Interventions for tears of the rotator cuff in adults

Ejnisman, Benno; Carrera, EF; Fallopa, Flávio; Peccin, MS; Cohen, M.

doi:10.1002/14651858.cd002758

Cited by 28 publications

(47 citation statements)

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“…Evidence does not support a difference in outcomes according to surgical technique, whether it is arthroscopic, mini-open, or single-or double-row techniques. 37 Acromioplasty is not usually necessary during a rotator cuff repair; acromioplasty does not change functional outcome after arthroscopic repair of the rotator cuff. [38][39][40][41] Distal clavicle resection as a routine part of acute rotator cuff tear repair is not recommended.…”

Section: Shoulder Conditionsmentioning

confidence: 99%

Shoulder Conditions

Codsi¹,

Howe²

2015

Physical Medicine and Rehabilitation Clinics of North America

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Section: Shoulder Conditionsmentioning

confidence: 99%

Shoulder Conditions

Codsi¹,

Howe²

2015

Physical Medicine and Rehabilitation Clinics of North America

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“…Fifteen results were considered for the second screening, as a result of which another seven results were excluded ( Table 2). Eight systematic reviews, [25][26][27][28][29][30][31][32] including two Cochrane reviews, 26,28 and all in English, were retained for analysis. The eight systematic reviews (Table 3) were published between 2002 and 2006 and covered searches from 1966 to 2005.…”

Section: Included Systematic Reviewsmentioning

confidence: 99%

“…One review was restricted to research on rotator cuff tears. 26 Two systematic reviews dealt with general shoulder pain but defined impingement-related subsamples. 28,29 Only two reviews were restricted to studies on manual therapy and exercise interventions.…”

Section: Included Systematic Reviewsmentioning

confidence: 99%

Manual therapy and exercise for impingementrelated shoulder pain

Braun¹,

Hanchard

2010

Physical Therapy Reviews

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Shoulder complaints are among the commonest causes of musculoskeletal pain. They are potentially disabling and frequently cause absenteeism from work and claims for sickness benefits. One of the most prevalent subtypes of shoulder pain is impingement. This is often managed physiotherapeutically, with 'hands-on' manual therapy and exercises being mainstays. Objectives: To assess the effectiveness of manual therapy and exercises to improve pain, disability and function in people with shoulder impingement. Methods: A systematic review was conducted including systematic reviews, quasi-randomized trials and randomized controlled trials published up to October 2008. Searches included the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Medline, Embase, Cinahl and PEDro. Methodological quality and risk of bias were assessed with appropriate instruments. All findings were critically analysed and discussed, and summary conclusions formulated. Results: Eight systematic reviews and six randomized controlled trials were included. Methodological quality and risk of bias as well as population and treatment parameters varied. Clinical heterogeneity prevented meta-analysis, thus all findings were synthesized narratively. The included research provides limited evidence to support the use of manual therapy and exercise interventions for shoulder impingement. This primarily relates to subacute and chronic conditions and short to medium-term effectiveness. Conclusions: Manual therapy and exercise seem effective for shoulder impingement, but varying methodological quality and risk of bias in reviews and trials warrant caution in the interpretation of the results. There is a need for further good-quality primary research.

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“…Scoring systems are different and timing of outcome variable [36]. Intervention studies are heterogeneous, and often the quality of data is poor because of inadequate methodology and inadequate sample sizes [37].…”

mentioning

confidence: 99%

Conservative Treatment and Rotator Cuff Tear Progression

Longo

Franceschi

Berton

et al. 2011

Medicine and Sport Science

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There is no definite consensus on the best management for patients with rotator cuff tears. No randomized controlled studies have compared the outcome of surgical versus conservative treatment. The described successful rate of conservative treatment varies widely, from 33 to 92%. Even though current evidence is not sufficient to allow definitive conclusions on conservative treatment of rotator cuff tears, non-operative management is often recommended in such patients. Prognostic factors seem to be clinical presentation, duration of symptoms and tear size. The best programme for conservative treatment is not defined. Physical therapy consists of stretching and strengthening exercises. The characteristics of exercise programmes are not standardized. In clinical practice, intra-articular injections are commonly used for treatment of shoulder pain. Systemic pharmacotherapy for patients with shoulder pain consists of non-steroidal anti-inflammatory drugs. Recently, cyclo-oxygenase-2-selective inhibitors have been introduced for management of shoulder pain. To date, few randomized controlled trials are available on conservative management of rotator cuff tears, and therefore further studies are required to clarify its role in such patients.

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Interventions for tears of the rotator cuff in adults

Cited by 28 publications

References 0 publications

Shoulder Conditions

Shoulder Conditions

Manual therapy and exercise for impingementrelated shoulder pain

Conservative Treatment and Rotator Cuff Tear Progression

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