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No strong evidence that the addition of joint mobilisation to an exercise programme improves outcomes for shoulder dysfunction
  1. Brent D Leininger1,
  2. Steven J Kamper2,3
  1. 1Wolfe-Harris Center for Clinical Studies, Northwestern Health Sciences University, Bloomington, Minnesota, USA
  2. 2EMGO+ Institute, VU University, Amsterdam, The Netherlands
  3. 3Musculoskeletal Division, The George Institute for Global Health, Sydney, New South Wales, Australia
  1. Correspondence to Brent D Leininger, Wolfe-Harris Center for Clinical Studies, Northwestern Health Sciences University, Bloomington, MN 55431, USA; bleininger{at}

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Shoulder pain is a common musculoskeletal complaint affecting approximately 18–31%1 of the population each month. Only 50–60% of those with shoulder pain completely recover in the year after onset.2 ,3 Shoulder disorders are responsible for substantial disability, healthcare costs and work absenteeism.4 ,5 Societal costs due to shoulder pain are large with work loss accounting for 50–80% of total costs.6 ,7 Thus, identifying effective interventions for shoulder pain is an important priority.


The authors’ primary aim was to determine the effectiveness of the addition of joint mobilisation to a therapeutic exercise programme in individuals with shoulder dysfunction.

Searches and inclusion criteria

The authors included all randomised clinical trials evaluating joint mobilisation and therapeutic exercise for adults with shoulder dysfunction. Trials including individuals with complete rotator cuff tears, shoulder pain of cervical or neurological origin or a history of shoulder surgery were excluded. Methodological quality was assessed using a 24-item checklist covering …

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  • ▸ Brudvig TJ, Kulkarni H, Shah S. The effect of therapeutic exercise and mobilisation on patients with shoulder dysfunction: a systematic review with meta-analysis. J Orthop Sports Phys Ther 2011;41:734–48.

  • Contributors BDL and SJK contributed to the conception and interpretation of data, drafting and critical revision for intellectual content and final approval of the published version.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.