The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis

CE Hanratty, JG McVeigh, D Kerr, JR Basford, MB Finch, A Pendleton, J Sim

    Research output: Chapter in Book/Report/Conference proceedingConference contribution

    Abstract

    OBJECTIVE:To evaluate the effectiveness of exercise in the treatment of people with subacromial impingement syndrome (SAIS).METHODS:A systematic review and meta-analysis were conducted. Ten electronic databases were searched from the dates of their inception until August 2010. Included studies were randomized controlled trials investigating exercise in the management of SAIS. Outcomes were pain, strength, function, and quality of life. Data were summarized qualitatively using a best evidence synthesis. Treatment effect size and variance of individual studies were used to give an overall summary effect and data were converted to standardized mean difference with 95% confidence intervals (standardized mean difference (SMD) (CI)).RESULTS:Sixteen studies were included (n = 1162). There was strong evidence that exercise decreases pain and improves function at short-term follow-up. There was also moderate evidence that exercise results in short-term improvement in mental well-being and a long-term improvement in function for those with SAIS. The most common risk of bias across the studies was inadequately concealed treatment allocation. Six studies in the review were suitable for meta-analysis. Exercise had a small positive effect on strength of the rotator cuff in the short term (SMD -0.46 (-0.76, 0.16); P = 0.003) and a small positive effect on long-term function (SMD -0.31 (-0.57, 0.04); P = 0.02).CONCLUSIONS:Physiotherapy exercises are effective in the management of SAIS. However, heterogeneity of the exercise interventions, coupled with poor reporting of exercise protocols, prevented conclusions being drawn about which specific components of the exercise protocols (ie, type, intensity, frequency and duration) are associated with best outcomes.
    LanguageEnglish
    Title of host publicationUnknown Host Publication
    Number of pages1
    Publication statusPublished - 21 Sep 2012
    EventIrish Society for Rheumatology Annual Conference Belfast, September 2012 - Belfast UK
    Duration: 21 Sep 2012 → …

    Conference

    ConferenceIrish Society for Rheumatology Annual Conference Belfast, September 2012
    Period21/09/12 → …

    Fingerprint

    Shoulder Impingement Syndrome
    Meta-Analysis
    Pain
    Rotator Cuff
    Therapeutics
    Randomized Controlled Trials
    Quality of Life
    Databases
    Confidence Intervals

    Keywords

    • Subacromial impingement
    • rotator cuff
    • shoulder pain
    • exercises
    • physiotherapy
    • rehabilitation
    • systematic review
    • meta-analysis

    Cite this

    Hanratty, CE., McVeigh, JG., Kerr, D., Basford, JR., Finch, MB., Pendleton, A., & Sim, J. (2012). The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. In Unknown Host Publication
    Hanratty, CE ; McVeigh, JG ; Kerr, D ; Basford, JR ; Finch, MB ; Pendleton, A ; Sim, J. / The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. Unknown Host Publication. 2012.
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    abstract = "OBJECTIVE:To evaluate the effectiveness of exercise in the treatment of people with subacromial impingement syndrome (SAIS).METHODS:A systematic review and meta-analysis were conducted. Ten electronic databases were searched from the dates of their inception until August 2010. Included studies were randomized controlled trials investigating exercise in the management of SAIS. Outcomes were pain, strength, function, and quality of life. Data were summarized qualitatively using a best evidence synthesis. Treatment effect size and variance of individual studies were used to give an overall summary effect and data were converted to standardized mean difference with 95{\%} confidence intervals (standardized mean difference (SMD) (CI)).RESULTS:Sixteen studies were included (n = 1162). There was strong evidence that exercise decreases pain and improves function at short-term follow-up. There was also moderate evidence that exercise results in short-term improvement in mental well-being and a long-term improvement in function for those with SAIS. The most common risk of bias across the studies was inadequately concealed treatment allocation. Six studies in the review were suitable for meta-analysis. Exercise had a small positive effect on strength of the rotator cuff in the short term (SMD -0.46 (-0.76, 0.16); P = 0.003) and a small positive effect on long-term function (SMD -0.31 (-0.57, 0.04); P = 0.02).CONCLUSIONS:Physiotherapy exercises are effective in the management of SAIS. However, heterogeneity of the exercise interventions, coupled with poor reporting of exercise protocols, prevented conclusions being drawn about which specific components of the exercise protocols (ie, type, intensity, frequency and duration) are associated with best outcomes.",
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    author = "CE Hanratty and JG McVeigh and D Kerr and JR Basford and MB Finch and A Pendleton and J Sim",
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    Hanratty, CE, McVeigh, JG, Kerr, D, Basford, JR, Finch, MB, Pendleton, A & Sim, J 2012, The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. in Unknown Host Publication. Irish Society for Rheumatology Annual Conference Belfast, September 2012, 21/09/12.

    The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. / Hanratty, CE; McVeigh, JG; Kerr, D; Basford, JR; Finch, MB; Pendleton, A; Sim, J.

    Unknown Host Publication. 2012.

    Research output: Chapter in Book/Report/Conference proceedingConference contribution

    TY - GEN

    T1 - The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis

    AU - Hanratty, CE

    AU - McVeigh, JG

    AU - Kerr, D

    AU - Basford, JR

    AU - Finch, MB

    AU - Pendleton, A

    AU - Sim, J

    PY - 2012/9/21

    Y1 - 2012/9/21

    N2 - OBJECTIVE:To evaluate the effectiveness of exercise in the treatment of people with subacromial impingement syndrome (SAIS).METHODS:A systematic review and meta-analysis were conducted. Ten electronic databases were searched from the dates of their inception until August 2010. Included studies were randomized controlled trials investigating exercise in the management of SAIS. Outcomes were pain, strength, function, and quality of life. Data were summarized qualitatively using a best evidence synthesis. Treatment effect size and variance of individual studies were used to give an overall summary effect and data were converted to standardized mean difference with 95% confidence intervals (standardized mean difference (SMD) (CI)).RESULTS:Sixteen studies were included (n = 1162). There was strong evidence that exercise decreases pain and improves function at short-term follow-up. There was also moderate evidence that exercise results in short-term improvement in mental well-being and a long-term improvement in function for those with SAIS. The most common risk of bias across the studies was inadequately concealed treatment allocation. Six studies in the review were suitable for meta-analysis. Exercise had a small positive effect on strength of the rotator cuff in the short term (SMD -0.46 (-0.76, 0.16); P = 0.003) and a small positive effect on long-term function (SMD -0.31 (-0.57, 0.04); P = 0.02).CONCLUSIONS:Physiotherapy exercises are effective in the management of SAIS. However, heterogeneity of the exercise interventions, coupled with poor reporting of exercise protocols, prevented conclusions being drawn about which specific components of the exercise protocols (ie, type, intensity, frequency and duration) are associated with best outcomes.

    AB - OBJECTIVE:To evaluate the effectiveness of exercise in the treatment of people with subacromial impingement syndrome (SAIS).METHODS:A systematic review and meta-analysis were conducted. Ten electronic databases were searched from the dates of their inception until August 2010. Included studies were randomized controlled trials investigating exercise in the management of SAIS. Outcomes were pain, strength, function, and quality of life. Data were summarized qualitatively using a best evidence synthesis. Treatment effect size and variance of individual studies were used to give an overall summary effect and data were converted to standardized mean difference with 95% confidence intervals (standardized mean difference (SMD) (CI)).RESULTS:Sixteen studies were included (n = 1162). There was strong evidence that exercise decreases pain and improves function at short-term follow-up. There was also moderate evidence that exercise results in short-term improvement in mental well-being and a long-term improvement in function for those with SAIS. The most common risk of bias across the studies was inadequately concealed treatment allocation. Six studies in the review were suitable for meta-analysis. Exercise had a small positive effect on strength of the rotator cuff in the short term (SMD -0.46 (-0.76, 0.16); P = 0.003) and a small positive effect on long-term function (SMD -0.31 (-0.57, 0.04); P = 0.02).CONCLUSIONS:Physiotherapy exercises are effective in the management of SAIS. However, heterogeneity of the exercise interventions, coupled with poor reporting of exercise protocols, prevented conclusions being drawn about which specific components of the exercise protocols (ie, type, intensity, frequency and duration) are associated with best outcomes.

    KW - Subacromial impingement

    KW - rotator cuff

    KW - shoulder pain

    KW - exercises

    KW - physiotherapy

    KW - rehabilitation

    KW - systematic review

    KW - meta-analysis

    M3 - Conference contribution

    BT - Unknown Host Publication

    ER -

    Hanratty CE, McVeigh JG, Kerr D, Basford JR, Finch MB, Pendleton A et al. The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. In Unknown Host Publication. 2012