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 |
| Onset: | | | |
| Not stated | | | |
| Duration of symptoms prior to treatment: | | | |
| Not stated | | | |
Bokor et al (1993)25 | 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 | | | |
| Onset: | | | |
| Trauma 40 patients | | | |
| Duration of symptoms prior to treatment: | | | |
| 39 no history of symptoms prior to onset. | | | |
| < 3 months – 28 patients | | | |
| 3–6 months – 9 patients | | | |
| > 6 months – 16 patients | | | |
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 | | | |
| Duration of symptoms prior to treatment: | | | |
| No acute tears (time not specified) | | | |
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 | | |
| Non-traumatic 12 | Drop arm sign | | |
| 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 | | |
| Group II: 28.8 (SD = 23.9) months | | | |
| Group III: 71.0 (SD = 48.3) months | | | |
Itoi and Tabata (1992)29 | 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 | | |
| Duration of symptoms prior to treatment: | Muscle atrophy | | |
| Acute tears (<3 weeks) [15 shoulders] | Night pain | | |
| 3 weeks to 3 months [19 shoulders] | Motion pain | | |
| 3 months to 12 months [19 shoulders] | Arthrogram confirmation of rotator cuff tear | | |
| > 12 months [9 shoulders] | 6 patients with traumatic anterior dislocation of the shoulder were also included | | |
Koubaa et al (2005)30 | 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 | | 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 |
| | Subjective benefit rated as: effective or very effective, little effect, not effective | | Proprioceptive exercises |
| | Returned to work on other functional activities | | Education (avoid shoulder flexion and sustained or repetitive overhead activities). |
| | All patients had refused surgical repair | | Biofeedback exercises |
| | 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) | | Phase II: Overhead curl |
| Onset: | MRI confirmation of FTT supraspinatus | | Commenced at week 8 |
| Head-on motor vehicle collision | | | Patient seen on 10 occasions in clinic and continued programme at home in own therapeutic pool |
| Duration of symptoms prior to treatment: | | | |
| 6.5 months | | | |
Piccoli and Hasson (2004)32 | Single case study | Clinical inclusion: | | 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 | | 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 | | Phase III |
| 1 week | Scapular symmetry | | Functional exercises, proprioceptive neuromuscular facilitation. |
| | Range of movement | | |
| | VAS (pain) | | |
| | Shoulder muscle strength | | |
| | MRI confirmation of FTT supraspinatus (5.0 cm) | | |
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: | | | |
| Mean 44 months (range 12 months to 11 years) | | | |