Treatment of Impingement Syndrome: A Systematic Review of the Effects on Functional Limitations and Return to Work
The goal of this systematic review is to evaluate the effectiveness of different treatments for impingement syndrome and rotator cuff tear on the improvement in functional limitations and concomitant duration of sick leave. A systematic search for clinical trials or controlled studies was conducted with the following text words: should*, rotator cuff, impingement, work, sick leave, disabilit*, function*. Nineteen articles were included in this review. For functional limitations, there is strong evidence that extracorporeal shock-wave therapy is not effective, moderate evidence that exercise combined with manual therapy is more effective than exercise alone, that ultrasound is not effective, and that open and arthroscopic acromioplasty are equally effective on the long term. For all other interventions there is only limited evidence. We found many studies using range of motion and pain as outcome measures but functional limitations were less often used as an outcome measure in this type of research. Duration of sick leave was seldom included as an outcome measure.
KEY WORDS:shoulder impingement syndrome functional limitations sick leave systematic review treatment outcome
This study was financially supported by the Erasmus MC Revolving Fund and the Dutch Order of Medical Specialists.
- 9.World Health Organization. International Classification of Functioning, Disability and Health (ICF). Geneva: World Health Organization, 2001.Google Scholar
- 10.Waddell G, Aylward M, Sawney P. Back pain, incapacity for work and social security benefits: An international literature review and analysis. London: Royal Society of Medicine Press, 2002.Google Scholar
- 20.Verhagen AP, de Vet HC, de Bie RA, Kessels AG, Boers M, Bouter LM, Knipschild PG. The Delphi list: A criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. J Clin Epidemiol 1998; 51(12): 1235–1241.PubMedCrossRefGoogle Scholar
- 26.Strobel G. Long-term therapeutic effect of different intra-articular injection treatments of the painful shoulder—Effect on pain, mobility and work capacity. Rehabilitation (Stuttg) 1996; 35(3): 176–178.Google Scholar
- 32.Brox JI, Gjengedal E, Uppheim G, Bohmer AS, Brevik JI, Ljunggren AE, Staff PH. Arthroscopic surgery versus supervised exercises in patients with rotator cuff disease (stage II impingement syndrome): A prospective, randomized, controlled study in 125 patients with a 2 1/2-year follow-up. J Shoulder Elbow Surg 1999; 8(2): 102–111.PubMedCrossRefGoogle Scholar
- 35.Lindh M, Norlin R. Arthroscopic subacromial decompression versus open acromioplasty. A two-year follow-up study. Clin Orthop 1993; (290): 174–176.Google Scholar
- 48.Teefey SA, Rubin DA, Middleton WD, Hildebolt CF, Leibold RA, Yamaguchi K. Detection and quantification of rotator cuff tears. Comparison of ultrasonographic, magnetic resonance imaging, and arthroscopic findings in seventy-one consecutive cases. J Bone Joint Surg Am 2004; 86-A(4): 708–716.PubMedGoogle Scholar