Exercise protocol for the treatment of rotator cuff impingement syndrome
Abstract
REFERENCE/CITATION:: Kuhn JE. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg. 2009;18(1):138–160.
CLINICAL QUESTION:: What is the role of exercise in the treatment of rotator cuff impingement syndrome (RCIS), and what evidence-based exercises can be synthesized into a criterion-standard exercise rehabilitation protocol?
DATA SOURCES:: Investigations were identified by PubMed, Ovid, the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, American College of Physicians Journal Club, and Database of Abstracts of Reviews of Effects. The search terms included shoulder, impingement, rotator cuff, rehabilitation, physical therapy, physiotherapy, and exercise. Additional searches were performed with bibliographies of retrieved studies.
STUDY SELECTION:: To qualify for inclusion, studies had to be level 1 or level 2 (randomized controlled trials); had to compare rehabilitation interventions, such as exercise or manual therapy, with other treatments or placebo; had to include validated outcome measures of pain, function, or disability; and had to be limited to individuals with diagnosed impingement syndrome. Impingement syndrome was determined by a positive impingement sign per Neer or Hawkins criteria, or both. Articles were excluded if they addressed other shoulder conditions (eg, calcific tendinosis, full-thickness rotator cuff tears,…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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