Effectiveness of physical therapy treatment of clearly defined subacromial pain: a systematic review of randomised controlled trials.
Author: Haik MN1, Alburquerque-Sendín F2, Moreira RF3, Pires ED1, Camargo PR1
Affiliation:
1Laboratory of Analysis and Intervention of the Shoulder Complex, Federal University of São Carlos, São Carlos, Brazil.
2Salamanca Institute for Biomedical Research (IBSAL), Salamanca, Spain Department of Nursing and Physical Therapy, University of Salamanca, Salamanca, Spain.
3Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.
Conference/Journal: Br J Sports Med.
Date published: 2016 Jun 10
Other:
Pages: bjsports-2015-095771 , Special Notes: doi: 10.1136/bjsports-2015-095771. [Epub ahead of print] , Word Count: 297
AIM: To summarise the current evidence regarding the effectiveness of physical therapy on pain, function and range of motion in individuals with subacromial pain syndrome (SAPS).
DESIGN: Systematic review.
DATA SOURCES: PubMed, Web of Science, CINAHL, Cochrane, Embase, Lilacs, Ibecs and Scielo databases.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials (RCTs) investigating physical therapy modalities for SAPS on pain, function/disability or range of motion were included.
RESULTS: 64 high-quality RCTs were included. Exercise therapy provided high evidence of being as effective as surgery intervention and better than no treatment or placebo treatment to improve pain, function and range of motion in the short, mid and long terms. The combination of mobilisation and exercises provided high evidence to decrease pain and improve function in the short term. There is limited evidence for improvements on the outcomes with the isolated application of manual therapy. High level of evidence was synthesised regarding the lack of beneficial effects of physical resources such as low-level laser, ultrasound and pulsed electromagnetic field (PEMF) on pain, function or range of motion in the treatment of SAPS. There is limited evidence for microwave diathermy and transcutaneous electrical nerve stimulation. There is moderate evidence to no benefits with taping in the short term. Effects of diacutaneous fibrolysis and acupuncture are not well established yet.
CONCLUSIONS: Exercise therapy should be the first-line treatment to improve pain, function and range of motion. The addition of mobilisations to exercises may accelerate reduction of pain in the short term. Low-level laser therapy, PEMF and taping should not be recommended.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
KEYWORDS: Exercise rehabilitation; Scapula; Shoulder
PMID: 27288517 [PubMed - as supplied by publisher]
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