Effectiveness of physical therapy treatment of clearly defined subacromial pain: a systematic review of randomised controlled trials

Haik, Melina Nevoeiro; Alburquerque‐Sendín, Francisco; Moreira, Raquel; Pires, Edleide Maria Freitas; Camargo, Paula R.

doi:10.1136/bjsports-2015-095771

Cited by 112 publications

(97 citation statements)

References 98 publications

(129 reference statements)

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“…This might be because previous reviews have included fewer studies, 13 and have not performed a meta-analysis and probably based their statements of evidence on non-significance of the individual trials. 57 Our results for ultrasound therapy, hyaluronate, tape, pulsed electromagnetic field therapy, ECSWT, microwave and platelet-rich plasma support previous reviews. 11 13 …”

Section: Comparisons With Other Studiessupporting

confidence: 86%

Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs

Steuri

Sattelmayer

Elsig³

et al. 2017

Br J Sports Med

233

192

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ObjectiveTo investigate the effectiveness of conservative interventions for pain, function and range of motion in adults with shoulder impingement.DesignSystematic review and meta-analysis of randomised trials.Data sourcesMedline, CENTRAL, CINAHL, Embase and PEDro were searched from inception to January 2017.Study selection criteriaRandomised controlled trials including participants with shoulder impingement and evaluating at least one conservative intervention against sham or other treatments.ResultsFor pain, exercise was superior to non-exercise control interventions (standardised mean difference (SMD) −0.94, 95% CI −1.69 to −0.19). Specific exercises were superior to generic exercises (SMD −0.65, 95% CI −0.99 to −0.32). Corticosteroid injections were superior to no treatment (SMD −0.65, 95% CI −1.04 to −0.26), and ultrasound guided injections were superior to non-guided injections (SMD −0.51, 95% CI −0.89 to −0.13). Nonsteroidal anti-inflammatory drugs (NSAIDS) had a small to moderate SMD of −0.29 (95% CI −0.53 to −0.05) compared with placebo. Manual therapy was superior to placebo (SMD −0.35, 95% CI −0.69 to −0.01). When combined with exercise, manual therapy was superior to exercise alone, but only at the shortest follow-up (SMD −0.32, 95% CI −0.62 to −0.01). Laser was superior to sham laser (SMD −0.88, 95% CI −1.48 to −0.27). Extracorporeal shockwave therapy (ECSWT) was superior to sham (−0.39, 95% CI −0.78 to –0.01) and tape was superior to sham (−0.64, 95% CI −1.16 to −0.12), with small to moderate SMDs.ConclusionAlthough there was only very low quality evidence, exercise should be considered for patients with shoulder impingement symptoms and tape, ECSWT, laser or manual therapy might be added. NSAIDS and corticosteroids are superior to placebo, but it is unclear how these treatments compare to exercise.

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Section: Comparisons With Other Studiessupporting

confidence: 86%

Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs

Steuri

Sattelmayer

Elsig³

et al. 2017

Br J Sports Med

233

192

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“…short wave diathermy [SWD]) and microwave diathermy were modalities commonly used in the physical therapy profession in the management of painful musculoskeletal conditions during the 1900s. The lack of rigorous scientific evidence to support effectiveness in comparison to exercise or placebo groups (Akyol et al, 2010;Haik et al, 2016;Kroeling et al, 2013;Page et al, 2014Page et al, , 2016, the dated nature of clinical evidence, and concerns regarding safety, have led to such modalities being excluded from many physical therapy entry-level curricula in some countries. Physical therapy is not yet a profession recognized by the Chinese government; and rehabilitation work in China is led by rehabilitation medicine practitioners, assisted by rehabilitation therapists.…”

Section: Introductionmentioning

confidence: 99%

Ultra-shortwave diathermy - a new purported treatment for management of patients with COVID-19

Jones

Dean

et al. 2020

Physiotherapy Theory and Practice

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The pandemic spread of coronavirus disease 2019 has driven efforts to address the global threat to public health and there is increasing pressure to exploit interventions to manage the pneumonic inflammation manifested in this disease. Ultra-shortwave diathermy (USWD) is proposed by some rehabilitation professions in China, purportedly to minimise pneumonic inflammation. However, treatment of any symptomatic pneumonia should be evidence-based. There is no valid evidence, published in English, which establishes any benefit of USWD in pulmonary conditions, let alone COVID-19. The need for rigorous research and evidence-based practice is discussed in this article. Novel interventions require a solid physiological basis and must undergo rigorous testing prior to clinical adoption even during a pandemic. We are of the view that deployment of USWD in patients with COVID-19 must be prudent and supported by a logical scientific basis. ARTICLE HISTORY

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“…A recent systematic review of 64 randomized controlled trials (RCTs) investigating the effect of physical therapy on individuals with SSI (Haik, Alburquerque-Sendin, Moreira, Pires, & Carmargo, 2016) reported that all studies measured subjective outcomes of pain and function and only 15 included an objective outcome measure, being active shoulder flexion, and abduction range.…”

Section: Introductionmentioning

confidence: 99%

“…No previous study has investigated the effect of physiotherapy interventions that increase thoracic range of motion or increase posterior shoulder range (Dickens, Williams, & Bhamra, 2005;Haik et al, 2016;Kromer et al, 2013). Common clinical physiotherapy techniques used to increase thoracic range of motion include central posteroanterior, unilateral posteroanterior, and transverse accessory mobilizations to the spine, as well as accessory mobilization of the ribs due to their strong attachment to the thoracic spine (Edmondston et al, 2007;Exelby, 2011).…”

Section: Introductionmentioning

confidence: 99%

Effect of manual physiotherapy in homogeneous individuals with subacromial shoulder impingement: A randomized controlled trial

Land

Gordon

Watt

2019

Physiotherapy Res Intl

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Objective To compare the effect of specific interventions aimed at (1) the upper thoracic spine (passive mobilization) and (2) the posterior shoulder (massage, passive mobilization, and stretching) to (3) an active control intervention in a homogeneous group with extrinsic subacromial shoulder impingement (SSI). Study Design Single‐centre, prospective, double‐blinded, randomized controlled trial. Method Eligible individuals with clearly defined extrinsic SSI were randomized to each group. Treatment duration was 12 consecutive weeks consisting of nine treatments over 6 weeks, followed by 6 weeks when one home exercise was performed daily. Outcomes included (1) active thoracic flexion/extension range of motion, (2) passive glenohumeral internal rotation and posterior shoulder range, (3) pain rating, and (4) shoulder pain and function disability index. Data were analysed at baseline, 6 and 12 weeks. Shoulder pain and function disability index scores were investigated via email 6 months after commencement of treatment. Results Twenty participants completed treatment in each group. No differences were identified between groups at baseline. Upper thoracic and posterior shoulder interventions, with a targeted home exercise, both significantly decreased pain and increased function scores and increased posterior shoulder range compared with active control at 12 weeks, and 6 months following cessation of the trial. Conclusion Manual therapy treatment that addresses these extrinsic factors, of thoracic spine or posterior shoulder tightness, decreases the signs and symptoms of SSI. The trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR; 12615001303538).

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Effectiveness of physical therapy treatment of clearly defined subacromial pain: a systematic review of randomised controlled trials

Abstract: Exercise therapy should be the first-line treatment to improve pain, function and range of motion. The addition of mobilisations to exercises may accelerate reduction of pain in the short term. Low-level laser therapy, PEMF and taping should not be recommended.

Cited by 112 publications

References 98 publications

Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs

Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs

Ultra-shortwave diathermy - a new purported treatment for management of patients with COVID-19

Effect of manual physiotherapy in homogeneous individuals with subacromial shoulder impingement: A randomized controlled trial

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