Julie Bury1, Morgan West2, Gema Chamorro-Moriana3, Chris Littlewood4. 1. Doncaster & Bassetlaw Hospitals, NHS Foundation Trust, Physiotherapy Dept., Doncaster Royal Infirmary, Doncaster, UK. Electronic address: julie.bury@nhs.net. 2. Sherwood Forest, NHS Foundation Trust, Kings Mill Hospital, Mansfield, UK. Electronic address: Morgan.West@sfh-tr.nhs.uk. 3. Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatric, University of Seville, Spain. Electronic address: gchamorro@us.es. 4. School of Health & Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire ST5 5BG, UK. Electronic address: c.littlewood@sheffield.ac.uk.
Abstract
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 0.402-1.026) in the short term (<6 weeks); regarding disability, there was significant benefit of SFA versus generalised approaches (mean difference 14.0; 95% CI 11.2-16.8) 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.
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 0.402-1.026) in the short term (<6 weeks); regarding disability, there was significant benefit of SFA versus generalised approaches (mean difference 14.0; 95% CI 11.2-16.8) 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.
Authors: Opeyemi O Babatunde; Joie Ensor; Chris Littlewood; Linda Chesterton; Joanne L Jordan; Nadia Corp; Gwenllian Wynne-Jones; Edward Roddy; Nadine E Foster; Danielle A van der Windt Journal: Ther Adv Musculoskelet Dis Date: 2021-09-09 Impact factor: 5.346
Authors: Ruedi Steuri; Martin Sattelmayer; Simone Elsig; Chloé Kolly; Amir Tal; Jan Taeymans; Roger Hilfiker Journal: Br J Sports Med Date: 2017-06-19 Impact factor: 13.800