Specific or general exercise strategy for subacromial impingement syndrome–does it matter? A systematic literature review and meta analysis

Shire, Alison R.; Stæhr, Thor André Brøndberg; Overby, Jesper B.; Dahl, Mathias Bastholm; Jacobsen, Julie Sandell; Christiansen, David Høyrup

doi:10.1186/s12891-017-1518-0

Cited by 70 publications

(50 citation statements)

References 86 publications

(230 reference statements)

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“…In addition, as psychosocial factors play a more prominent role in the onset and prevalence of non-specific SP—through other biological pathways such as muscle strain from the neck and shoulder muscles—targeted interventions counteracting these factors might also be considered. There are indications that specific strength training42–44 or just general exercise training,45 adjustment to furniture and equipment46 and improving work techniques like taking more breaks and reducing work demands can reduce specific and non-specific shoulder disorders 47…”

Section: Discussionmentioning

confidence: 99%

Work-related risk factors for specific shoulder disorders: a systematic review and meta-analysis

Molen¹,

Foresti

Daams³

et al. 2017

Occup Environ Med

128

110

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The objective of this systematic review and metaanalysis is to examine which work-related risk factors are associated with specific soft tissue shoulder disorders. We searched the electronic databases of Medline and Embase for articles published between 2009 and 24 March 2016 and included the references of a systematic review performed for the period before 2009. Primary cross-sectional and longitudinal studies were included when outcome data were described in terms of clinically assessed soft tissue shoulder disorders and at least two levels of work-related exposure were mentioned (exposed vs less or non-exposed). Two authors independently selected studies, extracted data and assessed study quality. For longitudinal studies, we performed meta-analyses and used GRADE (Grades of Recommendations, Assessment, Development and Evaluation) to assess the evidence for the associations between risk factors and the onset of shoulder disorders. Twenty-seven studies met the inclusion criteria. In total, 16 300 patients with specific soft tissue shoulder disorders from a population of 2 413 722 workers from Denmark, Finland, France, Germany and Poland were included in the meta-analysis of one case-control and six prospective cohort studies. This meta-analysis revealed moderate evidence for associations between shoulder disorders and arm-hand elevation (OR=1.9, 95% CI 1.47 to 2.47) and shoulder load (OR=2.0, 95% CI 1.90 to 2.10) and low to very low evidence for hand force exertion (OR=1.5, 95% CI 1.25 to 1.87), hand-arm vibration (OR=1.3, 95% CI 1.01 to 1.77), psychosocial job demands (OR=1.1, 95% CI 1.01 to 1.25) and working together with temporary workers (OR=2.2, 95% CI 1.2 to 4.2). Low-quality evidence for no associations was found for arm repetition, social support, decision latitude, job control and job security. Moderate evidence was found that arm-hand elevation and shoulder load double the risk of specific shoulder disorders. Low to very-low-quality evidence was found for an association between hand force exertion, handarm vibration, psychosocial job demands and working together with temporary workers and the incidence of specific shoulder disorders.

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Section: Discussionmentioning

confidence: 99%

Work-related risk factors for specific shoulder disorders: a systematic review and meta-analysis

Molen¹,

Foresti

Daams³

et al. 2017

Occup Environ Med

128

110

View full text Add to dashboard Cite

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“…However, the self-mobilisation performed by our patients cannot be compared to conventional rehabilitation made up of 30- to 40-min sessions of exercises, two to five times a week, for 6 weeks to 5 months (Gleyze et al 2011 ). It is hard to settle the case as shoulder disorders are quite heterogeneous, the physical treatments can be different and the methodological quality of trials in the field are variable, illustrated by the discordant conclusions of reviews (Hanratty et al 2012 ; Ellenbecker and Cools 2010 ; Shire et al 2017 ). A systematic review of physical therapy trials (Page et al 2015 ) reported that most of the 171 selected trials assessed mainly pain (87%), function (72%) and range of motion (67%); adverse events, overall assessment of treatment success and health-related QOL was considered in only 18–27% of trials, and work disability and referral for surgery were determined in less than 5% of trials.…”

Section: Discussionmentioning

confidence: 99%

Spa therapy together with supervised self-mobilisation improves pain, function and quality of life in patients with chronic shoulder pain: a single-blind randomised controlled trial

et al. 2018

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To determine whether spa therapy has a beneficial effect on pain and disability in patients with chronic shoulder pain, this single-blind randomised controlled clinical trial included patients with chronic shoulder pain due to miscellaneous conditions attending one of four spa centres as outpatients. Patients were randomised into two groups: spa therapy (18 days of standardised treatment combining thermal therapy together with supervised mobilisation in a thermal pool) and controls (spa therapy delayed for 6 months: ‘immediate versus delayed treatment’ paradigm). All patients continued usual treatments during the 6-month follow-up period. The main endpoint was the mean change in the French-Quick DASH (F-QD) score at 6 months. The effect size of spa therapy was calculated, and the proportion of patients reaching minimal clinically important improvement (MCII) was compared. Secondary endpoints were the mean change in SF-36, treatment use and tolerance. One hundred eighty-six patients were included (94 patients as controls, 92 in the spa group) and analysed by intention to treat. At 6 months, the mean change in the F-QD score was statistically significantly greater among spa therapy patients than controls (− 32.6 versus − 8.15%; p < 0.001) with an effect size of 1.32 (95%CI: 0.97–1.68). A significantly greater proportion of spa therapy patients reached MCII (59.3 versus 17.9%). Spa therapy was well tolerated with a significant impact on SF-36 components but not on drug intake. Spa therapy provided a statistically significant benefit on pain, function and quality of life in patients with chronic shoulder pain after 6 months compared with usual care.

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“…The rehabilitation program implemented for the aims of the study was specially designed for patients presenting with subacromial-deltoid impingement syndrome, for shoulder stretching, toning, rebalancing and stabilization purposes. According to one study, the higher effectiveness of a selected type of exercises can only be demonstrated provided that sufficient evidence is available (Shire et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

The role of isokinetic exercises in the rehabilitation of patients with impingement syndrome of the shoulder

Gnandt¹,

Irsay²,

Borda³

et al. 2018

Pm3

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Background. Scapulohumeral periarthritis is a medical condition consisting of the inflammation of tendinomuscular structures of the shoulder, causing pain, limited mobility, functional impotence and reduced quality of life. Aims. The study aimed to demonstrate the effectiveness of active kinesiotherapy programs combined with isokinetic exercises in improving the symptoms of patients presenting with scapulohumeral periarthritis. Methods. The study was conducted on a number of 30 patients diagnosed with simple shoulder pain, mixed shoulder pain or subacromial-deltoid impingement syndrome. The subjects were divided into two groups. The reference group, consisting of 15 patients, was subjected to an active kinesiotherapy program, as well as an active endurance one. The study group, also comprising 15 patients, was subjected to the same kinesiotherapy program, combined with isokinetic exercises. In order to objectify the results, assessment tests were performed on days 1 and 10 of treatment. These included the VAS (visual analog scale) for pain intensity, the flexion-abduction-external rotation articular test, and the Constant-Murley shoulder test. Results. On day 1 of treatment, the symptoms and levels of pathology observed among the two groups were similar. The study was performed on groups of homogeneous sex and age, ranging between 60 and 70 years. As per the VAS, the average pain intensity was measured at 5.8 among patients in the reference group and 5.7 among patients in the study group. On day 10 of treatment, the test indicated a reduction in the pain levels of both groups, the average pain intensity being measured at 2.2 and 1.6, respectively. In terms of the Constant-Murley scores, they were similar on day 1 of treatment and registered as 57.6 and 63.1, respectively, on day 10 of treatment. The articular test revealed an improvement in the range of motion of patients in the study group by 4% on flexion, 5% on abduction and 4% on external rotation as compared to patients in the reference group. The T-test results were statistically significant as regards the VAS (p<0.006), the Constant-Murley test (p<0.02), abduction (p<0.03), external rotation (p<0.005), and at the limit in terms of flexion (0<0.05). Conclusions. The active kinesiotherapy program combined with kinetic exercises ensures better outcomes in terms of pain relief, improved joint mobility, muscle rebalancing and, implicitly, improved quality of life among patients.

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Specific or general exercise strategy for subacromial impingement syndrome–does it matter? A systematic literature review and meta analysis

Cited by 70 publications

References 86 publications

Work-related risk factors for specific shoulder disorders: a systematic review and meta-analysis

Work-related risk factors for specific shoulder disorders: a systematic review and meta-analysis

Spa therapy together with supervised self-mobilisation improves pain, function and quality of life in patients with chronic shoulder pain: a single-blind randomised controlled trial

The role of isokinetic exercises in the rehabilitation of patients with impingement syndrome of the shoulder

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