Ainsworth (2006)24
|
10 patients |
Clinical inclusion: |
Neurological abnormality affecting the shoulder complex |
Defined programme involving: |
|
Mean age 76 years |
all or some of |
Potentially operable RC tears |
Active anterior deltoid strengthening, scapular exercises, patient education, adaptation, proprioception, home programme |
|
(range 70‐83 years) |
positive humeral thrust on elevation, |
Patients involved in industrial claim or litigation |
1 x 30 minute treatment each week for 4 weeks |
|
6 female |
gross weakness and wasting of the supraspinatus and infraspinatus, infraspinatus lag, rupture of long head biceps |
|
Then at 2–3 weekly intervals |
|
4 male |
Ultrasound confirmation of massive rotator cuff tear (defined as leading edge of tear retracted past glenoid margin) |
|
Duration and number of treatments not stated |
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Onset: |
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|
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Not stated |
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Duration of symptoms prior to treatment: |
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Not stated |
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Bokor et al (1993)25
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53 patients from initial group of 80 patients. |
Clinical inclusion: |
Previous or subsequent surgery on the involved shoulder |
NSAIDs |
|
Mean age at onset 62.2 years |
Pain and / weakness |
|
Strengthening and stretching |
|
(range 45–83 years) |
Nonoperative course of treatment chosen by patient and clinician |
|
Corticosteroid injections (16 shoulders) |
|
13 female |
Arthrogram confirmation of rotator cuff tear |
|
15 of these continued to have pain at final review |
|
40 male |
|
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Onset: |
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|
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Trauma 40 patients |
|
|
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Duration of symptoms prior to treatment: |
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|
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39 no history of symptoms prior to onset. |
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< 3 months – 28 patients |
|
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3–6 months – 9 patients |
|
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> 6 months – 16 patients |
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Goldberg et al (2001)26
|
46 patients |
Clinical inclusion: |
Workers compensation claim |
Education |
|
Mean age 65 years |
None stated |
Previous surgery |
Home strengthening and stretching programme |
|
(SD+11 years) |
Elective nonoperative management. |
|
Strengthening involving: rotator cuff specific exercises, |
|
24 female |
Ultrasound, MRI or arthrogram confirmation of non‐acute full thickness rotator cuff tear |
|
Progressive supine press |
|
22 male |
|
|
Stretching involving: |
|
Onset: |
|
|
flexion, external and internal rotation and cross‐body adduction |
|
Not stated |
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|
|
Duration of symptoms prior to treatment: |
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|
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No acute tears (time not specified) |
|
|
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Hawkins and Dunlop (1995)27
|
33 patients available for follow‐up (from initial group of 50) |
Clinical inclusion: |
|
Supervised exercises over a 4‐month period, and home programme, including: |
|
Mean age 59.6 years |
Not stated |
|
Internal and external rotation (with rubber tubing), short and long arc active flexion‐extension exercises, |
|
6 female |
Clinical assessment: |
|
Scapular retraction, supraspinatus drill, diagonal proprioneuromuscular facilitation patterns with weights |
|
27 male |
Muscle wasting |
|
Strengthening exercises and proprioceptive patterning |
|
Onset: |
‘Pop‐eye' deformity |
|
|
|
Traumatic 21 |
Active and passive movement |
|
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Non‐traumatic 12 |
Drop arm sign |
|
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Duration of symptoms prior to treatment: |
Strength tests |
|
|
|
1 month to 30 years |
Double contrast arthrogram confirmation of rotator cuff tear |
|
|
Heers et al (2005)28
|
34 patients recruited |
Clinical inclusion: |
X‐ray or MRI finding of subacromial spur |
Home‐based graduated exercise programme involving: 3 warm‐up exercises, 4 stretching exercises, 5 strengthening exercises |
|
23 female |
Neer Impingement Sign |
Younger than 40 years |
The home programme required 40 minutes per day for 12 weeks |
|
13 male |
and / or |
Older than 70 years |
|
|
Mean age 60.4 years (range 44–69) |
Hawkins and Kennedy Test |
Previous surgery |
|
|
Onset: |
Clinical assessment |
No analgesia permitted during 12‐week programme |
|
|
Not stated |
Range of movement: |
|
|
|
Duration of symptoms prior to treatment: |
external rotation, flexion, abduction |
|
|
|
Group I: 30.4 (SD = 34.5) months |
Ultrasound |
|
|
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Group II: 28.8 (SD = 23.9) months |
|
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Group III: 71.0 (SD = 48.3) months |
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Itoi and Tabata (1992)29
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114 patients (124 shoulders) recruited |
Clinical inclusion: |
Fracture or fracture dislocation of shoulder |
Various combinations of: rest, NSAIDs, steroid injection (repeated to a maximum of 4 times) |
|
55 Female |
None stated |
|
After the symptoms had subsided: active and passive range of motion, and muscle strengthening exercises started |
|
59 Male |
Clinical assessment: |
|
Mean treatment period: 26 months (range 1–83 months) |
|
Onset: |
Impingement test |
|
|
|
Not stated |
Palpation tenderness |
|
|
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Duration of symptoms prior to treatment: |
Muscle atrophy |
|
|
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Acute tears (<3 weeks) [15 shoulders] |
Night pain |
|
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3 weeks to 3 months [19 shoulders] |
Motion pain |
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3 months to 12 months [19 shoulders] |
Arthrogram confirmation of rotator cuff tear |
|
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> 12 months [9 shoulders] |
6 patients with traumatic anterior dislocation of the shoulder were also included |
|
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Koubaa et al (2005)30
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Case series of 24 patients |
Clinical inclusion: |
|
Analgesics for mild pain, analgesics and NSAID (Piroxicam 20 mg/day for 14 days) for stronger pain |
|
15 female |
None stated |
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Corticosteroid injection if medications did not reduce pain |
|
9 male |
Clinical assessment |
|
When pain was controlled rehabilitation programme commenced (3 times per week for 2 months) |
|
Mean age 59 years (range 44–83 years) |
Pain at rest |
|
This included: |
|
Onset: |
Pain with activity |
|
Pulsed ultrasound for 10 minutes and cervical massage prior to each treatment |
|
Chronic degenerative changes |
Pain at night |
|
Passive range of movement exercises. |
|
Duration of symptoms prior to treatment: |
Range of movement |
|
Humeral head depressor exercises (pectoralis major and latissimus dorsi). |
|
Mean 9.1 (SD = 12.3) months (range 3–32 months) |
Impairment (VAS) |
|
Abduction exercises |
|
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Subjective benefit rated as: effective or very effective, little effect, not effective |
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Proprioceptive exercises |
|
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Returned to work on other functional activities |
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Education (avoid shoulder flexion and sustained or repetitive overhead activities). |
|
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All patients had refused surgical repair |
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Biofeedback exercises |
|
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Ultrasound |
|
|
Palmer (1998)31
|
Single case study |
Clinical inclusion: |
None stated |
Active water‐based exercises including stretching and strengthening and swimming for 3.5 months, divided into two phases |
|
1 female |
None stated |
|
Phase I: Water‐based progressive resistance exercises, range of movement exercises, breast‐stroke |
|
78 years |
(Recommendation for surgery following medical examination) |
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Phase II: Overhead curl |
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Onset: |
MRI confirmation of FTT supraspinatus |
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Commenced at week 8 |
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Head‐on motor vehicle collision |
|
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Patient seen on 10 occasions in clinic and continued programme at home in own therapeutic pool |
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Duration of symptoms prior to treatment: |
|
|
|
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6.5 months |
|
|
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Piccoli and Hasson (2004)32
|
Single case study |
Clinical inclusion: |
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Physical therapy 3 times per week for 7 weeks (19 visits) |
|
1 female |
Full can test |
|
Phase I |
|
Age 76 years |
Drop arm test |
|
Pulsed ultrasound, isometric shoulder exercises, active assisted movements, isokinetic exercises, scapular exercises, home programme and ice |
|
Onset: |
Neer sign |
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Phase II |
|
Fall |
Clinical assessment: |
|
Isokinetic exercises, scapular exercises, active assisted exercises against gravity, active exercises, free weights, resistance tubing exercises |
|
Duration of symptoms prior to treatment: |
Forward head posture |
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Phase III |
|
1 week |
Scapular symmetry |
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Functional exercises, proprioceptive neuromuscular facilitation. |
|
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Range of movement |
|
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|
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VAS (pain) |
|
|
|
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Shoulder muscle strength |
|
|
|
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MRI confirmation of FTT supraspinatus (5.0 cm) |
|
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Yamada et al (2000)33
|
Case series of 13 patients choosing conservative treatment |
Clinical inclusion: |
|
Weeks 1–3 sling for comfort |
|
5 female |
Not stated |
|
CS injection (1–2/week; up to 15 injections in total) |
|
9 male |
Arthrography |
|
Hotpacks |
|
Mean age 70 years (range 55–81 years) |
|
|
Passive range of movement for flexion and external rotation |
|
Onset: |
|
|
Rotator cuff strengthening exercises |
|
Not stated |
|
|
Injection, heat, exercise, passive movement |
|
Duration of symptoms prior to treatment: |
|
|
|
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Mean 44 months (range 12 months to 11 years) |
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