Skip to main content

Table 3 Summary of findings for the comparison eccentric exercise versus control exercise for subacromial impingement syndrome

From: Effects of eccentric exercise in patients with subacromial impingement syndrome: a systematic review and meta-analysis

Outcomes, time frame Absolute effect estimates (95% CI) № of participants (studies) Certainty in effect estimates (GRADE) Conclusion
Control exercise Eccentric exercise
Pain: post-treatment (6–12 weeks)
Measured by VAS or NPRS, converted to VAS 0–100 mm (lower better)
MID: 15 mm
Mean post-treatment pain ranged across control groups from 15.0 to 63.9 mm Mean post-treatment pain in the experimental group was 12.3 mm lower (17.8 lower to 6.8 lower) 281 (6 studies) Lowa, b Eccentric exercise may provide a small but likely not important reduction in pain post-treatment compared with other types of exercise.
Pain: intermediate to long-term (6–12 months)
Measured by VAS or NPRS, converted to VAS 0–100 mm (lower better)
MID: 15 mm
Mean intermediate/long-term pain ranged across control groups from 18.0 to 52.1 mm Mean intermediate/long-term pain in the experimental group was 4.9 mm lower (15.4 lower to 5.6 higher) 167 (3 studies) Lowa, b Eccentric exercise may result in little or no important difference in pain compared with other types of exercise.
Function: post-treatment (6–12 weeks)
Multiple scales of various range
N/A Standardised mean post-treatment function in the experimental group was 0.10 SMD units better (0.79 better to 0.58 worse) 281 (6 studies) Very lowa, b, c It is uncertain whether eccentric exercise improves function more than other types of exercise post-treatment follow-up.
Function: intermediate to long-term (6–12 months)
Multiple scales of various range
N/A Standardised mean intermediate/long-term function in the experimental group was 0.28 SMD units worse (0.67 better to 1.24 worse) 167 (3 studies) Very lowa, b, c It is uncertain whether eccentric exercise improves function more than other types of exercise at intermediate/long-term follow-up.
  1. GRADE Working Group grades of evidence
  2. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
  3. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
  4. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
  5. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
  6. GRADE Grading of Recommendations Assessment, Development and Evaluation, MID minimal important difference, VAS Visual Analogue Scale, NPRS Numerical Pain Rating Scale, N/A not applicable
  7. aDowngraded one level due to serious risk of bias (mainly due to lack of blinding)
  8. bDowngraded one level due to serious imprecision (high heterogeneity in magnitude and direction of effect across studies, wide CIs, small study sizes)
  9. cDowngraded one level due to clear inconsistency of results
\