An Update of Systematic Reviews Examining the Effectiveness of Conservative Physiotherapy Interventions for Subacromial Shoulder Pain.
An Update of Systematic Reviews Examining the Effectiveness of Conservative Physiotherapy Interventions for Subacromial Shoulder Pain.
复制标题
系统评价的更新，检查保守物理治疗干预措施对肩峰下疼痛的有效性。
DOI：
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复制
发表时间：
2019
影响因子：
6.1
通讯作者：
F. Struyf
中科院分区：
文献类型：
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作者：
L. Pieters;Jeremy S. Lewis;Kevin Kuppens;J. Jochems;Twan Bruijstens;Laurence Joossens;F. Struyf
研究设计
系统评价。
背景
肩峰下肩痛（SSP）是一种常见的肩关节疾病。管理通常涉及锻炼计划，但可能包括许多其他干预措施。本综述旨在更新Littlewood等人于2013年发表的系统性综述，该综述重点评价了物理治疗范围内干预措施的有效性，包括运动、手动治疗、电疗和联合或多模式方法。
方法
对Pubmed、Web of Science和CINAHL进行了电子检索。使用AMSTAR系统评价检查表评估方法学质量。
结果
检索到16篇系统性综述。方法的质量是可变的。强烈建议将运动疗法作为改善SSP患者疼痛、活动性和功能的一线治疗。强烈建议将手动治疗作为附加治疗进行整合。对于其他常用的处方干预措施，如激光治疗、体外冲击波治疗、脉冲电磁和超声，发现了无影响的中度证据。
结论
使用运动疗法作为SSP干预的证据正在增加和加强。需要进行研究，以提供有关运动类型、剂量、持续时间和预期结果的指导。强烈建议在初始治疗阶段纳入手动治疗。J Orthop Sports Phys Ther，Epub 2019年11月15日。doi：10.2519/jospt.2020.8498。
STUDY DESIGN
Systematic review.
BACKGROUND
Subacromial shoulder pain (SSP) is a frequently diagnosed shoulder complaint. Management often involves an exercise programme but may include many other interventions. The aim of this review is to update the systematic review published by Littlewood et al. in 2013, which focused on evaluating the effectiveness of interventions within the scope of physiotherapy including exercise, manual therapy, electrotherapy and combined or multimodal approaches.
METHODS
An electronic search of Pubmed, Web of Science and CINAHL was undertaken. Methodological quality was assessed using the AMSTAR-checklist for systematic reviews.
RESULTS
Sixteen systematic reviews were retrieved. Methodological quality was variable. A strong recommendation can be made for exercise therapy as first-line treatment to improve pain, mobility and function in patients with SSP. Manual therapy may be integrated, with strong recommendation, as additional therapy. Moderate evidence of no effect was found for other commonly prescribed interventions, such as laser therapy, extracorporeal shock wave therapy, pulsed electromagnetic and ultrasound.
CONCLUSIONS
Evidence for the use of exercise therapy as an intervention for SSP is increasing and strengthening. Ongoing research is required to provide guidance on exercise type, dose, duration and expected outcomes. A strong recommendation may be made regarding the inclusion of manual therapy in the initial treatment phase. J Orthop Sports Phys Ther, Epub 15 Nov 2019. doi:10.2519/jospt.2020.8498.