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. 2018 Jun;13(3):335–378.
First Author (Year) Follow-up Period Outcome Scale Treatment groups (n = ) Intragroup difference Statistically significant (*clinical significance) Between group difference Statistically significant
Itoi (1992)109 3.4 yr (1 – 9 yr) -Wolfgang criteria Groups based off symptom duration
G1: < 3 wk (15)
G2: 3 wk – 3 mo (19)
G3: 3 mo – 12 mo (19)
G4: 12 mo (9)
(Pre→post)
Wolfgang criteria (points):
G1: 12.1 → 14.3
G2: 11.2 → 13.5
G3: 11.4 → 13.9
G4: 11.9 →12.5
(Post)
G1: p<0.05
G2: p<0.01*
G3: p<0.01*
G4: p>0.05 (NS)
NR NR
Bokor (1993)105 7.6 yr (3.7 - 12 yr) -ASES ADLs
-UCLA
G1: Non-surgical (53) (Pre→post)
ASES (Percent of cohort ‘mild or no
compromise’ in ADLs):
24.8%→77.4 %
UCLA (points; Avg score):
14.6 → 28.1
(Pre→Post)
ASES (change in points)
G1: + 52.6 > MCID: + 6.4202
UCLA (change in score)
G1: (MCID NA)
NA NA
Hawkins (1995)108 3.8 yr -Constant-Murley G1: Non-surgical (19)
G2: Not satisfied w/ non-surgical (14)
(Post)
Constant-Murley (score change):
G1: + 7.2
G2: -1.1
(Post)
G1: + 7.1 < MCID: + 10.4203
G2: -1.1 < MCID: + 10.4203
(Post)
Constant-Murley (score):
G1: 7.2; G2: -1.1
(Post)
Constant-Murley:
G1 vs G2: p = 0.038*
Wirth (1997)114 >/= 2 yr -UCLA G1: Exercise therapy (60) (Pre→post)
UCLA (score):
13.4→29.4
NR (MCID NA) NA NA
Palmer (1998)101 2 yr -Swimming Aquatic Therapy (1) Demonstrate front crawl 2x40 feet NR NA NA
Yamada (2000)115 4 yr (12 mo-19 yr) -JOAS G1: Non-surgical (14)
G2: Surgery (26)
(Post)
JOAS (Percent improvement):
G1: 21.5%
G2: 25.9%
(Post)
G1: p = 0.0060*
G2: p < 0.0001*
NR NR
Goldberg (2001)107 2.5 yr -SST
-SF-36
G1: Non-surgical (46) (Pre→2.5 yr)
Simple shoulder test (points):
5.6 (+/-3.2)→7.0 (+/-3.8)
Avg Improvement: 1.4(+/-3.6)
SF-36 (points):
Comfort: 48.3→58.5 (+10.1)
Vitality: 60.0→49.6 (-10.4)
Physical function: 60.4→48.3
(-12.2)
General health: 76.4→60.8
(-15.7)
(2.5 yr)
Simple shoulder test:
(p<0.01)*
SF-36:
Comfort: p=0.01*
Vitality: p<0.01*
Physical function: p<0.01*
General health: p<0.01*
NA NA
Shibata (2001)126 24 wk -UCLA G1: 25 mg sodium Hyaluronate & 3
mL 1% lidocaine (38)
G2: 2mg Dexamethasone & 3 mL
1% lidocaine (40)
(Pre→4wk→24wk)
UCLA (points):
G1: 13.6→27.6→26.2
G2: 11.9→26.5→25.3
(24 wk)
G1: 4 & 24 wk: p<0.0001*
G2: 4 & 24 wk: p<0.0001*
NR NR
Vad (2002)120 3.1 yr
(Range: 2-7 yr)
-Shoulder rating questionnaire G1a: PT + meds (28)
G1b: PT + meds + CS (12)
G2: Failed G1a/b arthroscopy (32)
G3: Primary surgery RCT repair (36)
(Pre→post)
SRQ (score):
G1a: 43/100 → 64/100
G1b: 44/100 → 75/100
G2: 44.5/100 →82/100
G3: 35/100 → 84/100
(Post)
SRQ (score):
G1a: p < 0.05*
G1b: p < 0.05*
G2: p < 0.05*
G3: p < 0.05*
(Post)
SRQ (score):
G1a: 64/100; G1b: 75/100
(Post)
SRQ: G1b vs G1a:
p < 0.05
Piccoli (2004)102 7 wk -SPADI
-SF-12
Single case (Pre→7 wk)
SPADI (points): 76→17
SF-12 (points):
PCS: 21.67 → 50.1
MCS: 56.28 → 58.49
(Pre→7 wk)
SPADI (change in points)
(-59) > MCID: + 8 points204
NA NA
Ainsworth (2006)104 Avg: 10.8 mo (Range: 2-36 mo) -ODSQ
-SF-36
G1: Non-surgical (10) (Torbay rehab program) (Pre→3 mo.)
ODSQ: (points)
Avg Score: 34.2 → 23.6
SF-36 (points):
Physical health: 25→35
Emotional health: 80→57
General health: 70→61
NR (MCID NA) NA NA
Levy (2007)116 9 mo -Constant-Murley G1: Non-surgical (17) (Pre→≥9 mo)
Constant Score (Avg score (range)):
26 (8-41)→63 (43-77)
(Pre→≥9 mo)
Constant Score (score change):
G1: + 37 > MCID: + 10.4203
NA NA
Lunn (2007)119 50 mo -Constant-Murley G1: Non-operative (14)
G2: Open repair (5)
(Pre→post)
Constant-murley (points [percent]):
G1: 51 [58.3%]→ 66.6 [75%]
G2: 53.0 [58%]→ 69.5 [75.4%]
(Post)
G1: p = 0.009
G2: p = 0.009
(Post)
Constant-murley (points [percent]):
G1: 66.6 [75%]
G2: 69.5% [75.4%]
(Post)
Constant-murley:
G1 vs G2: p = 0.61 (NS)
Ainsworth (2009)127 12 mo -OSS
-SF-36 physical Function (PF)
-MYMOP
G1: PT + Exercise (30)
G2: Control (Placebo) (no exercise) (30)
(3 mo→6 mo→12 mo)
OSS (score change time 0)
G1: 8.19→9.42→8.96
G2: 3.0→4.43→6.27
SF-36 PF(score change time 0)
G1: 7.78→4.42→5.21
G2: (-)3.5→(-)3.00→(-)3.17
MYMOP (score changed time 0)
G1: 1.03→1.27→1.02
G2: 0.46→0.67→1.08
NR (MCID NA) (3 mo→6 mo→12 mo)
OSS (score change)
G1: 8.19→9.42→8.96
G2: 3.0→4.43→6.27
SF-36 PF (score change)
G1: 7.78→4.42→5.21
G2: (-)3.5→(-)3.00→(-)3.17
MYMOP (score changed)
G1: 1.03→1.27→1.02
G2: 0.46→0.67→1.08
OSS: G1 vs G2:
3 mo: p = 0.002
6 mo: p = 0.008
12 mo: p = 0.16 (NS)
SF-36 PF: G1 vs G2:
3 mo: p = 0.005
6 mo: p = 0.136 (NS)
12 mo: p = 0.049
MYMOP: G1 vs G2:
3 mo: p = 0.052
6 mo: p = 0.047
12 mo: p = 0.847 (NS)
Baydar (2008)118 6 mo, 1 yr, 3 yr (Pt. report) -ASES
-Constant- Murley
-SF-36
G1: Non-surgical (20) (Pre→6 mo→1 yr→ 3yr)
ASES (points):
24.95→44.15→42.44→43.28
(Pre→ 6 mo)
Constant-Murley (points):
52.10→ 76.35
SF-36 (points):
Physical function: 48.75→82.5
Physical role: 11.25→78.75
Social functioning: 87.5→99.37
(All-time points)
ASES: P < 0.01*
(6 mo)
Constant-Murley: p<0.01*
SF-36:
Physical function: p < 0.001*
Physical role: p < 0.001*
Social functioning: p < 0.044
NA NA
Moosmayer (2010/2014)47,48 6mo, 1yr, 2yr 5 yr -ASES
-Constant-Murley
-SF-36
G1: Surgical (52)
G2: PT (51)
†G3: G2→F1 (12)
†G4: PT only (39)
(Pre→6 mo→1 yr→ 5 yr)
ASES (points):
G1: 45.5→85.3→93.6→92.8
G2: 48.2 →35.4 →83.6 →85.4
G3: 40.3
G4: 50.6
Constant-Murley (points):
G1: 35.3 →65.6 →77.7 →79.8
G2: 38.4 →63.9 →70.3 →74.2
SF-36 (points):
G1: 38.2 →48.3 →51.2 →50.1
G2: 38.6 →47.3 →50.3 →48.4
(Pre→5 yr)
ASES (point change):
G1: + 47.3 > MCID: + 6.4202
G2: + 37.2 > MCID: + 6.4202
Constant (point change ):
G1: + 44.5 > MCID: + 10.4203
G2: + 35.8 > MCID: + 10.4203
SF-36 (points): (MCID NA)
(Pre)
ASES (points):
G3: 40.3; G4: 50.6
(5 yr)
ASES (points):
G1: 92.8; G2: 85.4
Constant-murley (points):
G1: 79.8
G2: 74.2
G3: 73.3
G4: 70.1
SF-36 (points):
G1: 50.1
G2: 48.4
(Pre)
ASES:
G4 vs G3: P < 0.05*
(5 yr)
ASES:
G1 vs G2: P < 0.001
Constant-murley:
G1 vs G2: p < 0.01
G4 vs G2: p < 0.01
G3 vs G2: p = 0.23
(NS)
SF-36:
G1 vs G2: p = 0.38
(NS)
Tanaka (2010)113 G1: 2.4 yr G2: 2.2 yr -Constant-Murley G1: Non-surgical
(subjects: 62 shoulders: 65)
G2 Failed G1→surgery
(subjects: 56 shoulders: 58)
(Post)
Constant-Murley Score > 75:
G1: 100% of cohort
G2: NR
NR NR NR
Gialanella (2011)128 6 mo -Constant-Murley G1: PT & CS (x1) (20)
G2: PT & CS (x2) (20)
G3: PT (control) (20)
(Pre→3 mo→ 6 mo)
Constant-Murley (Total score):
G1: 23.7 →34.7 →28.0
G2: 24.8 →35.6 →29.2
G3: 30.5 →30.7 →29.9
(3 mo)
AROM sub-score:
G1 & G2: P < 0.001
(6 mo)
AROM sub-score:
G1: p < 0.05
G2: p < 0.001
(Pre→3 mo→ 6 mo)
Constant-Murley (Total
score):
G1: 23.7 →34.7 →28.0
G2: 24.8 →35.6 →29.2
G3: 30.5 →30.7 →29.9
(All time points)
p = NS
Merolla (2011)1 12 mo. -Constant-Murley
-Prediction scale
G0: Conservative therapy (60)
G1: ‘Successful’ (33)
G2: G0→ surgery (27)
(Pre→3 mo→6 mo→12 mo)
Constant-Murley (total score):
G0: 46.3→62.3→60.2→ (G1) 61.9
Prediction score (out of 21):
G1: range: 10.6 - 12.8/21
G2: range: 15.2-17.3/21
(3 mo, 6 mo, 12 mo)
Constant-Murley (total score):
G0: p<0.01*
Kijma (2012)110 12.9 yr -JOAS G1: 43 (Post)
JOAS (avg score): 9.4/10
No disturbance to ADLs (n = ): 31 (72%)
NR NR NR
Krischak (2013)124 2 mo -Constan-Murley
-EQ-5D
G1: Standard OT (22)
G2: Home exercises (16)
(Pre→2 mo)
Constant-Murley (points):
G1: 60.6→75.5
G2: 60.1→73.8
EQ-5D quality of life index (points):
G1: 0.97 →0.926
G2: 0.885 →0.933
EQ-5D status of health (points:)
G1: 53.8 →71.6
G2: 58.6 →61.8
(Pre→2 mo)
Constant (score change):
G1: + 14.9 > MCID: + 10.4203
G2: + 13.7 > MCID: + 10.4203
(2 mo)
Constant-Murley (points):
G1: 75.5; G2: 73.8
EQ-5D quality of life index (points):
G1: 0.926; G2: 0.933
EQ-5D status of health (points):
G1: 15.6; G2: 61.8
(Pre→2 mo)
EQ-5D status of health (point difference):
G1: 17.8; G2: 3.2
(2 mo)
Constant-Murley
G1 vs G2: p = 0.824
(NS)
EQ-5D QOL index:
G1 vs G2: p = 0.656
(NS)
EQ-5D health status:
G1 vs G2: p = 0.128
(NS)
(Pre→2 mo)
EQ-5D health status:
G1 vs G2: p < 0.05*
Kuhn (2013)40 1 yr -SF-12 MCS
-SF-12 PCS
-ASES
-WORC score
-SANE score
-SA scale
G0: PT program (422, 100%)
G1: Cured (237, 62.2%) (no formal f/u
scheduled)
G2: Improved (continue PT)
G3: No better (82, 26%)
(offered surgery)
(Pre→6 wk→12 wk)
SF-12 MCS:
G0: 40.26→40.57→40.84
SF-12 PCS:
G0: 35.34→35.64→36.01
ASES
G0: 54.47→77.98→83.67
WORC scale:
G0: 47.16→62.52→69.67
SANE scale:
G0: 46.6→62.73→70.27
SA scale:
G0: 9.89→10.15→10.01
(6 wk)
SF-12 MCS: p = 0.36 (NS)
SF-12 PCS: p<0.0001
ASES: p<0.0001*
WORC scale: p<0.0001*
SANE scale: p<0.0001*
SA scale: p = 0.096 (NS)
(12 wk)
SF-12 MCS: p = 0.895 (NS)
SF-12 PCS: p < 0.0001
ASES: p < 0.0001*
WORC scale: p < 0.0001*
SANE scale: p < 0.0001*
SA scale: p = 0.47 (NS)
NR NA
Benazzo (2014)99 29 mo -SST
-Constant-Murley
Non-surgical: (1) (1 d→40 d→80 d)
SST: 2→8→12
Constant-Murley: 44→57→100
(1 d→80 d)
SST (Score change):
- + 10 > MCID: + 2.0
Constant-Murley: (score change)
- + 76 > MCID: + 10.4203
NA NA
Boorman (2014)123 29 mo -RC-QOL G0: 3 mo supervised,
non-operative§
G1: “Successful” (no surgery) (70; 75%)
G2: “failed” (underwent surgery)
(23; 25%)
(Pre→3 mo→12 wk)
RC-QOL score (0-100)
G1: 49→82→80
G2: 33→38→NR
NR (MCID NA) (Pre)
RC-QOL score (0-100):
G1: 49 ± 21 (range: 0-84)
G2: 33 ± 15 (range: 6-66)
(Pre)
RC-QOL: G1 vs G2:
p<0.05 (P = 0.017*)
Güzelant (2014)117 66 mo (mean) -ASES
-UCLA
G1: “Conservative therapy” (33) (Pre→Post)
ASES (score): 25.4→86.7
UCLA (score): 10.6→25.6
(Post)
ASES: P < 0.05 (p = 0.0218*)
UCLA: P < 0.05 (p = 0.0314*)
NA NA
Kukkonen (2014/2015)52,125 24 mo -Constant-Murley
-Constant-Murley ADL subscale
-Satisfaction
G1: PT (55)
G2: Acromioplasty & PT (58)
G3: RC repair, acromioplasty & PT (54)
(Pre→12 mo→ 24 mo)
Constant-Murley (score):
G1: 57.8→74.1→76.2
G2: 59.6→77.2→80.1
G3: 58.0→77.9→80.6
Constant-Murley ADL subscale
(score):*
G1: 9.5→13.0→14.0→15.0
G2: 9.0→16.0→16.6→17.2
G3: 9.5→15.8→17.5→18.1
(24 mo)
Satisfied (percent of cohort):
G1: 89%; G2: 95%; G3: 94%
(Pre→12 mo→ 24 mo)
Constant-Murley (score):
G1: + 18.4 > MCID: + 10.4203
G2: + 20.5 > MCID: + 10.4203
G3: + 22.6 > MCID: + 10.4203
(12 mo)
Constant-Murley (score):
G1: 74.1
G2: 77.2
G3: 77.9
(Pre→24 mo)
Change in Constant-Murley
(points):
G1: 18.4; G2: 20.5; G3: 22.6
(12 mo; 24 mo)
Constant-Murley ADLs
(score):*
G1: 14.0; 15.0
G2: 16.6; 17.2
G3: 17.5; 18.1
(24 mo)
Satisfied (percent of cohort):
G1: 89%; G2: 95%; G3: 94%
(12 mo)
Constant-Murley:
G1 vs G2 vs G3:
p = 0.34 (NS)
(24 mo)
Change in Constant-murley:
G1 vs G2 vs G3:
p>0.05 (NS)
(12 mo)
Constant-murley ADLs
(score):*
G1 vs G2/G3*:
p<0.0001
(24 mo)
Constant-murley ADLs
(score):*
G1 vs G2/G3*:
p<0.01
(24 mo)
Satisfaction:
G1 vs G2 vs G3:
p=0.28 (NS)
Collin (2015)106 24 mo -Constant-Murley G1: “Rehab program”
(45) (nonoperative)
(Pre→post)
Constant-Murley (score): 43→56
(Post) p < 0.05 NA NA
Lambers Heerspink (2015)49 12 mo -Constant-Murley
-DSST
-Disability VAS
G1: “Conservative
Management” (31)
G2: RC repair (25)
(Pre→12 mo)
Constant-Murley (score):
G1: 56.9→73.7
G2: 55.6→81.9
DSST (score):
G1: 6.1→9.7
G2: 5.5→11.0
Disability VAS (cm):
G1: 5.8→3.5
G2: 6.2→2.1
(Pre→12 mo)
Constant (score change):
G1: + 16.8 > MCID: + 10.4203
G2: + 26.3 > MCID: + 10.4203
DSST (score change):
G1: + 3.6 > MCID: + 2.0203
G2: + 5.5 > MCID: + 2.0203
(12 mo)
Constant-Murley (score):
G1: 73.7; G2: 81.9
DSST (score):
G1: 9.7; G2: 11.0
Disability VAS (cm):
G1: 3.5; G2: 6.2→2.1
(12 mo)
Constant-Murley:
G1 vs G2: p > 0.05
(NS)
DSST: G1 vs G2:
p > 0.05 (NS)
Disability VAS:
G1 vs G2: p = 0.02*
Baumer (2016)121 ≥9 wk -WORC G1: PT (25)
G2: Healthy controls (25)
(Pre→≥9 wk)
WORC (score):
G1: 40.6→70.3
G2: 98.2
(Pre→≥9 wk)
WORC: G1: p<0.01*
(≥9 wk)
WORC (score):
G1: 70.3; G2: 98.2
(≥9 wk)
WORC: G1 vs G2:
p < 0.01*
Christensen (2016)122 ≥5 mo -OSS
-EQ-5D
G1: Non-operative (30)
G2: Control (30)Δ
(Pre→3 mo→≥5 mo)
OSS (score):
G1: 26.0→34.2→37.7
(Pre→≥5 mo)
EQ-5D (median score):
G1: 0.671 → 0.755
(Pre→3 mo)
OSS (score): G1: p < 0.05*
(3 mo →5 mo)
OSS (score): G1: p < 0.05*
(Pre→≥5 mo)
EQ-5D: G1: p = 0.009
NR NA
Miller (2016)111 12 wk -ASES
-WORC
-DASH
G1: Exercise therapy (5) (Pre→12 wk)
ASES (score): 50.7→88.1
DASH (score): 35→5.6
WORC (score): 1198.8→344.8
(12 wk)
ASES (score): p = 0.043*
DASH (score): p = 0.047*
WORC (score): p = 0.02*
NA NA
Mischke (2016)100 13 visits (time NR) -GROC
-Quick DASH
Conservative therapy (1) (Pre→visit 10→ visit 13)
GROC (score): NR→+3→+5
Quick DASH (score):
65.9→43.2→31.8
(Pre→visit 10→ visit 13)
GROC (score change):
+2 = MCID + 2
Quick DASH (score change):
+34.1 > MCID: 10.0203
NA NA
Upadhyaya (2016)103 10 yr -NR Non-operative treatment (1) NR NR NA NA
Moosmayer (2017)112 8.8 yr -Constant- Murley
-ASES
-SF-36 PHSS
-SF-36 MHSS
G1: Non-operative (49)
G1a: Tear size < 9.9 mm (33)
G1b: Tear size 10-19.9 mm (8)
G1c: Tear Size ≥ 20 mm (8)
(≥ 8.8 yr)
Constant-Murley (score):
G1a: 82.0; G1b: 81.0; G1c: 58.5
ASES (score):
G1a: 90.0; G1b: 82.5; G1c: 60.0
SF-36 PHSS (score):
G1a: 51.5; G1b: 50.5; G1c: 46.0
SF-36 MHSS (score):
G1a: 59.8; G1b: 61.1; G1c: 58.5
NR (≥ 8.8 yr)
Constant-Murley (score):
G1a & G1b: 81.0
G1c: 58.5
ASES (score):
G1a & G1b: 90.0
G1c: 60.0
SF-36 PHSS (score):
G1a & G1b: 51.5
G1c: 46.0
SF-36 MHSS (score:)
G1a & G1b: 59.9
G1c: 58.5
(≥ 8.8 yr)
Constant-Murley (score):
G1a & G1b vs G1c:
P = 0.008*
ASES (score):
G1a & G1b vs G1c:
P = 0.02*
SF-36 PHSS (score):
G1a & G1b vs G1c:
P = 0.14 (NS)
SF-36 MHSS (score):
G1a & G1b vs G1c:
P = 0. 53 (NS)

ASES, american shoulder and elbow surgeons index; ADLs, activities of daily living; Avg, average; Constant-murley, constant murley shoulder outcome score; CS, corticosteroid; DASH, disabilities of the arm, shoulder, and hand outcome measure; DSST, Dutch simple shoulder test; EQ-5D, EuroQol questionnaire; G, group; GROC, global rating of change; JOAS, Japanese orthopedic association score; MCID, minimally clinically important difference; MCS, mental component score; Mo, month; MYMOP, measure yourself medical outcome profile; NA, not applicable; NR; not reported; NS, not statistically significant; ODSQ, Oxford disability shoulder questionnaire; OSS, Oxford shoulder score; PCS, physical component score; PT, physical therapy; RC-QOL, rotator cuff quality of life index instrument; SA scale, shoulder activity scale; SANE score, single assessment numeric evaluation; SF-12, 12 item short form survey; SF-36, 36 item short form survey; SST, simple shoulder test score; UCLA, University of California Los Angeles shoulder rating scale; VAS, visual analog scale; wk, week; WORC, Western Ontario rotator cuff index; yr, year; *, clinical significance, indicates a statistical significant difference and a ≥20% difference; , G3 and G4 are a subset of G2; , all subjects began a physical therapy program and were reevaluated at 6 and 12 weeks, at those times patient were assigned to G1, G2, or G3 based on findings; §, all subjects underwent a 3 mo supervised program of non-operative treatment & with an evaluated by orthopedic surgeon and assigned to G1 or G2; *, values estimated to nearest tenth based off graphical representation, as no specific numerical values reported