Rotator cuff disorders: a survey of current (2016) UK physiotherapy practice

Littlewood, Chris; Lowe, Anna; Moore, John

doi:10.1177/1758573217717103

Cited by 41 publications

(71 citation statements)

References 32 publications

(60 reference statements)

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“…The survey was available for a 1-month period spanning 4 March-1 April 2019. This is consistent with previous surveys of this type (Bury & Littlewood, 2018).…”

Section: Dissemination and Data Analysissupporting

confidence: 94%

“…A clinical scenario (see Table 1) was used to describe a typical presentation of a patient who complains of shoulder pain (Bury & Littlewood, 2018). From this, survey responses were collected.…”

Section: Methodsmentioning

confidence: 99%

“…The rationale for this is not understood. This is perhaps illustrative of differences in the examination of the neck versus peripheral joints such as the shoulder, where resistance testing would be commonplace (Bury & Littlewood, 2018;Littlewood, Malliaras, Mawson, May, & Walters, 2014). "Less than expected muscle strength" considered significant by 64.4% and "Less than expected muscle endurance" considered significant by 44.6%, raises similar issues to those previously highlighted regarding examining the qualities of ROM; namely that the literature does not support the reliability of resisted muscle testing performed by the clinician in the absence of methods such as dynamometry or isokinetic testing (Burns et al, 2016;Land & Gordon, 2011;May et al, 2010).…”

Section: Diagnosticsmentioning

confidence: 99%

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Examination of the neck when a patient complains of shoulder pain: a global survey of current practice (2019)

Walker

Cuff

Salt

et al. 2020

Musculoskeletal Care

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Background Shoulder pain is a common musculoskeletal problem. Despite this, much uncertainty still exists regarding diagnosis, prognosis and effectiveness of treatments. One diagnostic challenge is determining the role of the neck when a patient complains of shoulder pain. The aim of this survey was to investigate healthcare professionals’ indications for examining the neck in this case and subsequent methods used. Methods An online survey was developed and distributed via Twitter and the authors’ professional networks. Responses were collected over a 4‐week period in 2019. Results In total, 918 respondents replied; 804 completed the full survey. The majority were physiotherapists. Over 80% would examine the neck of patients presenting with shoulder pain. The most commonly used method was neck active range‐of‐movement testing (n = 822/95.3%), followed by neurological examination (n = 713/78.1%). Less commonly used tests were neck resistance testing, palpation of the neck and Spurling's test. Fewer numbers (n = 176/22%) resorted to using diagnostic tests such as imaging. Conclusions This survey provides some insight as to how healthcare practitioners examine the neck when a patient complains of shoulder pain. Most would examine based on anterolateral shoulder pain, using variable combinations of movement, resistance, neurological and palpation/other testing. A minority would perform diagnostics or imaging. The results of the survey highlight that practice in this area is mixed, which may be due to uncertainty regarding optimal methods. This highlights the need for further work to understand this clinical dilemma better.

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“…The survey was available for a 1-month period spanning 4 March-1 April 2019. This is consistent with previous surveys of this type (Bury & Littlewood, 2018).…”

Section: Dissemination and Data Analysissupporting

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Section: Diagnosticsmentioning

confidence: 99%

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Examination of the neck when a patient complains of shoulder pain: a global survey of current practice (2019)

Walker

Cuff

Salt

et al. 2020

Musculoskeletal Care

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“…The wide range of diagnostic or descriptive terms used to explain this common clinical presentation reflect uncertainty in relation to understanding of the pathology, diagnosis, prognosis, and the most effective treatment options (1, [3][4][5]. A range of diagnostic tests, including imaging, and a range of different treatment options are available including exercise programmes, manual therapy, corticosteroid injections and surgery (6). Based on recent randomised controlled trials and systematic reviews, where clinical intervention is required, exercise is recommended as the first-line intervention of choice with comparable outcomes but at a lower cost and with fewer associated risks than surgical management.…”

Section: Introductionmentioning

confidence: 99%

“…This is important because it might mean that suboptimal exercise prescription leads to patients moving on to more costly, invasive and risky interventions, including corticosteroid injections and surgery, which are of questionable effectiveness (8,11,12). This concern is justified when it is recognised that the practice of physiotherapists across the UK with regards to exercise prescription is highly variable (6,13).…”

Section: Introductionmentioning

confidence: 99%

Physiotherapists’ recommendations for examination and treatment of rotator cuff related shoulder pain: A consensus exercise

Littlewood

Bateman

Connor

et al. 2019

PPR

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Background: Disorders associated with the rotator cuff are regarded as the most common shoulder pain presentation. The range of diagnostic terms used to explain this problem reflect uncertainty in relation to causative mechanisms, diagnosis, prognosis, and the most effective treatments. The aim of this consensus exercise was to facilitate a shared understanding as a means of reducing mixed messages, informing clinical practice and providing a foundation for future research. Methods: Ten physiotherapists with clinical and academic expertise in shoulder pain participated in an online and face-to-face consensus exercise. Results: This consensus exercise suggests specific factors in the history and physical examination that might raise the index of suspicion of Rotator Cuff Related Shoulder Pain. The suggestions for non-surgical management include a minimal number of exercises prescribed to challenge the functional deficit of the patient over a minimum 12-week period. Apart from aiding exclusion of red flag pathology, imaging is not regarded as useful unless the patient does not respond as expected. Steroid injections wouldn't be considered a first-line intervention unless pain was severe and preventing engagement with exercise. Conclusion: This consensus exercise provides a benchmark for clinical reflection while highlighting areas of uncertainty that still exist and require further research.

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French physiotherapy management of rotator cuff related shoulder pain: An observational study

Riera

Smythe

Malliaras

2021

Musculoskeletal Care

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Background: Rotator cuff related shoulder pain (RCRSP) is a common and disabling cause of shoulder pain contributing to great socio-economic costs. Conservative management is recommended as first-line treatment, with studies performed in the United Kingdom, Belgium, the Netherlands and Australia finding practice generally consistent with guideline recommendations. Current French guidelines for management of RCRSP were published more than a decade ago, and it is unknown if French physiotherapists manage RCRSP in line with the current guideline recommendations. The aim of this survey is to evaluate if management delivered by French physiotherapists for RCRSP is in line with the current evidence. Methods:A cross-sectional online survey was conducted and disseminated through various social media platforms and a mailing list from December 2018 to March 2019.Results: Two hundred and six French physiotherapists completed the survey. The results demonstrated that the majority of physiotherapists provide care consistent with recommended guideline management, through the delivery of exercise and education. Ideology and specific parameters of treatment delivery, particularly exercise treatment, were highly variable among the cohort, but comparable to findings among physiotherapists in the United Kingdom, Belgium, the Netherlands and Australia. Conclusion:French physiotherapists are broadly consistent with providing guideline recommended care of RCRSP; however, heterogeneity exists in the ideals and practice of specific treatment delivery, particularly within exercise management.

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Rotator cuff disorders: a survey of current (2016) UK physiotherapy practice

Abstract: The present study has highlighted that the clinical practice of the survey respondents was in line with current recommendations from research. Hence, in contrast to the survey conducted 5 years previously, research appears to be impacting on practice, which is a positive finding.

Cited by 41 publications

References 32 publications

Examination of the neck when a patient complains of shoulder pain: a global survey of current practice (2019)

Examination of the neck when a patient complains of shoulder pain: a global survey of current practice (2019)

Physiotherapists’ recommendations for examination and treatment of rotator cuff related shoulder pain: A consensus exercise

French physiotherapy management of rotator cuff related shoulder pain: An observational study

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