Scapula-focused approaches in patients with shoulder pain
Shoulder pain is notoriously common in the general population, and has widespread impacts from pain and functional limitations to chronic disability. It is readily accepted that active treatment is a primary focus of rehabilitation. However, current evidence is conflicting regarding best available treatments, including current scapula-focused approaches (SFA).
Scapular dyskinesia is often thought to be a contributing factor in shoulder pathology and thus is often a focus of treatment. Unfortunately, it has not been established how SFA compares to general exercise. The current systematic review and meta-analysis strives to draw conclusions on the current state of evidence as it applies to SFA.
The study focused on adults presenting with rotator cuff pathology with focus on pain, disability, and scapular mechanics. Study quality was assessed and recurring themes of heterogeneity and bias resulted in methodological concern.
Pain was found to have statistical, but clinically insignificant effects. Disability effects were found to have both a statistical and clinically significant effects in short term. Only 1 study reported on treatment effects at 3 months, however was found not statistically significant. Scapular biomechanics were shown to have conflicting evidence across all studies. This result was not surprising given its reliance on subjective interpretation.
The authors of this study alluded to the potential effects SFA have over general exercises. However, acknowledgements toward the challenges presented mainly reflect a body of evidence that is conflicted and in need of higher quality studies.
> From: Bury et al., Man Ther 25 (2017) 35-42. All rights reserved to Elsevier Ltd. Click here for the online summary.