Article

OBJECTIVE: To critically summarize the effectiveness of physio-therapy in
patients presenting clinical signs of shoulder impingement syndrome. DESIGN:
Systematic review. METHODS: Randomized controlled trials were searched
electronically and manually from 1966 to December 2007.
Study quality was
independently assessed by 2 reviewers using the Physiotherapy Evidence Database
(PEDro) scale. If possible, relative risks and weighted mean differences were
calculated for individual studies, and relative risks or standardized mean
differences for pooled data, otherwise results were summarized in a best evidence
synthesis. RESULTS: Sixteen studies were included, with a mean quality score of
6.8 points out of 10. Many different diagnostic criteria for shoulder impingement
syndrome were applied. Physio-therapist-led exercises and surgery were equally
effective treatments for shoulder impingement syndrome in the long term. Also,
home-based exercises were as effective as combined physiotherapy interventions.
Adding manual therapy to exercise programmes may have an additional benefit on
pain at 3 weeks follow-up. Moderate evidence exists that passive treatments are
not effective and cannot be justified. CONCLUSION:
This review shows an equal
effectiveness of physiotherapist-led exercises compared with surgery in the long
term and of home-based exercises compared with combined physiotherapy
interventions in patients with shoulder impingement syndrome in the short and
long term; passive treatments cannot be recommended for shoulder impingement
syndrome. However, in general, the samples were small, and different diagnostic
criteria were applied, which makes a firm conclusion difficult. More high-quality
trials with longer follow-ups are recommended.

Langue : ANGLAIS