Effectiveness of progressive and resisted and non-progressive or non-resisted exercise in rotator cuff related shoulder pain: a systematic review and meta-analysis of randomized controlled trials

Naunton, Josh; Street, Gabrielle; Littlewood, Chris; Haines, Terrence; Malliaras, Peter

Abstract

Objective: Synthesize evidence regarding effectiveness of progressive and resisted or non-progressive and non-resisted exercise compared with placebo or no treatment, in rotator cuff related pain.

Data sources: English articles, searched in Cochrane CENTRAL, MEDLINE, EMBASE and CINAHL databases up until May 19, 2020.

Methods: Randomized controlled trials in people with rotator cuff related pain comparing either progressive and resisted exercise or non-progressive and non-resisted exercise, with placebo or no treatment were included. Data extracted independently by two authors. Risk of bias appraised with the Cochrane Collaboration tool.

Results: Seven trials (468 participants) were included, four trials (271 participants) included progressive and resisted exercise and three trials (197 participants) included non-progressive or non-resisted exercise. There was uncertain clinical benefit for composite pain and function (15 point difference, 95% CI 9 to 21, 100-point scale) and pain outcomes at >6 weeks to 6 months with progressive and resisted exercise compared to placebo or no treatment (comparison 1). For non-progressive or non-resisted exercise there was no significant benefit for composite pain and function (4 point difference, 95% CI −2 to 9, 100-point scale) and pain outcomes at >6 weeks to 6 months compared to placebo or no treatment (comparison 2). Adverse events were seldom reported and mild.

Conclusions: There is uncertain clinical benefit for all outcomes with progressive and resisted exercise and no significant benefit with non-progressive and non-resisted exercise, versus no treatment or placebo at >6 weeks to 6 months. Findings are low certainty and should be interpreted with caution.

Citation

Naunton, J., Street, G., Littlewood, C., Haines, T., & Malliaras, P. (2020). Effectiveness of progressive and resisted and non-progressive or non-resisted exercise in rotator cuff related shoulder pain: a systematic review and meta-analysis of randomized controlled trials. Clinical Rehabilitation, 34(9), 1198-1216. https://doi.org/10.1177/0269215520934147

• Journal Article Type: Article
• Online Publication Date: Jun 22, 2020
• Publication Date: Sep 1, 2020
• Deposit Date: Nov 27, 2024
• Journal: Clinical Rehabilitation
• Print ISSN: 0269-2155
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 34
• Issue: 9
• Pages: 1198-1216
• DOI: https://doi.org/10.1177/0269215520934147
• Keywords: progressive exercise, resistance exercise, resistance training, Rotator cuff related pain, rotator cuff tendinopathy, shoulder pain, sub-acromial impingement
• Related Public URLs: https://e-space.mmu.ac.uk/625819/
• PMID: 32571081