Specifik eller generel træningsstrategi for subakromialt smerte syndrom - har det en betydning? Et systematisk litteratur review og metaanalyse

Alison R. Shire, Thor B. Stæhr, Mathias B. Dahl, Jesper B. Overby, Julie Sandell Jacobsen, David H. Christiansen

Publikation: Bidrag til tidsskriftTidsskriftsartikelForskningpeer review


Background: Exercise is frequently suggested as a treatment option for patients presenting with symptoms of
subacromial impingement syndrome. Some would argue implementing a specific exercise strategy with special
focus on correction of kinematic deficits would be superior to general exercise strategy. There is however a lack of
evidence comparing such exercise strategies to determine which is the most effective in the treatment of
subacromial impingement syndrome. The aim of this review is to evaluate whether implementing specific exercise
strategies involving resistive exercises are more effective than a general exercise strategy for the treatment of
patients with subacromial impingement syndrome.

Methods: Randomized controlled trials were identified through an electronic search on PubMed/MEDLINE,
EMBASE, Cochrane Central Register of Controlled Trials, Web of Science and PEDro. In addition, article reference lists
and Clinicaltrials.gov were searched. Studies were considered eligible if they included interventions with resistive
specific exercises as compared to general resistance exercise. Four reviewers assessed risk of bias and
methodological quality guided by Cochrane recommendations. Results were synthesised qualitatively or
quantitatively, where appropriate.

Results: Six randomized controlled trials were included with 231 participants who experienced symptoms of
subacromial impingement syndrome. Four studies evaluated the effectiveness of specific scapular exercise strategy
and two studies evaluated the effectiveness of specific proprioceptive strategy. Five studies were of moderate
quality and one study was of low quality. No consistent statistical significant differences in outcomes between
treatment groups were reported in the studies. Standardized mean difference (SMD) for pain was SMD −0.19 (95%
CI −0.61, 0.22) and SMD 0.30 (95% CI −0.16, 0.76) for function.

Conclusions: There is insufficient evidence to support or refute the effectiveness of specific resistive exercise
strategies in the rehabilitation of subacromial impingement syndrome. More high quality research is needed to
accurately assess this. This review provides suggestions on how to improve the methodological design of future
studies in this area.

Keywords: Impingement, Subacromial, Shoulder, Physiotherapy, Training, Function, Pain
Bidragets oversatte titelSpecifik eller generel træningsstrategi for subakromialt smerte syndrom - har det en betydning?: Et systematisk litteratur review og metaanalyse
TidsskriftBMC Musculoskeletal Disorders
Udgave nummer158
Sider (fra-til)1-18
Antal sider18
StatusUdgivet - 17 apr. 2017


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