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Physiotherapy Jun 2012Shoulder pain due to rotator cuff tendinopathy is a common problem. Exercise is one intervention used to address this problem but conclusions from previous reviews have... (Review)
Review
BACKGROUND
Shoulder pain due to rotator cuff tendinopathy is a common problem. Exercise is one intervention used to address this problem but conclusions from previous reviews have been mixed.
OBJECTIVE
To systematically review the effectiveness of exercise, incorporating loaded exercise (against gravity or resistance), for rotator cuff tendinopathy.
DATA SOURCES
An electronic search of AMED, CiNAHL, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PEDro and SPORTDiscus was undertaken from their inception to November 2010 and supplemented by hand searching related articles and contact with topic experts.
STUDY ELIGIBILITY CRITERIA
Randomised controlled trials evaluating the effectiveness of exercise, incorporating loaded exercise, in participants with rotator cuff tendinopathy.
STUDY APPRAISAL AND SYNTHESIS METHODS
Included studies were appraised for risk of bias using the tool developed by the Cochrane Back review Group. Due to heterogeneity of studies, a narrative synthesis was undertaken based upon levels of evidence.
RESULTS
Five articles detailing four studies were included, all of which were regarded as presenting a low risk of bias. Overall, the literature was supportive of the use of exercise in terms of pain and functional disability.
LIMITATIONS
The results should be regarded with some degree of caution due to limitations associated with the studies including lack of blinding, no intervention control groups and limitations of the outcome measures used. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS: The available literature is supportive of the use of exercise but due to the paucity of research and associated limitations further study is indicated.
Topics: Exercise Therapy; Humans; Randomized Controlled Trials as Topic; Rotator Cuff; Tendinopathy
PubMed: 22507359
DOI: 10.1016/j.physio.2011.08.002 -
International Journal of Environmental... Dec 2022(1) Background: Idiopathic scoliosis can be defined as a complex three-dimensional deformity of the spine and trunk, which occurs in basically healthy children. Schroth... (Meta-Analysis)
Meta-Analysis Review
(1) Background: Idiopathic scoliosis can be defined as a complex three-dimensional deformity of the spine and trunk, which occurs in basically healthy children. Schroth scoliosis-specific exercises have shown good results in reducing idiopathic scoliosis progression. This study aimed to critically evaluate the effect size of Schroth's method through a systematic review and meta-analysis. (2) Methods: Four databases were included in the search: PubMed, Cochrane Library, Web of Science, and Google Scholar. The following keywords were used: "Schroth exercise", "idiopathic scoliosis", "Cobb angle", "angle of trunk rotation", and "quality of life". Only articles written in English that met the following criteria were included in our study: subjects who had idiopathic scoliosis, the Schroth method was applied, and Cobb angle or angle of trunk rotation or quality of life as outcomes. (3) Results: Ten randomized controlled trials were included in this study. The effect size of the Schroth exercise ranged from almost moderate to large, for the outcomes used: Cobb angle (ES = -0.492, ˂ 0.005); ATR (ES = -0.471, = 0.013); QoL (ES = 1.087, 0.001). (4) Conclusions: The current meta-analysis indicates that the Schroth method has a positive effect on subjects with idiopathic scoliosis.
Topics: Child; Humans; Scoliosis; Quality of Life; Treatment Outcome; Spine; Exercise Therapy; Randomized Controlled Trials as Topic
PubMed: 36554613
DOI: 10.3390/ijerph192416730 -
Journal of Rehabilitation Medicine Oct 2019To conduct a systematic review and meta-analysis to identify risk and associated factors for symptomatic rotator cuff tendinopathy. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To conduct a systematic review and meta-analysis to identify risk and associated factors for symptomatic rotator cuff tendinopathy.
DATA SOURCES
PubMed, CINAHL and Scopus were searched from inception to June 2017.
STUDY SELECTION
Participants presented with signs and symptoms suggestive of rotator cuff tendinopathy/tendinosis/tendinitis, shoulder impingement syndrome, or subacromial bursitis diagnosed by clinical tests and/or conventional imaging.
DATA EXTRACTION
Screening, quality assessment and data extraction were carried out by 2 reviewers.
DATA SYNTHESIS
Sixteen studies were included in this review. Overall, 22 factors were identified and 5 factors were explored using meta-analysis. Pooled analyses provided strong evidence that age above 50 years (odds ratio (OR)?=?3.31, 95% confidence interval (95% CI)?=?2.304.76, I2?=?0%, p<0.001) and diabetes (OR?=?2.24, 95% CI?=?1.373.65, I2?=?0%, p?=?0.001) were associated with increased risk of rotator cuff tendinopathy. In addition, moderate evidence showed that work with the shoulder above 90° was associated with increased risk of rotator cuff tendinopathy (OR?=?2.41, 95% CI?=?1.314.45, I2=?83%, p?=?0.005).
CONCLUSION
Age above 50 years, diabetes and overhead activities were associated with increased risk of rotator cuff tendinopathy.
Topics: Female; Humans; Male; Middle Aged; Risk Factors; Rotator Cuff; Tendinopathy
PubMed: 31489438
DOI: 10.2340/16501977-2598 -
Journal of Musculoskeletal & Neuronal... Dec 2019This systematic review aims to determine the effectiveness of proprioceptive neuromuscular facilitation (PNF) treatment techniques in adhesive capsulitis for decreasing... (Meta-Analysis)
Meta-Analysis
This systematic review aims to determine the effectiveness of proprioceptive neuromuscular facilitation (PNF) treatment techniques in adhesive capsulitis for decreasing pain and disability and increasing range of motion (ROM) and function. A thorough, computerized search was done using database search engines by two reviewers. After meticulous scrutiny and screening of 410 studies, according to the selection criteria, 10 full-text articles were included in the review and meta-analysis. All 10 studies had undergone a methodological quality assessment by the Physiotherapy Evidence Database Scale. Meta-analysis was done for external rotation, abduction ROM and pain. The most common PNF techniques used by most of the studies were, hold-relax and contract-relax in upper limb D2 flexion, abduction, and an external rotation pattern, while some studies used scapular PNF patterns. Among the 10 included studies, nine showed that the PNF group is superior in decreasing pain and reducing disability, increasing ROM, improving function. The meta-analysis also showed a significant effect size and that the PNF is superior than conventional physical therapy in decreasing pain, increasing external rotation, and abduction ROM.
Topics: Bursitis; Humans; Physical Therapy Modalities; Proprioception; Range of Motion, Articular; Treatment Outcome
PubMed: 31789299
DOI: No ID Found -
Journal of the International Society of... 2022Tendinopathy is a painful condition that is prevalent in athletes as well as the general human population, and whose management is challenging. (Review)
Review
BACKGROUND
Tendinopathy is a painful condition that is prevalent in athletes as well as the general human population, and whose management is challenging.
OBJECTIVE
This systematic review aimed to evaluate the impact of nutrition on the prevention and treatment of tendinopathy.
METHODS
Searches were conducted in PubMed, EMBASE, Web of Science, and SPORTDiscus without restriction to year of publication. Studies examining the impact of exposure to nutrient intake in an adult human population on 1) prevalence/incidence of tendinopathy, 2) clinical outcomes of tendinopathy, 3) structural changes in the tendon by imaging modalities. Experimental and observational study designs written in English, Dutch, or German were eligible.
RESULTS
Nineteen studies met the inclusion criteria. The effects of the habitual diet were investigated in one study. Four studies examined the effects of exposure to alcohol. Alcohol consumption can be a potential risk factor associated with Achilles tendinopathy and rotator cuff tears, although findings were inconsistent. The use of dietary supplements was examined in fourteen studies. Among these, collagen-derived peptides were most often part of the supplements evaluated. Combining training and dietary supplements seems to induce better clinical and functional outcomes in tendinopathy.
CONCLUSION
This review demonstrates the paucity of high-quality studies and a wide variety among studies regarding nutrients, tendon location, study population, and reported outcome measures. Individual studies showed promising clinical implications for the use of dietary supplements, particularly those containing collagen-derived peptides. However, giving any definitive dietary recommendations on the prevention and treatment of tendinopathy remains elusive.
Topics: Achilles Tendon; Adult; Diet; Dietary Supplements; Humans; Nutritional Status; Observational Studies as Topic; Tendinopathy
PubMed: 35937777
DOI: 10.1080/15502783.2022.2104130 -
Journal of Experimental Orthopaedics Aug 2022The aim of this systematic review was to update the knowledge on risk factors and prevention strategies for shoulder injuries in overhead sports with special emphasis on... (Review)
Review
PURPOSE
The aim of this systematic review was to update the knowledge on risk factors and prevention strategies for shoulder injuries in overhead sports with special emphasis on methodological quality.
METHODS
All methodological procedures were performed in line with a previous systematic review by Asker et al. (2018). The literature search was conducted in the PubMed, Google Scholar, Cochrane, and SPORT-Discuss databases. Due to the risk of bias assessment, only studies with at least an acceptable methodological quality were included. A best-evidence synthesis was performed to clarify the evidence and direction of the risk factors and prevention strategies.
RESULTS
A total of nine studies were included in the data extraction process. One study had a high and eight studies had an acceptable methodological quality. Seven cohort studies investigated risk factors and two randomised controlled trails evaluated prevention strategies. Moderate evidence was found for two non-modifiable (playing position, gender) and three modifiable factors (shoulder rotational strength, scapular dyskinesia, shoulder prevention programme) that were associated with the shoulder injury risk. All further risk factors had moderate and no association with risk (shoulder rotational ROM, joint position sense) or limited (history of shoulder/elbow pain, age, training experience, training volume, school grade, playing level), and conflicting evidence (setting).
CONCLUSIONS
There is moderate evidence for two non-modifiable (playing position, gender) and three modifiable factors (shoulder rotational strength, scapular dyskinesia, shoulder prevention programme) being associated with the shoulder injury risk in overhead sports.
PubMed: 35971013
DOI: 10.1186/s40634-022-00493-9 -
British Journal of Sports Medicine Sep 2020To characterise whether preseason screening of shoulder range of motion (ROM) is associated with the risk of shoulder and elbow injuries in overhead athletes. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To characterise whether preseason screening of shoulder range of motion (ROM) is associated with the risk of shoulder and elbow injuries in overhead athletes.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
Six electronic databases up to 22 September 2018.
ELIGIBILITY CRITERIA
Inclusion criteria were (1) overhead athletes from Olympic or college sports, (2) preseason measures of shoulder ROM, (3) tracked in-season injuries at the shoulder and elbow, and (4) prospective cohort design. Exclusion criteria were (1) included contact injuries, (2) lower extremity, spine and hand injuries, and (3) full report not published in English.
RESULTS
Fifteen studies were identified, and they included 3314 overhead athletes (baseball (74.6%), softball (3.1%), handball (16.1%), tennis (2.0%), volleyball (2.0%) and swimming (2.2%)). Female athletes are unrepresented (12% of the overall sample). Study quality ranged from 11 to 18 points on a modified Downs and Black checklist (maximum score 21, better quality). In one study, swimmers with low (<93°) or high (>100°) shoulder external rotation were at higher risk of injuries. Using data pooled from three studies of professional baseball pitchers, we showed in the meta-analysis that shoulder external rotation insufficiency (throwing arm <5° greater than the non-throwing arm) was associated with injury (odds ratio=1.90, 95% confidence interval 1.24 to 2.92, p<0.01).
CONCLUSION
Preseason screening of shoulder external rotation ROM may identify professional baseball pitchers and swimmers at risk of injury. Shoulder ROM screening may not be effective to identify handball, softball, volleyball and tennis players at risk of injuries. The results of this systematic review and meta-analysis should be interpreted with caution due to the limited number of studies and their high degree of heterogeneity.
PROSPERO REGISTRATION NUMBER
CRD42017072895.
Topics: Athletic Injuries; Baseball; Elbow Joint; Humans; Range of Motion, Articular; Risk Factors; Rotation; Shoulder; Shoulder Injuries; Swimming; Tennis; Volleyball; Elbow Injuries
PubMed: 31937577
DOI: 10.1136/bjsports-2019-100698 -
BMC Musculoskeletal Disorders Jan 2017Physical examination tests of the shoulder (PETS) are clinical examination maneuvers designed to aid the assessment of shoulder complaints. Despite more than 180 PETS... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Physical examination tests of the shoulder (PETS) are clinical examination maneuvers designed to aid the assessment of shoulder complaints. Despite more than 180 PETS described in the literature, evidence of their validity and usefulness in diagnosing the shoulder is questioned.
METHODS
This meta-analysis aims to use diagnostic odds ratio (DOR) to evaluate how much PETS shift overall probability and to rank the test performance of single PETS in order to aid the clinician's choice of which tests to use. This study adheres to the principles outlined in the Cochrane guidelines and the PRISMA statement. A fixed effect model was used to assess the overall diagnostic validity of PETS by pooling DOR for different PETS with similar biomechanical rationale when possible. Single PETS were assessed and ranked by DOR. Clinical performance was assessed by sensitivity, specificity, accuracy and likelihood ratio.
RESULTS
Six thousand nine-hundred abstracts and 202 full-text articles were assessed for eligibility; 20 articles were eligible and data from 11 articles could be included in the meta-analysis. All PETS for SLAP (superior labral anterior posterior) lesions pooled gave a DOR of 1.38 [1.13, 1.69]. The Supraspinatus test for any full thickness rotator cuff tear obtained the highest DOR of 9.24 (sensitivity was 0.74, specificity 0.77). Compression-Rotation test obtained the highest DOR (6.36) among single PETS for SLAP lesions (sensitivity 0.43, specificity 0.89) and Hawkins test obtained the highest DOR (2.86) for impingement syndrome (sensitivity 0.58, specificity 0.67). No single PETS showed superior clinical test performance.
CONCLUSIONS
The clinical performance of single PETS is limited. However, when the different PETS for SLAP lesions were pooled, we found a statistical significant change in post-test probability indicating an overall statistical validity. We suggest that clinicians choose their PETS among those with the highest pooled DOR and to assess validity to their own specific clinical settings, review the inclusion criteria of the included primary studies. We further propose that future studies on the validity of PETS use randomized research designs rather than the accuracy design relying less on well-established gold standard reference tests and efficient treatment options.
Topics: Humans; Physical Examination; Shoulder Impingement Syndrome; Shoulder Pain
PubMed: 28122541
DOI: 10.1186/s12891-017-1400-0 -
Annals of Physical and Rehabilitation... Jan 2021Several studies reported the importance of glenohumeral and scapular muscle activity and scapular kinematics in multidirectional shoulder instability (MDI), yet a... (Review)
Review
BACKGROUND
Several studies reported the importance of glenohumeral and scapular muscle activity and scapular kinematics in multidirectional shoulder instability (MDI), yet a systematic overview is currently lacking.
OBJECTIVE
This systematic review evaluates and summarizes the evidence regarding muscle activity and shoulder kinematics in individuals with MDI compared to healthy controls.
METHOD
The electronic databases PubMed and Web of Science were searched in September 2020 with key words regarding MDI (population), muscle activity, and glenohumeral and scapular movement patterns (outcomes). All studies that compared muscle activity or scapular kinematics between shoulders with MDI and healthy shoulders were eligible for this review, except for case reports and case series. All articles were screened on the title and abstract, and remaining eligible articles were screened on full text. The risk of bias of included articles was assessed by a checklist for case-control data, as advised by the Cochrane collaboration.
RESULTS
After full text screening, 12 articles remained for inclusion and one study was obtained by hand search. According to the guidelines of the Dutch Institute for Healthcare Improvement, most studies were of moderate methodological quality. We found moderate evidence that MDI individuals show increased or prolonged activity of several rotator cuff muscles that control and centre the humeral head. Furthermore, we found evidence of decreased and/or shortened activity of muscles that move or accelerate the arm and shoulder girdle as well as increased and/or lengthened activity of muscles that decelerate the arm and shoulder girdle. The most consistent kinematic finding was that MDI individuals show significantly less upward rotation and more internal rotation of the scapula during elevation of the arm in the scapular plane as compared with controls. Finally, several studies also suggest that the humeral head demonstrates increased translations relative to the glenoid surface.
CONCLUSION
There is moderate evidence for altered muscle activity and altered humeral and scapular kinematics in MDI individuals as compared with controls.
Topics: Biomechanical Phenomena; Humans; Joint Instability; Muscle, Skeletal; Range of Motion, Articular; Scapula; Shoulder; Shoulder Joint
PubMed: 33221471
DOI: 10.1016/j.rehab.2020.10.008 -
Sports Health 2020Shoulder injuries are highly prevalent in sports involving the upper extremity. Some risk factors have been identified in the literature, but consensus is still lacking.
CONTEXT
Shoulder injuries are highly prevalent in sports involving the upper extremity. Some risk factors have been identified in the literature, but consensus is still lacking.
OBJECTIVES
To identify risk factors of overuse shoulder injury in overhead athletes, as described in the literature.
DATA SOURCES
A systematic review of the literature from the years 1970 to 2018 was performed using 2 electronic databases: PubMed and Scopus.
STUDY SELECTION
Prospective studies, written in English, that described at least 1 risk factor associated with overuse shoulder injuries in overhead sports (volleyball, handball, basketball, swimming, water polo, badminton, baseball, and tennis) were considered for analysis.
STUDY DESIGN
Systematic review.
LEVEL OF EVIDENCE
Level 3.
DATA EXTRACTION
Data were extracted from 25 studies. Study methodology quality was evaluated using the Modified Coleman Methodology Score.
RESULTS
Intrinsic factors, previous injury, range of motion (lack or excess), and rotator cuff weakness (isometric and isokinetic) highly increase the risk of future injuries. Additionally, years of athletic practice, body mass index, sex, age, and level of play seem to have modest influence. As for the effect of scapular dysfunction on shoulder injuries, it is still controversial, though these are typically linked. Extrinsic factors, field position, condition of practice (match/training), time of season, and training load also have influence on the occurrence of shoulder injuries.
CONCLUSION
Range of motion, rotator cuff muscle weakness, and training load are important modifiable factors associated with shoulder injuries. Scapular dysfunction may also have influence. The preventive approach for shoulder injury should focus on these factors.
Topics: Athletic Injuries; Cumulative Trauma Disorders; Humans; Range of Motion, Articular; Risk Factors; Rotator Cuff; Scapula; Shoulder Injuries
PubMed: 32758080
DOI: 10.1177/1941738120931764