Effectiveness of scapula-focused approaches in patients with rotator cuff related shoulder pain: A systematic review and meta-analysis

Bury, Julie; West, Morgan; Chamorro-Moriana, Gema; Littlewood, Chris

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.

Citation

Bury, J., West, M., Chamorro-Moriana, G., & Littlewood, C. (2016). Effectiveness of scapula-focused approaches in patients with rotator cuff related shoulder pain: A systematic review and meta-analysis. Manual Therapy, 25, 35-42. https://doi.org/10.1016/j.math.2016.05.337

• Journal Article Type: Article
• Acceptance Date: May 29, 2016
• Online Publication Date: Jun 4, 2016
• Publication Date: 2016-09
• Deposit Date: Dec 18, 2024
• Journal: Manual Therapy
• Print ISSN: 1356-689X
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 25
• Pages: 35-42
• DOI: https://doi.org/10.1016/j.math.2016.05.337
• Keywords: Exercise, Rehabilitation, Rotator cuff, Scapula, Systematic review
• Related Public URLs: https://eprints.whiterose.ac.uk/101408/3/WRRO_101408.pdf