The adjunctive benefit of manual therapy in addition to therapeutic exercise for shoulder impingement syndrome: A systematic review

2016 ◽  
Vol 25 ◽  
pp. e153
Author(s):  
X. Konstantakis ◽  
C. Pazaridis ◽  
N. Heneghan

Author(s):  
Saurabh Sharma ◽  
Mohammed Ejaz Hussain ◽  
Shalini Sharma

Introduction: Shoulder complaints are the third most common musculoskeletal presentation, after back and neck disorders, in primary care. Among people with shoulder pain, Shoulder Impingement Syndrome (SIS) has the highest prevalence and accounts for 27% of shoulder disorders. Various treatment options are available for SIS. However, literature suggests the need of a review regarding the addition of Manual Therapy (MT) to the Therapeutic Exercise (TE) program. Aim: To investigate the effectiveness of MT combined with TEs versus TEs alone for the management of SIS. Materials and Methods: The study examined published randomised controlled trials and quasi-experimental studies. A comprehensive search of two electronic databases (PubMed and PEDro) was performed from inception till the last week of August, 2020. The selected studies were assessed on methodological quality rating using the PEDro scale and the modified downs and black scale for experimental and quasi-experimental studies, respectively. The extracted outcomes were pain levels, strength, Range of Motion (ROM) and Shoulder Pain and Disability Index (SPADI) scale score. The meta-analysis was done on continuous data and the data were summarised qualitatively and quantitatively. Results: Seven trials were included (n=437) after evaluation. Standard Mean Difference (SMD) with 95% CI was used to denote summary effects of the outcome measures. Pain {SMD: -1.07; 95%CI: -1.85, -0.28; p<0.01} showed positive effect when managed with MT combined with TE while external rotation strength {SMD: 0.55; 95%CI 0.27, 0.84; p<0.01} improved with TE alone. The majority of the studies (six out of seven) had low risk of bias. Conclusion: The results indicate that evidence exists for improvement in pain level and muscle strength with MT combined with TE and TE alone respectively. The qualitative evidence suggests that glenohumeral mobilisation and exercises are associated with best outcomes for SIS management.





2020 ◽  
pp. 026921552097176
Author(s):  
Amir Letafatkar ◽  
Pouya Rabiei ◽  
Sarvenaz Kazempour ◽  
Samaneh Alaei-Parapari

Objective: To investigate if adding Kinesio tape to therapeutic exercise is an effective treatment to improve clinical outcomes compared to therapeutic exercise alone and no intervention, in patients with shoulder impingement syndrome. Design: Three-arm randomized controlled trial Setting: Outpatient setting Subjects: One hundred and twenty patients (mean (SD): age 37.8 (5.4)) with shoulder impingement syndrome. Intervention: Patients were randomly assigned to eight-weeks therapeutic exercise alone, therapeutic exercise with Kinesio tape, and control group. Main measures: Pain was measured with a numerical rating scale and disability and scapular kinematics were measured with a relative questionnaire and motion analysis software respectively, at baseline and after eight-weeks intervention. Results: There was significant differences in therapeutic exercise with Kinesio tape group vs. therapeutic exercise alone and control group respectively for pain ( d = –0.34, P = 0.042; and d = –1.53, P = 0.001), disability ( d = –0.46, P = 0.024; and d = –2.18, P = 0.001), scapular upward rotation at sagittal plane ( d = 0.33, P = 0.033; and d = 0.68, P = 0.001), scapular plane ( d = 0.18, P = 0.045; and d = 0.43, P = 0.001), scapular tilt at sagittal plane ( d = 0.55, P = 0.043; and d = 1.39, P = 0.001), and scapular plane ( d = 0.29, P = 0.034; and d = 0.58, P = 0.001). Therapeutic exercise alone was superior over control group in all significant outcomes ( P < 0.05). Conclusion: Although therapeutic exercises alone showed positive effect on clinical outcomes, adding Kinesio tape to therapeutic exercises had more significant effects with larger effect sizes. Adding Kinesio tape to therapeutic exercise may be of some assistance to clinicians in improving clinical outcomes in patients with shoulder impingement syndrome.



2013 ◽  
Vol 17 (2) ◽  
pp. 212-218 ◽  
Author(s):  
Alberto Marcos Heredia-Rizo ◽  
Antonia López-Hervás ◽  
Patricia Herrera-Monge ◽  
Ana Gutiérrez-Leonard ◽  
Fernando Piña-Pozo


2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Saurabh Sharma ◽  
Amer K. Ghrouz ◽  
M. Ejaz Hussain ◽  
Shalini Sharma ◽  
Mosab Aldabbas ◽  
...  

Reduction in isometric strength of the scapulohumeral muscles is a commonly seen impairment in overhead athletes afflicted with shoulder impingement syndrome (SIS). The purpose of this study was to compare the effects of two different treatment programs: progressive resistance exercises plus manual therapy (PRE plus MT) and motor control exercises (MCE), on isometric strength of upper trapezius (UT), middle trapezius (MTr), lower trapezius (LT), serratus anterior (SA), supraspinatus (Supr.), anterior deltoid (A.D), and latissimus dorsi (LD). 80 male university-level overhead athletes clinically diagnosed with SIS were randomly allocated into either of the two groups: PRE plus MT and MCE group. Athletes in the PRE plus MT group underwent graduated exercises with resistance elastic band, stretching exercises, and mobilization of the thoracic and shoulder joints. MCE group was submitted to motor control exercises in varied planar positions. Athletes in both groups underwent management 3 times a week for 8 weeks. Isometric strength of UT, MTr, LT, Supr, A.D, SA, and LD was measured at three-time points: baseline, 4th week, and 8th week. Relative to baseline, both interventions were found to be effective in increasing and optimizing the isometric strength of muscles ( p < 0.05 ) except for supraspinatus in the MCE group ( p > 0.05 ). However, athletes in PRE plus MT group presented a more pronounced increase in isometric strength than those in the MCE group. Between groups analysis found the largest isometric strength improvement in PRE plus MT group for A.D, followed by Supr. and UT muscles ( p < 0.05 ; effect size: 0.39 to 0.40). The study concluded that compared to MCE, PRE plus MT provides greater improvement in the isometric strength of scapulohumeral muscles.





2016 ◽  
Vol 9 (1) ◽  
pp. 31-41 ◽  
Author(s):  
Amy R. Watts ◽  
Ben Williams ◽  
Susan W. Kim ◽  
Donald C. Bramwell ◽  
Jeganath Krishnan

Background Shoulder impingement syndrome (SIS) is a common diagnosis for patients with pain and dysfunction of the shoulder. Variations in the signs and symptoms might lead to uncertainty regarding the definition of SIS. The aim of this review is to explore the participant selection criteria used in the literature when investigating SIS and to assess differences in criteria among treating professions. Methods This is a PRISMA systematic review of publications from 2009 to 2014 from MEDLINE, PubMed, The Cochrane Library, Embase, Scopus and CINAHL. Results Ninety-seven articles met inclusion criteria for this review. Twenty-five different surgical and nonsurgical treatments were investigated. Impingement-specific index tests were used in all studies. Exclusion index tests were used in 62% of studies. Twenty index tests were identified. Radiological investigations were reported in 53% of all studies, of which a further 53% reported using two or more radiological investigations. Conclusions This systematic review has illustrated that studies investigating SIS test for various signs and symptoms, which is in keeping with describing the condition as a ‘syndrome’. However, there are inconsistencies in participant selection criteria between health disciplines, highlighting a need for harmonization of the selection criteria in the form of an international editorial consensus.



Sign in / Sign up

Export Citation Format

Share Document