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Review
. 2023 Nov;15(4 Suppl):92-107.
doi: 10.1177/17585732221140113. Epub 2022 Nov 17.

Content reporting and effectiveness of therapeutic exercise in the management of massive rotator cuff tears: A systematic review with 490 patients

Rubén Fernández-Matías  1   2 , Fernando García-Pérez  2 , Néstor Requejo-Salinas  3   4 , Carlos Gavín-González  5 , Javier Martínez-Martín  5 , Homero García-Valencia  5 , Mariano Tomás Flórez-García  2
Affiliations
Review

Content reporting and effectiveness of therapeutic exercise in the management of massive rotator cuff tears: A systematic review with 490 patients

Rubén Fernández-Matías et al. Shoulder Elbow. 2023 Nov.

Abstract

Background: Massive rotator cuff tears (MRCT) account for a substantial fraction of tears above the age of 60 years. However, there are no clear criteria for prescription parameters within therapeutic exercise treatments. The aim of this study was to evaluate the effects and characteristics of therapeutic exercise treatments in patients with MRCT.

Methods: A systematic search was conducted in MEDLINE/PubMed, Web of Science, SPORTDiscus, SciELO, Scopus and EMBASE from inception to August 2022. Studies were included if they evaluated the effects of exercise on patients with MRCT. The risk of bias was evaluated and the Consensus on Exercise Reporting Template (CERT) was also used. A narrative synthesis without meta-analysis was performed.

Results: One randomized controlled trial, two non-randomized studies, six non-controlled studies, one case series and four retrospective studies were included. They ranged from serious to moderate risk of bias. The CERT reflected a poor description of the exercise programmes. Studies showed a pattern of improvements in most patient-reported outcome measures (PROM) surpassing the MCID, and active elevation range of motion.

Conclusions: There is limited evidence that exercise and co-interventions are effective in the management of some patients with MRCT, based on a systematic review without meta-analysis. Future research should improve content reporting.

Level of evidence: IV.

Keywords: exercise; massive rotator cuff tear; older adults; physical therapy; shoulder.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram of included studies.
Figure 2.
Figure 2.
Changes in Constant-Murley score (CONSTANT) and Oxford Shoulder Score (OSS) within prospective included studies. Line plots (a and c) represent raw values at each measurement point. Bar plots (b and d) represent changes from baseline to each follow-up. Dashed lines (bar plots b and d) represent the minimal clinically important difference (MCID), with a value of 6.9 points for OSS and a value of 10 points for CONSTANT.
See this image and copyright information in PMC

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