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Consensus for physiotherapy for shoulder pain

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Abstract

Purpose

Shoulder pain is a common disorder. Despite growing evidence of the importance of physiotherapy, in particular active exercise therapy, little data is available to guide treatment. The aim of this project was to contribute to the development of an internationally accepted assessment and treatment algorithm for patients with shoulder pain.

Methods

Nine physiotherapists with expertise in the treatment of shoulder dysfunction met in Sweden 2012 to begin the process of developing a treatment algorithm. A questionnaire was completed prior to the meeting to guide discussions. Virtual conferences were thereafter the platform to reach consensus.

Results

Consensus was achieved on a clinical reasoning algorithm to guide the assessment and treatment for patients presenting with local shoulder pain, without significant passive range of motion deficits and no symptoms or signs of instability. The algorithm emphasises that physiotherapy treatment decisions should be based on physical assessment findings and not structural pathology, that active exercises should be the primary treatment approach, and that regular re-assessment is performed to ensure that all clinical features contributing to the presenting shoulder pain are addressed. Consensus was also achieved on a set of guiding principles for implementing exercise therapy for shoulder pain, namely, a limited number of exercises, performed with appropriate scapulo-humeral coordination and humeral head alignment, in a graduated manner without provoking the presenting shoulder pain.

Conclusion

The assessment and treatment algorithm presented could contribute to a more formal, extensive process aimed at achieving international agreement on an algorithm to guide physiotherapy treatment for shoulder pain.

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Conflict of interest

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Authors and Affiliations

  1. Institution Neuroscience and Physiology/Physiotherapy, University of Gothenburg and Physiotherapy Department Sahlgrenska University Hospital, Gothenburg, Sweden

    Ingrid Hultenheim Klintberg & Ann-Christine Gunnarsson Holzhausen

  2. Department of Rehabilitation Sciences & Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium

    Ann M. J. Cools & Annelies G. Maenhout

  3. Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden

    Theresa M. Holmgren & Kajsa Johansson

  4. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University Hospitals Trust, Oxford, UK

    Jane S. Moser

  5. University of Genoa, Genoa, Italy

    Valentina Spunton

  6. Discipline of Biomedical Science, School of Medical Sciences, Sydney Medical School, The University of Sydney, Sydney, Australia

    Karen Ginn

  7. Department of Physiotherapy, Sahlgrenska University Hospital/Mölndal, SE 431 80, Mölndal, Sweden

    Ingrid Hultenheim Klintberg

Authors
  1. Ingrid Hultenheim Klintberg
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  2. Ann M. J. Cools
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  3. Theresa M. Holmgren
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  4. Ann-Christine Gunnarsson Holzhausen
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  5. Kajsa Johansson
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  6. Annelies G. Maenhout
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  7. Jane S. Moser
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  8. Valentina Spunton
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  9. Karen Ginn
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Correspondence to Ingrid Hultenheim Klintberg.

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Klintberg, I.H., Cools, A.M.J., Holmgren, T.M. et al. Consensus for physiotherapy for shoulder pain. International Orthopaedics (SICOT) 39, 715–720 (2015). https://doi.org/10.1007/s00264-014-2639-9

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  • DOI: https://doi.org/10.1007/s00264-014-2639-9

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