Bury, J, West, M, Chamorro-Moriana, G and Littlewood, C (2016) Effectiveness of scapula-focused approaches in patients with rotator cuff related shoulder pain: a systematic review and meta-analysis. Manual Therapy, 25. pp. 35-42. ISSN 1532-2769

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G Littlewood - Effectiveness of scapula-focused approaches in patients with rotator cuff related shoulder pain - a systematic review and meta-analysis.pdf - Accepted Version
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Abstract

Background
Rotator cuff related shoulder pain (RCSP) is common with a range of conservative treatments currently offered. Evidence supporting superiority of one approach over another is lacking. Scapula focused approaches (SFA) are frequently prescribed and warrant investigation.

Objective
To evaluate the effectiveness of SFA in RCSP.

Design
Systematic review of randomised controlled trials.

Methods
An electronic search including MEDLINE, PEDro, ENFISPO to January 2016 was supplemented by hand searching. Randomised controlled trials were included; appraised using the PEDro scale and synthesised via meta-analysis or narratively, where appropriate.

Results
Four studies (n = 190) reported on pain and three studies (n = 122) reported on disability. Regarding pain, there was statistical but not clinically significant benefit of SFA versus generalised approaches (mean difference (VAS) 0.714; 95% CI 0.402–1.026) in the short term (<6 weeks); regarding disability, there was significant benefit of SFA versus generalised approaches (mean difference 14.0; 95% CI 11.2–16.8) in the short term (<6 weeks). One study (n = 22) reported disability at 3 months, which was not statistically significant. Evidence is conflicting from four studies relating to the effect of SFA on scapula position/movement.

Conclusion
SFA for RCSP confers benefit over generalised approaches up to six weeks but this benefit is not apparent by 3 months. Early changes in pain are not clinically significant. With regards to scapula position/movement, the evidence is conflicting. These preliminary conclusions should be treated with significant caution due to limitations of the evidence base.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Elsevier at https://doi.org/10.1016/j.math.2016.05.337 Please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: scapula; rotator cuff, rehabilitation, exercise, systematic review
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 09 Jun 2016 14:58
Last Modified: 13 Jun 2018 11:24
URI: http://eprints.keele.ac.uk/id/eprint/1830

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