Can a Conservative Rehabilitation Strategy Improve Shoulder Proprioception? A Systematic Review

Abstract

Context: Proprioception deficits contribute to persistent and recurring physical disability, particularly with shoulder disorders. Proprioceptive training is thus prescribed in clinical practice. It is unclear whether nonsurgical rehabilitation can optimize shoulder proprioception. Objectives: To summarize the available evidence of conservative rehabilitation (ie, nonsurgical) on proprioception among individuals with shoulder disorders. Evidence Acquisition: PubMed, Web of Science, and EBSCO were systematically searched, from inception until November 24, 2019. Selected articles were systematically assessed, and the methodological quality was established using the Dutch Cochrane Risk of Bias Tool and the Newcastle-Ottawa Quality Assessment Scale. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were utilized for this review. The conservative treatments were categorized as follows: (1) conventional therapy, (2) proprioceptive training, (3) elastic kinesiology tape, and (4) other passive therapies. Evidence Synthesis: Twelve articles were included, yielding 58 healthy control shoulders and 362 shoulders affected by impingement syndrome, glenohumeral dislocations, nonspecific shoulder pain, rotator cuff dysfunction, or subluxation poststroke. The level of agreement between the evaluators was excellent (84.9%), and the studies were evaluated to be of fair to excellent quality (risk of bias: 28.5%–100%). This review suggests, with moderate evidence, that proprioceptive training (upper-body wobble board or flexible foil training) can improve proprioception in the midterm. No decisive evidence exists to suggest that conventional therapy is of added value to enhance shoulder proprioception. Conflicting evidence was found for the improvement of proprioception with the application of elastic kinesiology tape, while moderate evidence suggests that passive modalities, such as microcurrent electrical stimulation and bracing, are not effective for proprioceptive rehabilitation of the shoulder. Conclusions: Proprioceptive training demonstrates the strongest evidence for the effective rehabilitation of individuals with a shoulder proprioceptive deficit. Elastic kinesiology tape does not appear to affect the sense of shoulder proprioception. This review suggests a possible specificity of training effect with shoulder proprioception.

Algorithm for Creating a Multidisciplinary Team in the Palliative Care System

“…The findings of the present study are consistent with reports available in the literature [26][27][28][29][30][31][32].…”

Evaluation of the Therapeutic Effects of a Series of Treatments with Whole-Body Cryotherapy on Pain of the Cervical Spine in the Course of Degenerative Disease

“…The beneficial effect of whole-body cryotherapy was also seen in studies of Cholewka and Drzazga [29,30], in which an attempt was made to compare the effectiveness of treatments performed using a 2-stage cryochamber and with cold retention. The study involved 46 patients with back pain syndromes in the course of degenerative changes, who underwent a series of 10 whole-body cryotherapy treatments lasting from 2 to 3 minutes followed by kinesitherapy.…”

“…Some authors in their studies highlighted the feasibility of using passive exercises, which were used only during the exacerbation of the pathological process [30]. Therefore, such exercises are not used for SIS prevention.…”

Kinesiology Tape: A Descriptive Survey of Healthcare Professionals in the United States

“…2 Since 2010, approximately thirtyeight KT systematic reviews have been published appraising the efficacy for specific conditions. The reviews found inconclusive evidence for shoulder, 3,4 knee, 5 and elbow disorders, 6 as well as spinal pain, 7 proprioception, 8 brachial plexus injury in children, 9 muscle strength, 10 and sports performance. 11 Researchers also appraised the KT literature on musculoskeletal conditions, 2,[12][13][14][15] chronic musculoskeletal pain, 16,17 sports injuries, 18 in eight systematic reviews and found inconclusive results.…”