Therapeutic exercise is an effective intervention for the treatment of painful shoulder conditions; however, subsequent research is necessary for translation into clinical practice, say authors of a meta-analysis published online in Journal of Shoulder and Elbow Surgery.
The authors searched Medline via Ovid, CINAHL, and the Cochrane Central Register of Controlled Trials from 1997 through March 2011. Randomized controlled trials comparing physical therapist-prescribed exercises against any other type of intervention were included. Five separate reviewers qualitatively evaluated the articles using the Physiotherapy Evidence Database scale. Data from included studies were extracted and synthesized with respect to the primary outcomes of range of motion (ROM), pain, and function. Individual effect sizes were calculated with a standard formula, and overall effect was calculated by use of random- and fixed-effects models.
Of the 19 articles that were qualitatively reviewed, 17 achieved the criterion of 6 or better on the Physiotherapy Evidence Database scale. Significant heterogeneity in reporting among included studies limited quantitative assessment. Overall, therapeutic exercise has a positive effect on pain and function above all other interventions. The findings for ROM were inconclusive.