Journal of Orthopaedic & Sports Physical Therapy
Published Online:February 29, 2020 Volume50 Issue3 Pages131-141
https://www.jospt.org/doi/10.2519/jospt.2020.8498
Abstract
Objective
To update a systematic review published in 2013 that focused on evaluating the effectiveness of interventions within the scope of physical therapy, including exercise, manual therapy, electrotherapy, and combined or multimodal approaches to managing shoulder pain.
Design
Umbrella review.
Literature Search
An electronic search of PubMed, Web of Science, and CINAHL was undertaken. Methodological quality was assessed using the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) checklist for systematic reviews.
Study Selection Criteria
Nonsurgical treatments for subacromial shoulder pain.
Data Synthesis
Sixteen systematic reviews were retrieved. Results were summarized qualitatively.
Results
A strong recommendation can be made for exercise therapy as the first-line treatment to improve pain, mobility, and function in patients with subacromial shoulder pain. Manual therapy may be integrated, with a strong recommendation, as additional therapy. There was moderate evidence of no effect for other commonly prescribed interventions, such as laser therapy, extracorporeal shockwave therapy, pulsed electromagnetic energy, and ultrasound.
Conclusion
There is a growing body of evidence to support exercise therapy as an intervention for subacromial shoulder pain. Ongoing research is required to provide guidance on exercise type, dose, duration, and expected outcomes. A strong recommendation may be made regarding the inclusion of manual therapy in the initial treatment phase. J Orthop Sports Phys Ther 2020;50(3):131–141. Epub 15 Nov 2019. doi:10.2519/jospt.2020.8498