Terminology and diagnostic criteria used in studies investigating patients with subacromial pain syndrome from 1972 to 2019: a scoping review

Abstract

IntroductionThere is no recognised terminology, nor diagnostic criteria, for patients with subacromial pain syndrome (SAPS). This is likely to cause heterogeneity across patient populations. This could be a driver of misconceptions and misinterpretations of scientific results. We aimed to map the literature regarding terminology and diagnostic criteria used in studies investigating SAPS.Materials and methodsElectronic databases were searched from inception to June 2020. Original peer-reviewed studies investigating SAPS (also known as subacromial impingement or rotator cuff tendinopathy/impingement/syndrome) were eligible for inclusion. Studies containing secondary analyses, reviews, pilot studies and studies with less than 10 participants were excluded.Results11 056 records were identified. 902 were retrieved for full-text screening. 535 were included. 27 unique terms were identified. Mechanistic terms containing ‘impingement’ are used less than before, while SAPS is used increasingly. For diagnoses, combinations of Hawkin’s, Neer’s, Jobe’s, painful arc, injection test and isometric shoulder strength tests were the most often used, though this varied considerably across studies. 146 different test combinations were identified. 9% of the studies included patients with full-thickness supraspinatus tears and 46% did not.ConclusionThe terminology varied considerably across studies and time. The diagnostic criteria were often based on a cluster of physical examination tests. Imaging was primarily used to exclude other pathologies but was not used consistently. Patients with full-thickness supraspinatus tears were most often excluded. In summary, studies investigating SAPS are heterogeneous to an extent that makes it difficult, and often impossible, to compare studies.

Effect of scapular stabilization exercises on subacromial pain (impingement) syndrome: a systematic review and meta-analysis of randomized controlled trials

“…This study, while providing valuable insights, is not without its limitations. Firstly, the lack of universally accepted terminology or diagnostic criteria for SAPS patients leads to significant variations across studies and over time, resulting in heterogeneity within and between included patients (77). A recent scoping review (77) proposes identifying three subgroups of SAPS patients, which may help address this issue in future studies.…”

“…Firstly, the lack of universally accepted terminology or diagnostic criteria for SAPS patients leads to significant variations across studies and over time, resulting in heterogeneity within and between included patients (77). A recent scoping review (77) proposes identifying three subgroups of SAPS patients, which may help address this issue in future studies. Secondly, it is hypothesized that interventions may yield divergent effects at different stages of the condition.…”

Shoulder & Elbow

“…In order to assess this and aid our understanding of the problem, researchers from Copenhagen (Denmark) performed a scoping review study to map the literature on this subject. 8 Original peer-reviewed studies which investigated subacromial pain were included, encompassing subacromial impingement and terms such as rotator cuff tendinopathy/impingement/syndrome. Smaller studies of ten patients or fewer were excluded.…”

Cervical-Shoulder Syndrome: Shoulder and Cervical Surgeries Are Risk Factors for Each Other

“…Unfortunately, our review of literature reveals no consensus on which tests are the most accurate and sensitive with the diagnosis of subacromial impingement or labral lesion, and the exploration on this topic is beyond the scope of the present study. 20,21,22,23 Biomechanical Interdependence…”