available
Learning objectives: To discuss current evidence for the delivery of site- and disorder-specific interventions compared to general interventions for musculoskeletal disorders. To gain knowledge on the available treatment options and modes of delivery for the most common musculoskeletal disorders. To explore common mechanisms of physiotherapy interv...
Article
Background While pain is common in older adults, the association with physical activity is unclear. Currently, the role physical activity plays in impacting pain developing over time is not well‐defined. Methods Latent transition analysis (LTA) is a model‐based approach to identifying underlying subgroups in a population, longitudinally, based on...
Article
Background Research suggests that the frequency of training, combined with the repetitive motion involved in high volume swimming can predispose swimmers to symptoms of over-training. The prevention of pain, injury and illness is of paramount importance in competitive swimming in order to maximise a swimmer’s ability to train and perform consistent...
Article
Objective The objective of this study was to review and synthesize qualitative research studies exploring the experiences of individuals living with shoulder pain to enhance understanding of the experiences of these individuals as well as facilitate health care developments. Methods A meta-ethnographic approach was adopted to review and synthesize...
Article
Objectives: To appraise the quality of clinical practice guidelines (CPGs) for physical therapy management of non-traumatic shoulder pain disorders. Study design: Systematic review of clinical practice guidelines. Literature search: Seven databases and seven grey literature sources were independently searched by two reviewers. Study selection...
Article
Background While pain is very common in older adults, the associated impact on daily life, including usage of medication and healthcare, varies considerably and often pain remains inadequately treated. It is not clear what is associated with this variation. Methods Latent class analysis (LCA) is a model‐based approach to identifying underlying sub...
Article
Background Current clinical practice guidelines for degenerative meniscal tears recommend conservative management yet patients are frequently referred to the consultant orthopaedic surgeon despite a lack of evidence for the use of arthroscopy. Objectives To explore the beliefs about their condition and treatment expectations of patients referred t...
Preprint
Full-text available
Background In response to issues with timely access for musculoskeletal physiotherapy, telephone assessment and advice services have been evaluated in primary care settings. It is unclear whether this service model can reduce wait times and non-attendance rates for Emergency Department (ED) physiotherapy, compared to usual care. A secondary aim was...
Preprint
Full-text available
.Background In response to issues with timely access for musculoskeletal physiotherapy, telephone assessment and advice services have been evaluated in primary care settings. It is unclear whether this service model can reduce non-attendance rates and wait times and for Emergency Department (ED) physiotherapy, compared to usual care. A secondary ai...
Preprint
Full-text available
Background In response to issues with timely access and high non-attendance rates for Emergency Department (ED) physiotherapy, a telephone assessment and advice service was evaluated as part of a quality improvement project. This telehealth option requires minimal resources, with the added benefit of allowing the healthcare professional streamline...
Article
BACKGROUND: Shoulder pain is a common musculoskeletal complaint and disorders of the rotator cuff (RC) are widely regarded as the most common cause. Where clinical care is required, physiotherapists play an integral role. Previous studies have reported physiotherapy practice across other countries as a means of determining current practice and unde...
Article
Background: Persistent strength deficits secondary to Achilles tendinopathy (AT) have been postulated to account for difficulty engaging in tendon-loading movements, such as running and jumping, and may contribute to the increased risk of recurrence. To date, little consensus exists on the presence of strength deficits in AT. Consequently, researc...
Article
Full-text available
Objective: To update an existing systematic review of randomized clinical trials evaluating the clinical effectiveness of non-surgical management interventions for people with primary frozen shoulder in terms of pain, movement, self-reported function and disability, quality of life, recovery time, return to work and recreation, and adverse events....
Conference Paper
Introduction Exercise is an effective intervention for rotator cuff related shoulder pain (RCRSP). Self-report methods of exercise adherence are subject to bias. The BandCizer™ is a resistance band mounted device offering objective measurement of adherence. It is valid and reliable for measuring exercise quality (time-under-tension (TUT)) and quant...
Conference Paper
Full-text available
To investigate the feasibility of using a BandCizer™ device to evaluate adherence to a home exercise programme for adults with shoulder pain.
Poster
Full-text available
To investigate the feasibility of using a BandCizer™ device to evaluate adherence to a home exercise programme for adults with shoulder pain.
Article
Full-text available
Objectives Rotator cuff tendinopathies are the most common shoulder disorders. As persistent symptoms lasting more than 3 months have been shown to be a strong indicator of poor outcomes, it is important to have successful interventions in the acute stage. However, there is no evidence yet to guide clinical interventions in an acute pain context. T...
Article
Objective: Recent evidence has demonstrated that group-based physiotherapy interventions for musculoskeletal pain can have similar clinical outcomes compared to one-to-one treatment. This study qualitatively explored the experiences of individuals who participated in a physiotherapist-led group exercise class for people with nonspecific shoulder p...
Article
Study design: A case series was carried out. Introduction: There is a lack of evidence exploring the effectiveness of group exercise classes for people with nonspecific shoulder pain (NSSP). Also, there is a lack of research that measures potential reductions in thoracic kyphosis after exercise interventions in people with NSSP. Purpose of the...
Article
Full-text available
Background/aim Exercise imparts a load on tendon tissue that leads to changes in tendon properties. Studies suggest that loading immediately reduces tendon thickness, with a loss of this response in symptomatic tendinopathy. No studies investigating the response of tendon dimensions to load for the rotator cuff tendons exist. This study aimed to ex...
Article
Introduction: Physiotherapists commonly use the manual inclinometer and Flexicurve for the clinical measurement of thoracic spinal posture. The aim of this study is to examine the concurrent validity of the Flexicurve and manual inclinometer in relation to the radiographic Cobb angle for the measurement of thoracic kyphosis. Methods: Eleven subj...
Article
Background: Achilles tendinopathy (AT) is associated with persistent pain leading to a significant physical and psychological burden. Psychosocial factors are considered to be important mediators following exercise interventions. Despite the recognition of the importance of psychosocial variables in persistent MSK disorders, there is a distinct la...
Article
Background Ultrasound [US] imaging is commonly used to visualise tendon structure. It is not clear whether the presence of structural abnormalities in asymptomatic tendons predicts the development of future tendon symptoms in the Achilles or patellar tendon. This led to considerable uncertainty in the management of sporting populations with a high...
Article
Background: Diagnostic ultrasound (US) is a commonly used imaging modality for visualising tendon pathology and morphology. In comparison to magnetic resonance imaging (MRI), diagnostic US is perceived to have a higher risk of error when evaluating tendon size. Aim: To systematically assess the evidence regarding the Intra rater and Inter rater...
Article
Full-text available
Background Musculoskeletal conditions involving the shoulder are common and, because of the importance of the upper limb and hand in daily function, symptoms in this region are commonly associated with functional impairment in athletic and non-athletic populations. Deriving a definitive diagnosis as to the cause of shoulder symptoms is fraught with...
Article
Background Ultrasound (US) imaging is commonly used to visualise tendon structure. It is not clear whether the presence of structural abnormalities in asymptomatic tendons predicts the development of future tendon symptoms in the Achilles or patellar tendon. Aim To perform a systematic review and meta-analysis investigating the ability of US imagi...
Article
Objective: Real-time ultrasound imaging is an established objective outcome measurement with proven reliability. However, it is still largely biased by user-ability. Published research in the area of real-time ultrasound imaging reliability in the cervical region and in particular the deep cervical flexors is quite sparse. The purpose of this inve...
Conference Paper
Full-text available
iii) Background: Clinicians and patients have commonly reported that the clinician-patient interaction is an important factor in the outcome of musculoskeletal pain. Clinician-patient interaction incorporates factors such as clinician empathy and listening, patient-clinician communication, shared goals, confidence and trust in clinicians, non-verba...
Article
Introduction: Excessive thoracic kyphosis is considered a predisposing factor for shoulder pain, though there is uncertainty about the nature of the relationship between shoulder pain and thoracic spine posture. The aim of this systematic review was to investigate the relationship between thoracic kyphosis and shoulder pain, shoulder range of moti...
Article
Background Musculoskeletal pain is common and its treatment costly. Both group and individual physiotherapy interventions which incorporate exercise aim to reduce pain and disability. Do the additional time and costs of individual physiotherapy result in superior outcomes? Objective To compare the effectiveness of group and individual physiotherapy...
Article
Full-text available
The study aim was to elicit the motivators, barriers, and benefits of participation in a Community of Practice (CoP) for primary care physiotherapists. We used a qualitative approach using semistructured interviews. The participants were twelve physiotherapists partaking in a newly formed Shoulder CoP. A desire for peer support was the strongest mo...
Article
Purpose: Rotator cuff (RC) tendinopathy has been widely ascribed to impingement of the supraspinatus tendon (SsT) in the subacromial space, measured as the acromiohumeral distance (AHD). Ultrasound (US) is suitable for measuring AHD and SsT thickness, but few reliability studies have been carried out in symptomatic populations, and interrater reli...
Article
Full-text available
Regional distribution of adiposity and lean tissue mass are predictors of health risk that cannot be defined by body mass index but can be attained by dual-energy X-ray absorptiometry (DXA). Age and sex-related adult ranges of whole-body and regional adiposity and lean tissue are not available for Irish men and women. The aim of this study was to c...
Article
The purpose of this project was to create a sonographic phantom model of the shoulder that was accurate in bone configuration. Its main purpose was for operator training to measure the acromiohumeral distance. A computerized 3-dimensional model of the superior half of the humerus and scapula was rendered and 3-dimensionally printed. The bone model...
Article
Ultrasound has a high degree of diagnostic accuracy in the assessment of rotator cuff tendons. Increasingly, ultrasound is being used to measure other parameters of rotator cuff pathology, including the size of the subacromial space, or acromiohumeral distance (AHD). Although this measure has been found to be clinically reliable, no assessment of i...
Article
Full-text available
Groin/hip injuries are common in the athletic population, particularly in sports requiring kicking, twisting, turning and rapid acceleration and deceleration. Chronic hip, buttock and groin pain account for 10% of all attendances to sports medicine centres. Understanding risk factors for field-based sports (FBS) players is important in developing p...
Article
Groin/Hip injuries are among the top 6 most commonly cited injuries in Rugby Union (RU). These injuries have increased significantly since 2002 moving from 16th to 4th place in the most common training injuries in 2012 RU annual audit. To identify intrinsic risk factors for groin/hip injuries in an academy level RU population. Prospective cohort st...
Article
Pathological tendons are known to increase their AP diameter. Ultrasound is an important complementary technique to MRI for assessment of musculoskeletal disorders. Although systematic reviews have confirmed its reliability for the measurement of muscle thickness, no such reviews exist to examine the reliability of US measures of tendon dimensions....
Article
Background Steroid injection and active physiotherapy are the two standard conservative therapies used to treat SIS1 and the outcome from these two treatments varies depending on numerous prognostic factors. Outcome predictors may identify patients suitable for specific therapies. The role of MSUS in the diagnosis of rotator cuff disease is well do...
Article
A wide array of instruments are available for non-invasive thoracic kyphosis measurement. Guidelines for selecting outcome measures for use in clinical and research practice recommend that properties such as validity and reliability are considered. This systematic review reports on the reliability and validity of non-invasive methods for measuring...
Article
Background Subacromial impingement syndrome has historically been ascribed to extrinsic compression of the supraspinatus tendon (SsT) due to altered acromial morphology. More recently intrinsic tendon pathology has been proposed as an important mechanism, leading to degenerative changes in the tendon, superior translation of the humeral head occurs...
Article
This case report describes a patient with an acromio-clavicular joint (ACJ) cyst, associated with a complete tear of the supraspinatus tendon, and the related arthropathy. Ultrasound was a suitable imaging modality to make the diagnosis, and rule out other pathologies. Full assessment of the rotator cuff must be carried out in the presence of ACJ c...
Article
This report describes the case of an amateur soccer player with chronic patellar tendinopathy who underwent ultrasound imaging before and after engaging in an 8-week programme of eccentric exercise. On initial assessment, greyscale ultrasound imaging demonstrated tendon thickening and reduced echogenicity, while Power Doppler imaging demonstrated a...
Article
This study evaluated the ability of ultrasound measurement of subcutaneous adiposity to accurately determine whole body and segmental body fat in young adults aged 18-29 years. Subcutaneous adipose tissue (SAT) thickness was measured by ultrasound at five body sites in 135 subjects (83 men, 52 women) and compared with the corresponding segmental fa...
Article
The gluteus medius (Gmed) is proposed to consist of 3 functional subdivisions (anterior, middle, and posterior). Gmed weakness and dysfunction have been implicated in numerous lower extremity disorders, including patellofemoral pain syndrome (PFPS). PFPS is a knee condition that frequently occurs in females and is associated with activities such as...
Article
A correctly positioned vehicle head restraint (HR) can reduce whiplash injury risk in collisions, however, HRs are often sub-optimally positioned. The primary aim of this study was to investigate vehicle HR position and driver knowledge of correct HR positioning in an Irish population. Secondary aims were to investigate the associations with driver...