Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol.

  title={Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol.},
  author={John E. Kuhn},
  journal={Journal of shoulder and elbow surgery},
  volume={18 1},
  • J. Kuhn
  • Published 2009
  • Medicine, Psychology
  • Journal of shoulder and elbow surgery

The Effectiveness of Exercise Therapy in Reducing Pain and Improving Clinical Outcomes in Rotator Cuff Tendinopathy : a Systematic Review

The evidence suggests that exercise interventions can lead to improvements in all of the abovementioned clinical outcomes, and specific shoulder exercises appear to be more effective than general, non-specific neck and upper extremity exercises.


The current literature indicates GRADE B recommendation (moderate strength) to support the use of ET in the management of FTT, and further need for well-designed randomized controlled trials.

Exercise-Based Muscle Development Programmes and Their Effectiveness in the Functional Recovery of Rotator Cuff Tendinopathy: A Systematic Review

All exercise programs were effective in RC tendinopathy, improving pain and shoulder function and no solid results were obtained when the interventions were compared due to their heterogeneity.

evidence-based review syndrome and rotator cuff injuries: an Rehabilitation of shoulder impingement

An evidence-based review of the key treatment strategies to rehabilitate and restore shoulder function of the athlete with rotator cuff impingement is presented.

Therapeutic exercise for rotator cuff tendinopathy: a systematic review of contextual factors and prescription parameters

  • C. LittlewoodP. MalliarasK. Chance-Larsen
  • Medicine, Psychology
    International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation
  • 2015
A systematic review of published exercise programmes for rotator cuff tendinopathy suggested that exercise programmes are widely applicable and can be successfully designed by physiotherapists with varying experience and should demonstrate clinically significant outcomes by 12 weeks.

Manual therapy and exercises for shoulder impingement revisited

This systematic review update provides some further evidence supporting the effectiveness of manual therapy and exercises for shoulder impingement, but methodological deficits/risk of bias warrant cautious interpretation.

Role And Outcomes of Conservative Treatment in Management of Rotator Cuff Tears: A Systematic Review of Randomised Controlled Trials

An algorithm which proposes conservative therapy as the central mode of management for rotator cuff tear patients has been described and more high-quality studies are required to allow for a quantitative review of the various non-surgical treatment modalities of rotators cuff tears.



Therapeutic Exercise and Orthopedic Manual Therapy for Impingement Syndrome: A Systematic Review

There is limited evidence to support the efficacy of therapeutic exercise and manual therapy to treat impingement syndrome, and more methodologically sound studies are needed to further evaluate these interventions.

Exercise therapy for the conservative management of full thickness tears of the rotator cuff: a systematic review

The findings suggest that some evidence exists to support the use of exercise in the management of full thickness rotator cuff tears, and there is a definite need for well-planned randomised controlled trials investigating the efficacy of exercise.

Evaluation of interventions for rotator cuff pathology: a systematic review.

There is insufficient evidence to strongly support or refute the effectiveness of any available treatment intervention for rotator cuff pathology, and a clear need for more methodologically sound studies to achieve strong evidence on which treatment practices can be based.

Effectiveness of rehabilitation for patients with subacromial impingement syndrome: a systematic review.

The limited evidence currently available suggests that exercise and joint mobilizations are efficacious for patients with SAIS, and it is imperative that clinical guidelines are developed to indicate those patients who are likely to respond to rehabilitation.

Arthroscopic surgery compared with supervised exercises in patients with rotator cuff disease (stage II impingement syndrome)

Surgery or a supervised exercise regimen significantly, and equally, improved rotator cuff disease compared with placebo in both groups given the active treatments.

Supervised exercises in relation to rotator cuff disease (impingement syndrome stages II and III): A treatment regimen and its rationale

Reactivating the supraspinatus muscle to improve the initial movement pattern in abduction, together with promotion of agility of movement, are central elements of ‘supervised exercises’.

Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up.

Surgical treatment of rotator cuff syndrome with subacromial impingement was not superior to physiotherapy with training, and it is recommended that samples are stratified according to disability level.

Rehabilitation of the Rotator Cuff: An Evaluation‐Based Approach

The available literature on shoulder rehabilitation, in conjunction with clinical observation that takes into consideration the underlying tissue quality and structural integrity of the rotator cuff, can be compiled into a set of rehabilitation guidelines.