Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol.

Authors: Kuhn JE (1)
(1) Vanderbilt Shoulder Center
Source: J Shoulder Elbow Surg. 2009 Jan-Feb;18(1):138-60
DOI: 10.1016/j.jse.2008.06.004 Publication date: 2009 Jan E-Publication date: Oct. 2, 2008 Availability: abstract Copyright: © 2009 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
Language: English Countries: Not specified Location: Not specified Correspondence address: Khun JE : j.kuhn@vanderbilt.edu


Article abstract

A systematic review of the literature was performed to evaluate the role of exercise in treating rotator cuff impingement and to synthesize a standard evidence-based rehabilitation protocol. Eleven randomized, controlled trials (level 1 and 2) evaluating the effect of exercise in the treatment of impingement were identified. Data regarding demographics, methodology, and outcomes of pain, range of motion, strength, and function were recorded. Individual components of each rehabilitation program were catalogued. Effectiveness was determined by statistical and clinical significance. Although many articles had methodologic concerns, the data demonstrate that exercise has statistically and clinically significant effects on pain reduction and improving function, but not on range of motion or strength. Manual therapy augments the effects of exercise, yet supervised exercise was not different than home exercise programs. Information regarding specific components of the exercise programs was synthesized into a gold standard rehabilitation protocol for future studies on the nonoperative treatment of rotator cuff impingement.

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