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There are few studies that have investigated higher dose exercise for rotator cuff tendinopathy. There was low to very low certainty and conflicting evidence regarding the value of higher exercise dose in individuals with rotator cuff tendinopathy.
Epub 30 Nov 2018. doi:10.2519/jospt.2019.8240.
A fully powered multi-centre randomised trial is feasible with minor amendments addressing exercise adherence and questionnaire response rate. Future trials should utilise outcomes that consider participants baseline physical activity levels and adequately measure pain disparate from performance.
There were improvements in pain and shoulder function, increased isometric muscle strength for arm elevation and internal rotation, increased muscle activity of the infraspinatus and serratus anterior, and reduced pain during arm elevation after 6 weeks of intervention. This case report showed improvements on pain and function, increases on isometric strength of the shoulder and on electromyographic activity of the serratus anterior and infraspinatus muscles, as well as decreases on pain during arm elevation, after a 6-week intervention of RC isometric exercises associated with scapular muscle stretching and strengthening in patients with RC tendinopathy.
We found no differences between the groups (P<.05) regarding adverse effects, frequency of the weekly home exercises, and overall perceived effect. Applying IPM along with therapeutic exercises does not have additional effects on pain intensity and disability in individuals with rotator cuff tendinopathy.
Internal tendon architecture remained unchanged over the intervention. These findings suggest that tendon variables included in this study may be relevant only early in the intervention and that other factors should be investigated across different times of the intervention.
These patients showed improvement just in TFAST scale up to 72 h (P > 0.08). The results showed that EE + DN could be more effective compare than EE alone on treatment of the patients with chronic rotator cuff tendinopathy.
Isometric exercise can be used as part of a progressive loading programme as it may be beneficial for selected individuals. CRD42019147179.
TE could serve as an alternative to manual therapy, offering cost-benefit advantages, especially in administration via telecare and group sessions, highlighting its broader application in physiotherapy. NCT06241404.
Progressive exercise seems effective to manage upper limb tendinopathies, but the superiority of a progression criterion against others remains unclear. Low-quality evidence supported progressive exercise with eccentric components in adding a significant and moderate effect on pain/function at short-term.
Resistance exercise dose is poorly reported within tendinopathy management literature. However, this large meta-analysis identified some consistent patterns indicating greater efficacy on average with therapies prescribing higher intensities (through inclusion of additional loads) and lower frequencies, potentially creating stronger stimuli and facilitating adequate recovery.
The effect size of exercise on tendinopathy is dependent on the type of outcome measure assessed. Threshold values presented here can be used to guide interpretation and assist with further research better establishing minimal important change.
Further research including greater consistency in measurement tools is required to explore and where possible, identify patient- and exercise-related moderating factors that can be used to improve person-centred care. PROSPERO ID=CRD42020168187 CONTRIBUTION OF PAPER.
The findings of this systematic review demonstrate that participant characteristics are poorly reported in exercise trials in tendinopathy. To improve effectiveness of exercise interventions in tendinopathy, improved reporting of participant characteristics may allow better comparisons and targeted interventions for specific subgroups.
However, there was no superiority of either exercise training regarding the RC, scapula retractor, deltoid muscle thicknesses, or improvements in shoulder ER strength and shoulder pain/function. The study was registered in ClinicalTrials.gov named Blood Flow Restriction Training in Patients with Shoulder Pain and the registration number is NCT04333784.
The findings of this study suggest that Dynamic taping techniques may be a more effective approach for improving AHD for symptomatic patients. Therefore, Dynamic taping has the potential to be clinically beneficial before engaging in exercises.
CONCLUSION: HILT, applied alone or as an adjunctive therapy, provides significant benefits for pain and disability in rotator cuff tendinopathy, whereas standalone LLLT shows limited effectiveness. Further studies should examine long-term outcomes and standardized laser dosing.
Epub 10 May 2018. doi:10.2519/jospt.2018.7871.
Telerehabilitation may reduce pain and improve range of motion in patients with non-operatively managed shoulder conditions, particularly when interventions are sustained for 12 weeks or longer. However, the certainty of evidence remains low due to methodological limitations, highlighting the need for further high-quality trials to confirm these findings.
Participants expressed the value of practical, informative, condition specific knowledge; the importance of tangible progress with their exercise programme; and appreciation for a low level of burden in adhering to their exercise. Individualisation of exercise intensity is important, yet needs to consider individual preference, response to the load stimulus and the patients baseline physical capacity.