Skip to main content

Table 4 Characteristics and evaluation of included studies

From: Specific or general exercise strategy for subacromial impingement syndrome–does it matter? A systematic literature review and meta analysis

Study Method Participants Outcome measures Results/comments Key domains Score Quality
Baskurt 2011 [54] Randomized by simple random table. n = 40, 13 male, 27 female.
2471 year. with a mean age of 51.
Measured before and after intervention.
Pain:VAS
ROM: Goniometer
Strength: Hand held dynamometer
Function and QoL: WORC.
Clinical tests: Joint Position Sense and Lateral Scapular Slide Test
Patients outcomes improved statistically in both groups (P < 0.05).
No significant difference between groups in all parameters (P > 0.05) except muscle strength for lower trapezius and supraspinatus and clinical tests (P < 0.05).
Comments: Missing P-values and CI in results section. No protocol registered.
Low risk:
Randomization
Drop-out rate
Intention-to-treat
Unclear risk:
Allocation
Compliance
High risk:
Other bias (sample size)
High risk (downgrade 1) Moderate
Dilek 2016 [57] Randomized using block randomization. n = 63, 21 male, 42 women.
2565 years. with a mean age of 49.13.
Mean duration of symptoms: approx. 17 months.
Measured at baseline, 6 and 12 weeks.
Pain: VAS
ROM: Goniometer
Strength: Isokinetic dynamometer system (Cybex Norm)
Function and QoL: WORC and ASES
Both groups improved significantly in ROM, pain scores, isometric strength in all angles, Sense of kinesthesia at 0° ER, ASES and WORC (P < 0.05). No significant difference was found between groups in any of the parameters (P > 0.05).
Comments: No protocol registered.
Low risk:
Randomization
Allocation
Drop-out rate
Intention-to-treat
Unclear risk:
Compliance
High risk:
Other bias (sample size)
High risk (downgrade 1) Moderate
Martins 2012 [58] Unclear randomization n = 18, nursing professionals with age ranging from 30 to 50+ yrs.
16 subjects completed the study consisting of 2 male and 14 females. (no information on gender n = 2)
Pain: VNS
Function and QoL: WORC
Both groups exhibited significant reduction in pain scores (P < 0.05), however, no significant differences between groups.
Only the intervention group improved WORC scores significantly.
Comments: Outcomes of pain was less well presented and reduces transparency of data.
Low risk:
Allocation
Drop-out rate
Intention-to-treat
Compliance
Unclear risk:
Randomization
High risk:
Other bias (sample size)
High risk (downgrade 1) Moderate
Mulligan 2016 [53] Randomized using blind draw. n = 50, 14 male and 26 females, (no information on gender n = 10) Measured at baseline, 4 weeks, 8 weeks, 16 weeks
Pain: NPRS
Function and QoL: ASES; GPF; GROC.
No significant between group and time. Both groups exhibited significant reduction in pain scores and function. However, no significant differences between groups.
Comments: Protocol registered. Unclear reporting of co-interventions.
Low risk:
Randomization
Drop-out rate
Intention-to-treat
Allocation
Unclear risk:
Compliance
High risk:
Other bias (sample size)
High risk (downgrade 1) Moderate
Struyf 2013 [55] Randomized using closed envelopes. n = 22, 10 male and 12 females. Aging from 30 to 61 years with a mean age of 45.8. Measured at baseline, after nine sessions (4–8 weeks) and 12 weeks Post treatment.
Pain:VAS and VNRS
Function and QoL: SDQ
Clinical measures: Strength: handheld
Dynamometer, Impingement test VAS Hawkins, Empty Can or Neer tests. Acromial distance, pectoralis minor length, scapula upward rotation and kinetic medial rotation test.
After nine sessions the Experimental group demonstrated significant effect on self-reported disability compared to the Control group (P = 0.025). Both groups increased from baseline in all outcomes measured (P < 0.05).
No significant differences between group for strength or clinical measures, with exception for VAS by Neers test (p = 0.02)
Comments: The protocol states that outcomes will be measured after 6 months.
It is reported interim analysis was planned, however, is not mentioned in the protocol.
Low risk:
Randomization
Allocation
Intention-to-treat
Drop-out rate
Unclear risk:
Compliance
High risk:
Other bias (sample size and interim analyze)
High risk (downgrade 1) Moderate
Wang 2006 [56] Randomized using pre-prepared sealed envelopes. n = 38, aging from 26 to 68 years. with a mean age of 44.6. Of the 38 subjects, 30 were analyzed consisting of 15 male and 15 female. Measured at baseline, 4 and 8 weeks.
Pain: VAS
Function and QoL: FLEX-SF
ROM: Goniometer
Strength: handheld dynamometer
No significant interaction between group and time.
Both groups had significant improvements in regards to pain, function and muscle strength.
FLEX-SF improved significantly after 8 weeks. Pain improved significantly after 4 and 8 weeks.
Comments: No protocol registered. No gender distribution of the included subjects.
Low risk:
Randomization
Intention-to-treat
Compliance
Unclear risk:
Allocation
High risk:
Drop-out rate
Other bias (sample size)
High risk (downgrade 2) Low
  1. Abbreviations: VAS Visual Analog Scale, ROM Range of mortion, QoL Quality of life, WORC Western Ontario Rotator cuff Index, CI Confidence intervals, ASES American Shoulder and Elbow Surgeons Standardized Assessment Form-self reported scale, GPF Global Percentage of Function, GROC Global Rating of Change Scale, ER External rotation, VNS Verbal Numeric Scale, SDQ Shoulder Disability Questionnaire, FLEX-SF Flexilevel Scale of Shoulder Function, VNRS Verbal Numeric Rating Scale, NPRS Numeric Pain Rating Scale