Treatment of shoulder injuries: effect and grading the quality of evidence
| Injury | Effect | Effect size | ||
| Large | Moderate | Small | ||
| Subacromial impingement | ||||
| Intervention including shoulder specific warm-up and exercises versus no intervention; n=30, male baseball51 | Within-in group baseline and follow-up scores (SD) of pain (NRS) Intervention 7.88 (1.02) to 3.56 (1.31) Control 7.71 (0.83) to 8.00 (0.88) | Moderate quality of evidence | ||
| Intervention including strengthening exercises (no comparator group); n=47; male/female mixed sports55 | Within-in group baseline and follow-up scores (SD) of pain and function (SPADI) 29.86 (17.03) to 11.7 (13.78) | Very low quality of evidence | ||
| Supraspinatus tendinopathy | ||||
| Interventions including hyperthermia or ultrasound versus passive stretches; n=37, male/female mixed sports54 | Within-in group baseline and follow-up scores (SD) of pain (VAS) Hyperthermia 5.96 (0.83) to 1.2 (0.63) Ultrasound 6.3 (0.86) to 5.15(0.87) Passive stretches 6.1(0.89) to 4.9(0.88) | Moderate quality of evidence | ||
| Interventions including hyperthermia or ultrasound versus passive stretches; n=37, male/female mixed sports54 | Within-in group baseline and follow-up scores (SD) of physical function (Constant and Murley score) Hyperthermia 58.6 (3.9) to 82.0 (5.7) Ultrasound 58.9(2.8) to 61.8(4.2) Passive stretches 59.5 (2.7) to 63.3 (5.6) | Moderate quality of evidence | ||
| Shoulder pain | ||||
| Intervention including anteroposterior mobilisation of the shoulder joint vs manual treatment versus attention; n=31, male/female overhead athletes52 | Within-group changes (95% CI) of pain (NRS) Mobilisation 0.6 (0.1 to 1.1) Manual treatment 0.0 (0.0 to 0.3) Attention 0.2 (−0.2 to 0.7) | Moderate quality of evidence | ||
| Intervention including anteroposterior mobilisation of the shoulder joint versus manual treatment versus attention; n=31, male/female overhead athletes52 | Within-group changes (95% CI) of physical function (DASH) Mobilisation 0.3 (−2.7 to 3.4) Manual treatment 0.5 (−0.3 to 1.3) Attention 0.7 (−0.6 to 2.0) | Moderate quality of evidence | ||
| Intervention including posture correcting exercises versus no intervention; n=28, swimming53 | Within-in group baseline and follow-up scores (SD) of physical function and pain (ASES) Intervention Right shoulder: 89.1 (11.2) to 89.3 (14.6) Left shoulder: 89.9 (11.4) to 91.1 (10.6) Control Right shoulder: 90.8 (11.7) to 86.4 (17.9) Left shoulder: 90.7 (12.4) to 86.9 (15.5) | Low quality of evidence | ||
| Intervention include strengthening exercises (no comparator group); n=29, male/female overhead athletes56 | Within-in group baseline and follow-up scores (SD) of pain (VAS) 3 months follow-up: 7.5 (2.3) to 3.4 (1.8) 6 months follow-up: 7.5 (2.3) to 2.9 (2.1) | Very low quality of evidence | ||
| Intervention including scapula-focused stretching and strengthening exercises (no comparator group); n=31, male/female volleyball57 | Within-in group baseline and follow-up scores (SD) of pain (VAS) 3 months follow-up: 7.2 (1.3) to 2.4 (1.8) 6 months follow-up: 7.2 (1.3) to 2.6 (1.4) | Very low quality of evidence | ||
ASES, The American Shoulder and Elbow Surgeons Shoulder Score; DASH, Disabilities of the Arm, Shoulder, and Hand; NRS, Numeric Rating Scale; SPADI, Shoulder Pain and Disability Index; VAS, Visual Analogue Scale.