Effectiveness of Progressive and Resisted and Non-Progressive or Non-Resisted Exercise in Rotator Cuff Related Shoulder Pain: A Systematic Review and Meta-analysis of Randomised Controlled Trials

Naunton, Josh, Littlewood, Christopher ORCID: https://orcid.org/0000-0002-7703-727X, Street, Gabrielle, Haines, Terry and Malliaras, Peter (2020) Effectiveness of Progressive and Resisted and Non-Progressive or Non-Resisted Exercise in Rotator Cuff Related Shoulder Pain: A Systematic Review and Meta-analysis of Randomised Controlled Trials. Clinical Rehabilitation, 34 (9). pp. 1198-1216. ISSN 0269-2155

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Abstract

Objective: Synthesize evidence regarding effectiveness of progressive and resisted or non-progressive and non-resisted exercise compared with placebo or no treatment, in rotator cuff related pain. Data sources: English articles, searched in Cochrane CENTRAL, MEDLINE, EMBASE and CINAHL databases up until May 19, 2020. Methods: Randomized controlled trials in people with rotator cuff related pain comparing either progressive and resisted exercise or non-progressive and non-resisted exercise, with placebo or no treatment were included. Data extracted independently by two authors. Risk of bias appraised with the Cochrane Collaboration tool. Results: Seven trials (468 participants) were included, four trials (271 participants) included progressive and resisted exercise and three trials (197 participants) included non-progressive or non-resisted exercise. There was uncertain clinical benefit for composite pain and function (15 point difference, 95% CI 9 to 21, 100-point scale) and pain outcomes at >6weeks to 6months with progressive and resisted exercise compared to placebo or no treatment (comparison 1). For non-progressive or non-resisted exercise there was no significant benefit for composite pain and function (4 point difference, 95% CI –2 to 9, 100-point scale) and pain outcomes at >6weeks to 6months compared to placebo or no treatment (comparison 2). Adverse events were seldom reported and mild. Conclusions: There is uncertain clinical benefit for all outcomes with progressive and resisted exercise and no significant benefit with non-progressive and non-resisted exercise, versus no treatment or placebo at >6weeks to 6months. Findings are low certainty and should be interpreted with caution

Item Type:	Article
Peer-reviewed:	Yes
Date Deposited:	24 Jun 2020 11:03
Publisher:	SAGE Publications
Additional Information:	This is an Author Accepted Manuscript of a paper accepted for publication in Clinical Rehabilitation, published by and copyright SAGE Publications. Users who receive access to an article through a repository are reminded that the article is protected by copyright and reuse is restricted to non-commercial and no derivative uses. Users may also download and save a local copy of an article accessed in an institutional repository for the user's personal reference.
Divisions:	Faculties > Health and Education
Subject terms:	progressive exercise, resistance exercise, resistance training, rotator cuff related pain, rotator cuff tendinopathy, shoulder pain, sub-acromial impingement, Humans, Shoulder Pain, Exercise Therapy, Randomized Controlled Trials as Topic, Rotator Cuff Tear Arthropathy, Rotator cuff related pain, progressive exercise, resistance exercise, resistance training, rotator cuff tendinopathy, shoulder pain, sub-acromial impingement, Exercise Therapy, Humans, Randomized Controlled Trials as Topic, Rotator Cuff Tear Arthropathy, Shoulder Pain, 11 Medical and Health Sciences, Rehabilitation
URI:	https://e-space.mmu.ac.uk/id/eprint/625819
DOI:	https://doi.org/10.1177/0269215520934147
ISSN	0269-2155
e-ISSN	1477-0873

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