Exercise therapy is effective for improvement in range of motion, function and pain in patients with frozen shoulder: a systematic review and meta-analysis
Abstract
OBJECTIVE
To determine 1) the effect of exercise therapy alone or in combination with other interventions compared to solely exercises and programs with or without exercises? And 2) what kind of exercise therapy or combination with other interventions is most effective?
DESIGN
Systematic review and meta-analysis.
PARTICIPANTS
Patients with frozen shoulder.
INTERVENTION
Exercise therapy as sole intervention or combined with other physical therapy interventions.
OUTCOME MEASURES
Range of motion (ROM), function, disability pain, muscle strength and patient satisfaction.
RESULTS
Thirty-three studies were included in the qualitative and 19 in the meta-analysis. Preliminary evidence was found for supervised exercises to be more beneficial than home exercises for ROM and function. Multimodal programs comprising exercises may result in little to no difference in ROM compared to solely exercises. Programs comprising muscle energy techniques show little to no difference in ROM when compared to programs with other exercises. Adding stretches to a multimodal program with exercises may increase ROM. There is uncertain evidence that there is a difference between those programs regarding function and pain. Preliminary evidence was found for several treatment programs including exercises to be beneficial for improvement in both passive and active ROM, function, pain, and muscle strength. No studies used patient satisfaction as an outcome measure.
CONCLUSION
ROM, function and pain improve…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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