The Effectiveness of Physiotherapy Exercises in Subacromial Impingement Syndrome: A Systematic Review and Meta-Analysis

Hanratty, Catherine; McVeigh, JG; Kerr, Daniel; Basford, Jeffrey R.; Finch, M B; Pendleton, Adrian; Sim, Julius

doi:10.1016/j.semarthrit.2012.03.015

Cited by 200 publications

(186 citation statements)

References 52 publications

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“…5,6 Exercise can be considered the standard of care and an accepted first line intervention for individuals experiencing SAPS. 7 Variations of exercise interventions for SAPS have demonstrated effectiveness including supervised exercise, unsupervised home program exercise, and multi-modal interventions provided by a physical therapist. 8 No significant, long term difference has been demonstrated between these various management approaches, however, efficacy of exercise over placebo treatment or no treatment has been established.…”

Section: Introductionmentioning

confidence: 99%

Shoulder External Rotator Eccentric Training Versus General Shoulder Exercise for Subacromial Pain Syndrome: A Randomized Controlled Trial

Chaconas

Kolber

Hanney

et al. 2017

Intl J Sports Phys Ther

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Background: Shoulder pain affects up to 67% of the population at some point in their lifetime with subacromial pain syndrome (SAPS) representing a common etiology. Despite a plethora of studies there remains conflicting evidence for appropriate management of SAPS.Purpose: To compare outcomes, for individuals diagnosed with SAPS, performing a 6-week protocol of eccentric training of the shoulder external rotators (ETER) compared to a general exercise (GE) protocol. Study Design: Randomized controlled trialMethods: Forty-eight individuals (mean age 46.8 years +/-17.29) with chronic shoulder pain, and a clinical diagnosis of SAPS were randomized into either an experimental group performing ETER or a control group performing a GE program. The intervention lasted for six weeks, and outcomes were measured after three weeks, six weeks, and again at six months post intervention.

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Section: Introductionmentioning

confidence: 99%

Shoulder External Rotator Eccentric Training Versus General Shoulder Exercise for Subacromial Pain Syndrome: A Randomized Controlled Trial

Chaconas

Kolber

Hanney

et al. 2017

Intl J Sports Phys Ther

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“…Conservative treatment, including exercise therapy, is recommended as the primary treatment; but there is considerable uncertainty relating to the relative effectiveness of such approaches (6)(7)(8)(9)(10)(11)(12), and as a result large variations in practice exist (3,6,9,13,14). Furthermore, there is uncertainty relating to the role that altered scapula position and movement plays, termed scapula dyskinesis; which is widely regarded as a common finding with this condition (15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of scapula-focused approaches in patients with rotator cuff related shoulder pain: A systematic review and meta-analysis

et al. 2016

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Background: Rotator cuff related shoulder pain (RCSP) is common with a range of conservative treatments currently offered. Evidence supporting superiority of one approach over another is lacking. Scapula focused approaches (SFA) are frequently prescribed and warrant investigation. Objective: To evaluate the effectiveness of SFA in RCSP. Design: Systematic review of randomised controlled trials. Methods: An electronic search including MEDLINE, PEDro, ENFISPO to January 2016 was supplemented by hand searching. Randomised controlled trials were included; appraised using the PEDro scale and synthesised via meta-analysis or narratively, where appropriate. Results: Four studies (n = 190) reported on pain and three studies (n = 122) reported on disability. Regarding pain, there was statistical but not clinically significant benefit of SFA versus generalised approaches (mean difference (VAS) 0.714; 95% CI 0.402 to 1.026) in the short term (< 6 weeks); regarding disability, there was significant benefit of SFA versus generalised approaches (mean difference 14.0; 95% CI 11.2 to 16.8) in the short term (< 6 weeks). One study (n = 22) reported disability at 3 months, which was not statistically significant. Evidence is conflicting from four studies relating to the effect of SFA on scapula position/ movement. Conclusion: SFA for RCSP confers benefit over generalised approaches up to six weeks but this benefit is not apparent by 3 months. Early changes in pain are not clinically significant. With regards to scapula position/ movement, the evidence is conflicting. These preliminary conclusions should be treated with significant caution due to limitations of the evidence base.

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“…20 In conjunction with exercise, physical therapists often add manual therapy (MT) interventions to address impairments potentially associated with RC tendinopathy. 50 Thus, the aim of this systematic review and meta-analysis was to perform an updated review of the evidence regarding the efficacy of MT, used either alone or in combination with other interventions, for the treatment of RC tendinopathy.…”

mentioning

confidence: 99%

“…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 impairments potentially associated with RC tendinopathy. 50 Manual therapy interventions have been defined by the International Federation of Orthopaedic Manipulative Physical Therapists as skilled hand movements performed by a therapist.…”

mentioning

confidence: 99%

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

107

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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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The Effectiveness of Physiotherapy Exercises in Subacromial Impingement Syndrome: A Systematic Review and Meta-Analysis

Cited by 200 publications

References 52 publications

Shoulder External Rotator Eccentric Training Versus General Shoulder Exercise for Subacromial Pain Syndrome: A Randomized Controlled Trial

Shoulder External Rotator Eccentric Training Versus General Shoulder Exercise for Subacromial Pain Syndrome: A Randomized Controlled Trial

Effectiveness of scapula-focused approaches in patients with rotator cuff related shoulder pain: A systematic review and meta-analysis

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

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