FITT Odyssey: A Scoping Review of Exercise Programs for Managing Rotator Cuff-Related Shoulder Pain

Abstract

OBJECTIVE: To summarize the FITT (frequency, intensity, time, type), components of exercise programs included in randomized controlled trials (RCTs) that compared 2 or more programs for managing rotator cuff-related shoulder pain (RCRSP). DESIGN: Scoping review. LITERATURE SEARCH: Electronic searches were conducted up to May 2023. STUDY SELECTION CRITERIA: RCTs comparing the effects of 2 or more types of exercise programs, differing in prescription according to the FITT principle, in people with RCRSP. DATA SYNTHESIS: We extracted data from each trial report so that we could answer items 1 to 10 and 13 to 15 from the Consensus on Exercise Reporting Template (CERT). Descriptive analysis of the exercise programs was performed by summarizing and presenting the FITT characteristics, and other relevant CERT characteristics (material, provider, delivery, tailoring). RESULTS: FITT characteristics from 46 exercise programs included in 22 trials were extracted. The exercise programs were divided into 4 categories (defined in accordance to the original authors' description and proposed rationale): motor control (n = 8), scapula-focused (n = 7), eccentric (n = 8), and nonspecific exercise programs (n = 28). Five programs were allocated to 2 different categories. The different program types had similar parameters. Exercise programs frequency ranged from 2 to 7 times per week, dose ranged from 1 to 3 sets and 4 to 30 repetitions per sets, and exercise program duration ranged from 4 to 16 weeks. CONCLUSION: There was considerable variability in the parameters used to prescribe exercises for RCRSP. Clinicians seeking guidance on FITT parameters derived from trials should do so cautiously because there was no one-size-fits-all approach. J Orthop Sports Phys Ther 2024;54(8):513-529. Epub 4 June 2024. doi:10.2519/jospt.2024.12452.

Keywords: exercise; rotator cuff; shoulder; tendinopathy.