Efficacy of standardised manual therapy and home exercise programme for chronic rotator cuff disease: randomised placebo controlled trial

Bennell, Kim L; Wee, Elin; Coburn, Sally L.; Green, Sally; Harris, Anthony; Staples, Margaret; Forbes, Andrew Benjamin; Buchbinder, Rachelle

doi:10.1136/bmj.c2756

Cited by 171 publications

(206 citation statements)

References 55 publications

(62 reference statements)

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“…Nine trials 4,5,10,22,27,28,42,44,52 used validated functional outcome measures. Shoulder ac- Group 1 (n = 7): MT (anterior, posterior, inferior mobilization or traction of the GH joint) and standard care Group 2 (n = 7): standard care (hot packs, active ROM, stretching and strengthening shoulder exercises, soft tissue mobilization, and patient education)…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Fourteen studies [1][2][3]5,6,10,11,27,28,35,37,[42][43][44] used a visual analog scale (VAS) or a numeric pain-rating scale to measure a variety of pain-related outcomes. Nine trials 4,5,10,22,27,28,42,44,52 used validated functional outcome measures.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Blinding of assessors was adequately reported in 11 studies. 2,5,11,12,22,27,28,35,44,48,54 Risk of reporting bias was present in 17 of the 21 studies, because no protocol or trial registration number was provided (FIGURES 2 and 3). …”

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confidence: 99%

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The Efficacy of Manual Therapy for Rotator Cuff Tendinopathy: A Systematic Review and Meta-analysis

Desjardins‐Charbonneau¹,

Roy²,

Dionne³

et al. 2015

J Orthop Sports Phys Ther

116

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® T t STUDY DESIGN:Systematic review and metaanalysis. T t OBJECTIVES:To evaluate the efficacy of manual therapy (MT) for patients with rotator cuff (RC) tendinopathy. T t BACKGROUND:Rotator cuff tendinopathy is a highly prevalent musculoskeletal disorder, for which MT is a common intervention used by physical therapists. However, evidence regarding the efficacy of MT is inconclusive. T t METHODS:A literature search using terms related to shoulder, RC tendinopathy, and MT was conducted in 4 databases to identify randomized controlled trials that compared MT to any other type of intervention to treat RC tendinopathy. Randomized controlled trials were assessed with the Cochrane risk-of-bias tool. Meta-analyses or qualitative syntheses of evidence were performed. T t RESULTS:Twenty-one studies were included.The majority had a high risk of bias. Only 5 studies had a score of 69% or greater, indicating a moderate to low risk of bias. A small but statistically significant overall effect for pain reduction of MT compared with a placebo or in addition to another intervention was observed (n = 406), which may or may not be clinically important, given a mean difference of 1.1 (95% confidence interval: 0.6, 1.6) on a 10-cm visual analog scale. Adding MT to an exercise program (n = 226) significantly decreased pain (mean difference, 1.0; 95% confidence interval: 0.7, 1.4), as reported on a 10-cm visual analog scale, which may or may not be clinically important. Based on qualitative analyses, it is unclear whether MT used alone or added to an exercise program improves function. T t CONCLUSION:For patients with RC tendinopathy, based on low-to moderate-quality evidence, MT may decrease pain; however, it is unclear whether it can improve function. More methodologically sound studies are needed to make definitive conclusions. T t LEVEL OF EVIDENCE:Therapy, level 1a-. Ther 2015;45(5):330-350. Epub 26 Mar 2015. doi:10.2519/jospt.2015 T t KEY WORDS: mobilization, physical therapy, shoulder impingement syndrome, shoulder pain S houlder pain is highly prevalent and among mus culoskeletal disorders is the third most common reason for visiting a primary care physician. 16,33,46 As many as two thirds of people who have shoulder complaints receive a diagnosis of rotator cuff (RC) tendinopathy. 46 Rotator cuff tendinopathy often leads to decreased function, 34 lower health related quality of life, 34 poor sleep quality, 47 and work absenteeism. J Orthop Sports Phys 40Rotator cuff tendinopathy is a broad diagnosis, and mounting evidence suggests that diagnoses such as shoulder impingement syndrome, RC tendinitis/ tendinosis, as well as subacromial bursitis may be considered as the same clinical entity. 19 Conservative treatment of RC tendinopathy generally includes rest, nonsteroidal anti-inflammatory drugs, and rehabilitation interventions such as exercise.19 High-level evidence supports exercise as an effective treatment. 20 In conjunction with exercise, physical therapists often add manual therapy (MT) interventions to address impairm...

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Section: Outcome Measuresmentioning

confidence: 99%

Section: Outcome Measuresmentioning

confidence: 99%

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The Efficacy of Manual Therapy for Rotator Cuff Tendinopathy: A Systematic Review and Meta-analysis

Desjardins‐Charbonneau¹,

Roy²,

Dionne³

et al. 2015

J Orthop Sports Phys Ther

116

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“…As tendinopatias da bai� nha rotadora e a síndrome de colisão do ombro podem apresentar um início súbito ou gradual, afectar o ombro e/ou a região lateral e superior do braço e estão, normalmente, associadas a dor durante o movimento, fraqueza muscular, alte� rações da amplitude de movimento e limitação da função 8 . A semelhança de sinais e sintomas leva alguns autores a afirmar que o diagnóstico diferencial é muitas vezes difícil 8 e que ambas as condições poderiam ser agrupadas sob o nome de patologia crónica da bainha rotadora 9 . Independentemente da etiologia, o trata� mento preferencial para a dor no ombro é a fisio� terapia.…”

Section: Introductionunclassified

“…Verifica�se que 79% dos médicos enca� minham os seus utentes com queixas de dor no ombro para a fisioterapia 10 . Tem�se o objectivo de reduzir a dor e de melhorar a função, melho� rando a biomecânica e padrões de movimento do complexo articular do ombro 9 . O tratamento pode incluir diversas técnicas e procedimentos, tais como electroterapia, massagem, exercícios, mobilização e manipulação, sendo a mobiliza� ção passiva uma das mais frequentemente uti� lizadas 11 .…”

Section: Introductionunclassified

A efectividade da mobilização passiva no tratamento de patologias do ombro

Santos¹,

Cunha²,

Silva³

2011

Cons. Saúde

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Introdução: A dor no ombro é muito comum e o tratamento preferencial é a fisioterapia. Objectivo: Avaliar a efectividade da mobilização passiva na dor, força, amplitude de movimento e/ou função no tratamento de indivíduos com tendinopatias da coifa ou síndrome de colisão do ombro por meio de revisão sistemática de literatura. Métodos: Os estudos foram pesquisados na PubMed, Cochrane Library, Scielo, PEDro e Web of Science. Dois investigadores analisaram os artigos para determinar os trabalhos a incluir. A qualidade metodológica desses foi avaliada por meio da escala de PEDro e feita a sua caracterização detalhada. Resultados: Os resultados sugerem que a mobilização passiva quando aplicada em conjunto com outros tratamentos leva a significativa diminuição da dor e a melhoria da força e função. Conclusão: A mobilização passiva aplicada em conjunto com outros tratamentos parece ser uma mais valia no tratamento de tendinopatias da bainha rotadora e síndrome de colisão do ombro. São necessários mais estudos que confirmem esses resultados.

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Effect of Corticosteroid Injection, Physiotherapy, or Both on Clinical Outcomes in Patients With Unilateral Lateral Epicondylalgia

Coombes

Bisset

Brooks

et al. 2013

JAMA

311

251

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Efficacy of standardised manual therapy and home exercise programme for chronic rotator cuff disease: randomised placebo controlled trial

Abstract: Objective To investigate the efficacy of a programme of manual therapy and exercise treatment compared with placebo treatment delivered by physiotherapists for people with chronic rotator cuff disease.

Cited by 171 publications

References 55 publications

The Efficacy of Manual Therapy for Rotator Cuff Tendinopathy: A Systematic Review and Meta-analysis

The Efficacy of Manual Therapy for Rotator Cuff Tendinopathy: A Systematic Review and Meta-analysis

A efectividade da mobilização passiva no tratamento de patologias do ombro

Effect of Corticosteroid Injection, Physiotherapy, or Both on Clinical Outcomes in Patients With Unilateral Lateral Epicondylalgia

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