An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain

Pieters, Louise; Lewis, Jeremy; Kuppens, Kevin; Jochems, Jill; Bruijstens, Twan; Joossens, Laurence; Struyf, Filip

doi:10.2519/jospt.2020.8498

Cited by 118 publications

(95 citation statements)

References 38 publications

(61 reference statements)

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“…Exercise is recommended as one treatment for patients with subacromial pain (9)(10)(11)(12). Although, research suggests that exercise including some level of resistance and maintained for at least 12 weeks might be important prescription parameters, there remains a lack of knowledge about the optimal type-and dosage of exercises (13).…”

Section: Introductionmentioning

confidence: 99%

Adherence to Self-managed Exercises for Patients with Persistent Subacromial Pain: The Ad-Shoulder Feasibility Study

Major

Grotle

Littlewood

et al. 2020

Preprint

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Background: Exercise is recommended for patients with subacromial pain. It has been suggested that good exercise adherence improves clinical outcomes. Despite this, little attention has been paid to the need for behavioural frameworks to enhance adherence to home exercise programs for patients with subacromial pain.Methods: A feasibility study with pre-post design was used. Participants aged > 18 years, with subacromial pain, who had received conservative treatment during the past six months, were recruited. The Ad-Shoulder intervention consisted of 1-5 individual sessions provided over 3 months and was based on 5 self-management skills, which aimed to enhance the patients’ self-efficacy and adherence to self-managed exercises. The primary objectives were assessed according to predefined progression criteria: 1) The recruitment rate (10 patients enrolled within 12 weeks); 2) Follow-up rate (≥80% on all self-reported measures); 3) Objective physical activity measures (≥80% of participants would contribute valid data at each time point), 4) Adherence with the self-managed exercises (≥80% of the participants would adhere to ≥80% of the assigned home exercise program); 5) Fidelity of the delivery of the intervention (The therapists delivered the intervention according to the protocol); 6) Adverse events (<30% would report adverse events (including mild)). The results were reported using descriptive statistics.Results: Eleven patients were recruited during 16 weeks. Ten patients completed the self-reported measures at baseline and Week 12. Objective physical activity measures were successfully obtained for 100% at baseline, 64% at week six and 82% at week 12. 55% of the participants satisfactorily completed at least 80% of their home exercise program. All sessions were delivered according to the protocol. None of the patients reported any adverse events. Conclusions: Objective physical activity data measures at baseline and week 12, follow-up, the physiotherapists’ fidelity to the intervention and adverse events met our pre-specified progression criteria. Recruitment and adherence to the self-managed exercise program were both below the anticipated level. Further intervention development is necessary to understand whether adherence to the self-managed exercises could be enhanced and additional methods of recruitment would need to be considered, including additional recruitment sites, in any planning for a future main trial.Trial registration: ClinicalTrials.gov NCT04190836, Registered December 9, 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04190836

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Section: Introductionmentioning

confidence: 99%

Adherence to Self-managed Exercises for Patients with Persistent Subacromial Pain: The Ad-Shoulder Feasibility Study

Major

Grotle

Littlewood

et al. 2020

Preprint

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“…As described, Manual Therapy techniques targeting joint or extra-articular soft tissue can be very effective in relieving pain and improving ROM in individuals with musculoskeletal disorders, both in the spine and in the limbs [21].…”

Section: Joint Manual Therapymentioning

confidence: 99%

“…Today, there is a wealth of literature supporting the effectiveness of Manual Therapy in improving pain and mobility in patients with musculoskeletal disorders [19][20][21]. However, these improvements are mainly short-term and have a reduced efficacy, particularly in subjects with chronic symptoms [21].…”

Section: Introductionmentioning

confidence: 99%

Manual Therapy: Art or Science?

Bizzarri¹,

Foglia²

2020

Physical Therapy Effectiveness

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Manual Therapy is one of the most widely used therapeutic solutions in the treatment of pain and musculoskeletal disorders. Its evolution began several centuries ago and culminated in the modern reference methods in the field of physiotherapy, osteopathy, and chiropractic, which mainly address the treatment of joint and myofascial tissues. The advent of evidence-based medicine and the ever-growing literature available in the field of Manual Therapy has led this therapeutic approach to be heavily criticized on the basis of studies that have shown its limitations with regard to manual and palpatory assessment techniques, the poor biomechanical validity of therapeutic methods, and the poor long-term results in the treatment of patients with musculoskeletal pain. A better understanding of the mechanisms underlying the effectiveness of Manual Therapy, as well as of the mediators of the medium-and long-term effectiveness of musculoskeletal rehabilitation processes, has made it possible to reconsider the role of Manual Therapy and the healthcare professionals specializing in manipulative therapy within the framework of the biopsychosocial model, which focuses on the patient and their functionality.

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“…Exercise is recommended as one treatment for patients with subacromial pain [ 8 – 11 ]. Although research suggests that exercise including some level of resistance and maintained for at least 12 weeks might be important prescription parameters, there remains a lack of knowledge about the optimal type- and dosage of exercises [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Adherence to self-managed exercises for patients with persistent subacromial pain: the Ad-Shoulder feasibility study

Major

Grotle

Littlewood

et al. 2021

Pilot Feasibility Stud

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Background Exercise is recommended for patients with subacromial pain. It has been suggested that good exercise adherence improves clinical outcomes. Despite this, little attention has been paid to the need for behavioural frameworks to enhance adherence to home exercise programmes for patients with subacromial pain. Methods A feasibility study with pre-post design was used. Participants aged > 18 years, with subacromial pain, who had received conservative treatment during the past 6 months, were recruited. The Ad-Shoulder intervention consisted of 1–5 individual sessions provided over 3 months and was based on 5 self-management skills, which aimed to enhance the patients’ self-efficacy and adherence to self-managed exercises. The primary objectives were assessed according to predefined progression criteria: (1) the recruitment rate (10 patients enrolled within 12 weeks), (2) follow-up rate (≥ 80% on all self-reported measures), (3) objective physical activity measures (≥ 80% of participants would contribute valid data at each time point), (4) adherence with the self-managed exercises (≥ 80% of the participants would adhere to ≥ 80% of the assigned home exercise programme), (5) fidelity of the delivery of the intervention (the therapists delivered the intervention according to the protocol) and (6) adverse events (< 30% would report adverse events (including mild)). The results were reported using descriptive statistics. Results Eleven patients were recruited during 16 weeks. Ten patients completed the self-reported measures at baseline and week 12. Objective physical activity measures were successfully obtained for 100% (11/11) at baseline, 64% (7/11) at week six and 82% at week 12. Fifty-five percent (6/11) of the participants satisfactorily completed at least 80% of their home exercise programme. All sessions were delivered according to the protocol. None of the patients reported any adverse events. Conclusions Objective physical activity data measures at baseline and week 12, follow-up, the physiotherapists’ fidelity to the intervention and adverse events met our pre-specified progression criteria. Recruitment and adherence to the self-managed exercise programme were both below the anticipated level. Further intervention development is necessary to understand whether adherence to the self-managed exercises could be enhanced and additional methods of recruitment would need to be considered, including additional recruitment sites, in any planning for a future main trial. Trial registration ClinicalTrials.gov, NCT04190836, Registered December 9, 2019—retrospectively registered

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An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain

Cited by 118 publications

References 38 publications

Adherence to Self-managed Exercises for Patients with Persistent Subacromial Pain: The Ad-Shoulder Feasibility Study

Adherence to Self-managed Exercises for Patients with Persistent Subacromial Pain: The Ad-Shoulder Feasibility Study

Manual Therapy: Art or Science?

Adherence to self-managed exercises for patients with persistent subacromial pain: the Ad-Shoulder feasibility study

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