Scapular focused interventions to improve shoulder pain and function in adults with subacromial pain: A systematic review and meta-analysis

The relationship between subacromial pain syndrome (SAPS) and altered scapular movement has been previously reported. The purpose of this review was to determine the effect of interventions that focus on addressing scapular components to improve shoulder pain, function, shoulder range of motion (ROM), and muscle strength in adults with SAPS. Databases searched in September 2016 were: PubMed, the Cochrane Central Register of Controlled Trials [Central], EMBASE [via Ovid] and PEDro. All studies selected for this review were randomized controlled trials. In total, six studies met the inclusion criteria and were included in the meta-analyses. In adults with SAPS, scapular focused interventions significantly improved pain with activities (MD [95% CI] = −0.88 [−1.19 to −0.58], I2 43%) and shoulder function (−11.31 [−17.20 to −5.41] I2 65%) in the short term. No between-group difference in shoulder pain and function were found at follow up (4 weeks). A between-group difference in shoulder abduction ROM in the short term only was found (12.71 [7.15 to 18.26]°, I2 36%). No between-group difference in flexion ROM, supraspinatus muscle strength, pectoralis minor length or forward shoulder posture were found. In conclusion, in adults with SAPS, scapular focused interventions can improve short-term shoulder pain and function.

肩峰下疼痛综合征（subacromial pain syndrome, SAPS）与肩胛骨运动异常的关联既往已有报道。本综述旨在明确以聚焦肩胛骨问题的干预方案，对肩峰下疼痛综合征成人患者的肩部疼痛、肩关节功能、活动范围（range of motion, ROM）及肌肉力量的改善效果。2016年9月检索的数据库包括PubMed、Cochrane对照试验中心注册库（Cochrane Central）、通过Ovid平台检索的EMBASE以及PEDro。本综述纳入的所有研究均为随机对照试验，最终共有6项研究符合纳入标准并被纳入本次荟萃分析。针对肩峰下疼痛综合征成人患者，聚焦肩胛骨的干预措施可在短期内显著改善活动时疼痛（均差[95%置信区间] = −0.88 [−1.19至−0.58]，I²=43%）与肩部功能（−11.31 [−17.20至−5.41]，I²=65%）。随访4周时，两组间肩部疼痛及功能无显著差异。仅在短期随访中观察到肩关节外展活动范围存在组间差异（12.71 [7.15至18.26]°，I²=36%）。而在肩关节屈曲活动范围、冈上肌肌力、胸小肌长度及前伸肩姿势方面，未观察到组间差异。综上，对于肩峰下疼痛综合征成人患者，聚焦肩胛骨的干预措施可改善其短期肩部疼痛与功能。