Authors: Kromer, Thilo O.; Tautenhahn, Ulrike G.; de Bie, Rob A.; Staal, J. Bart; Bastiaenen, Caroline H.G.

Source: Journal of Rehabilitation Medicine, Volume 41, Number 11, October 2009 , pp. 870-880(11)

Publisher: Medical Journals Limited

Abstract:

Objective: To critically summarize the effectiveness of physiotherapy in patients presenting clinical signs of shoulder impingement syndrome.

Design: Systematic review.

Methods: Randomized controlled trials were searched electronically and manually from 1966 to December 2007. Study quality was independently assessed by 2 reviewers using the Physiotherapy Evidence Database (PEDro) scale. If possible, relative risks and weighted mean differences were calculated for individual studies, and relative risks or standardized mean differences for pooled data, otherwise results were summarized in a best evidence synthesis.

Results: Sixteen studies were included, with a mean quality score of 6.8 points out of 10. Many different diagnostic criteria for shoulder impingement syndrome were applied. Physiotherapist-led exercises and surgery were equally effective treatments for shoulder impingement syndrome in the long term. Also, home-based exercises were as effective as combined physiotherapy interventions. Adding manual therapy to exercise programmes may have an additional benefit on pain at 3 weeks follow-up. Moderate evidence exists that passive treatments are not effective and cannot be justified.

Conclusion: This review shows an equal effectiveness of physiotherapist-led exercises compared with surgery in the long term and of home-based exercises compared with combined physiotherapy interventions in patients with shoulder impingement syndrome in the short and long term; passive treatments cannot be recommended for shoulder impingement syndrome. However, in general, the samples were small, and different diagnostic criteria were applied, which makes a firm conclusion difficult. More high-quality trials with longer follow-ups are recommended.

Keywords: SHOULDER IMPINGEMENT SYNDROME; PHYSICAL THERAPY; TREATMENT OUTCOME; REVIEW

Document Type: Research article

DOI: http://dx.doi.org/10.2340/16501977-0453

Publication date: 2009-10-01

More about this publication?

• Journal of Rehabilitation Medicine is the international peer-reviewed journal published in English, with at least 10 issues published per year.
  
  Original articles, reviews, case reports, short communications, special reports and letters to the editor are published, as also are editorials and book reviews. The journal strives to provide its readers with a variety of topics including: functional assessment and intervention studies, clinical studies in various patient groups, methodology in physical and rehabilitation medicine, epidemiological studies on disabling conditions and reports on vocational and sociomedical aspects of rehabilitation.
  
  The journal is read by a wide group of healthcare professionals including specialists in rehabilitation medicine, neurology, clinical neurophysiology, general medicine, psychologists, physiotherapists, occupational therapists and social workers.
  
  Contributions from all parts of the world and from different professions in rehabilitation are welcome.
  
  ISI Impact Factor 2009: 1.882.
  
  Owned by Foundation of Rehabilitation Information.

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