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Br J Sports Med ; 50(18): 1124-34, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27288517

RESUMEN

AIM: To summarise the current evidence regarding the effectiveness of physical therapy on pain, function and range of motion in individuals with subacromial pain syndrome (SAPS). DESIGN: Systematic review. DATA SOURCES: PubMed, Web of Science, CINAHL, Cochrane, Embase, Lilacs, Ibecs and Scielo databases. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials (RCTs) investigating physical therapy modalities for SAPS on pain, function/disability or range of motion were included. RESULTS: 64 high-quality RCTs were included. Exercise therapy provided high evidence of being as effective as surgery intervention and better than no treatment or placebo treatment to improve pain, function and range of motion in the short, mid and long terms. The combination of mobilisation and exercises provided high evidence to decrease pain and improve function in the short term. There is limited evidence for improvements on the outcomes with the isolated application of manual therapy. High level of evidence was synthesised regarding the lack of beneficial effects of physical resources such as low-level laser, ultrasound and pulsed electromagnetic field (PEMF) on pain, function or range of motion in the treatment of SAPS. There is limited evidence for microwave diathermy and transcutaneous electrical nerve stimulation. There is moderate evidence to no benefits with taping in the short term. Effects of diacutaneous fibrolysis and acupuncture are not well established yet. CONCLUSIONS: Exercise therapy should be the first-line treatment to improve pain, function and range of motion. The addition of mobilisations to exercises may accelerate reduction of pain in the short term. Low-level laser therapy, PEMF and taping should not be recommended.


Asunto(s)
Manejo del Dolor/métodos , Modalidades de Fisioterapia , Dolor de Hombro/terapia , Terapia por Acupuntura , Diatermia , Terapia por Estimulación Eléctrica , Terapia por Ejercicio , Humanos , Manipulaciones Musculoesqueléticas , Evaluación de Resultado en la Atención de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto , Rango del Movimiento Articular
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