Effectiveness of Therapeutical Interventions on the Scapulothoracic Complex in the Management of Patients with Subacromial Impingement and Frozen Shoulder: A Systematic Review

Abstract

Shoulder pain is one the most common musculoskeletal complaints. The most common pathological causes of shoulder pain in the general population are subacromial impingement syndrome and adhesive capsulitis, commonly referred to as “frozen shoulder”. The purpose of this study was to evaluate the role of the scapulo-thoracic complex, particularly in scapular kinematic functions, in rehabilitative interventions for shoulder pain in patients suffering from these two common conditions. This systematic review was performed using the scientific search engines PubMed, PEDro and Cochrane Library, considering only randomized controlled clinical trials. Selected articles were evaluated according to the level of evidence and methodological quality. Thirteen randomized clinical trials were selected. Interventions have been divided into three macro-categories: (1) manual therapy in patients with subacromial impingement, (2) therapeutic exercise programs including interventions on the scapulothoracic complex in patients with subacromial impingement syndrome, and (3) therapeutic exercise programs including interventions on the scapulothoracic complex in patients with frozen shoulder. Following this, a qualitative analysis was performed according to outcomes such as pain, shoulder function, and scapular kinematics. Physiotherapy exercise programs that included scapular motor control training and scapular mobilizations, in particular, those of the scapulo-thoracic complex in scapular kinematic function, represent valid alternatives in the management of patients with subacromial impingement syndrome.

Is there ‘trustworthy’ evidence for using manual therapy to treat patients with shoulder dysfunction?: A systematic review

“…Desjardins et al [ 2 ] included 21, of which approximately 76% had a high risk of bias, with approximately 81% not providing a registration number. Additionally, two-year delays in publication are commonly observed in several of the previous SRs [ 3 , 19 , 21 ]. The most significant delay was observed in the SR by Gebremariam et al [ 16 ], where the search was conducted through March 2009, but the SR itself was not published until November 2013.…”

“…Additionally, a lack of evidence from which to build high-quality SRs has been repeatedly noted [ 1 , 2 , 8 , 9 , 11 – 14 , 22 – 24 , 26 ]. A cursory review of the literature for SRs studying the effectiveness of manual therapy as a treatment for shoulder dysfunction reveals 29 SRs, with or without meta-analyses, published since 2003 [ 1 – 29 ], including eight (~ 28%) published in the last five years [ 4 , 5 , 19 – 21 , 25 , 28 , 29 ]. This indicates a high interest amongst researchers in providing clinicians with summary recommendations to implement in their clinical practice.…”

“…Systematic reviews (SRs) examining manual therapy's effectiveness in treating shoulder pathology have been methodologically diverse. These include the usage of broad [1][2][3][4][5] versus more narrow [6][7][8][9][10][11][12] definitions of the term "manual therapy," manual therapy being included in umbrella reviews along with other conservative interventions [4,6,[12][13][14][15][16][17][18][19][20][21], and the inclusion of only one shoulder-related diagnosis in some reviews [3,5,8,11,[13][14][15][16][17][18][19][20]22] while others include many or prefer not to differentiate at all based upon diagnosis [6,10,[23][24][25]. Additionally, a lack of evidence from which to build high-quality SRs has been repeatedly noted [1, 2, 8, 9, 11-14, 22-24, 26].…”

Single Assessment Numeric Evaluation score in shoulder pathologies: cross-cultural adaptation and validation into Russian

“…Жалобы на боль и ухудшение функции плечевого сустава являются одними из самых частых со стороны опорно-двигательного аппарата, а также входят в число основных причин обращений к врачу по поводу хронической боли [1,2,3].…”

Nonsurgical Management of Shoulder Pain in Rotator Cuff Tears: Ultrasound-Guided Biceps Tenotomy Combined With Corticosteroid Injection

“… 3 Therapeutic options include conservative management, which consists of scapular and glenohumeral stabilization exercises to increase the subacromial space and improve control of the upper quadrant. 4 …”