Abstract | OBJECTIVE: To investigate the effectiveness of conservative interventions for pain, function and range of motion in adults with shoulder impingement. DESIGN: Systematic review and meta-analysis of randomised trials. DATA SOURCES: Medline, CENTRAL, CINAHL, Embase and PEDro were searched from inception to January 2017. STUDY SELECTION CRITERIA: Randomised controlled trials including participants with shoulder impingement and evaluating at least one conservative intervention against sham or other treatments. RESULTS: For pain, exercise was superior to non-exercise control interventions (standardised mean difference (SMD) -0.94, 95% CI -1.69 to -0.19). Specific exercises were superior to generic exercises (SMD -0.65, 95% CI -0.99 to -0.32). Corticosteroid injections were superior to no treatment (SMD -0.65, 95% CI -1.04 to -0.26), and ultrasound guided injections were superior to non-guided injections (SMD -0.51, 95% CI -0.89 to -0.13). Nonsteroidal anti-inflammatory drugs ( NSAIDS) had a small to moderate SMD of -0.29 (95% CI -0.53 to -0.05) compared with placebo. Manual therapy was superior to placebo (SMD -0.35, 95% CI -0.69 to -0.01). When combined with exercise, manual therapy was superior to exercise alone, but only at the shortest follow-up (SMD -0.32, 95% CI -0.62 to -0.01). Laser was superior to sham laser (SMD -0.88, 95% CI -1.48 to -0.27). Extracorporeal shockwave therapy (ECSWT) was superior to sham (-0.39, 95% CI -0.78 to -0.01) and tape was superior to sham (-0.64, 95% CI -1.16 to -0.12), with small to moderate SMDs. CONCLUSION:
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Authors | Ruedi Steuri, Martin Sattelmayer, Simone Elsig, Chloé Kolly, Amir Tal, Jan Taeymans, Roger Hilfiker |
Journal | British journal of sports medicine
(Br J Sports Med)
Vol. 51
Issue 18
Pg. 1340-1347
(Sep 2017)
ISSN: 1473-0480 [Electronic] England |
PMID | 28630217
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Copyright | © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. |
Topics |
- Comparative Effectiveness Research
- Exercise Therapy
- Humans
- Laser Therapy
- Musculoskeletal Manipulations
- Randomized Controlled Trials as Topic
- Range of Motion, Articular
- Shoulder Impingement Syndrome
(therapy)
- Shoulder Pain
(therapy)
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