Is exercise effective for the management of XXXX and other soft tissue injuries of the shoulder? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.

@entity5818 @entity158
BACKGROUND: Exercise is a key component of rehabilitation for soft tissue injuries of the shoulder; however its effectiveness remains unclear. OBJECTIVE: Determine the effectiveness of exercise for @entity158 . METHODS: We searched seven databases from 1990 to 2015 for randomized controlled trials (RCTs), cohort and case control studies comparing exercise to other interventions for @entity158 . We critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network (SIGN) criteria. We synthesized findings from scientifically admissible studies using best-evidence synthesis methodology. RESULTS: We retrieved 4853 articles. Eleven RCTs were appraised and five had a low risk of bias. Four studies addressed @entity5818 . One study addressed nonspecific @entity158 . For variable duration @entity5818 : 1) supervised strengthening leads to greater short-term improvement in @entity158 and disability over wait listing; and 2) supervised and home-based strengthening and stretching leads to greater short-term improvement in @entity158 and disability compared to no treatment. For persistent @entity5818 : 1) supervised and home-based strengthening leads to similar outcomes as surgery; and 2) home-based heavy load eccentric training does not add benefits to home-based rotator cuff strengthening and physiotherapy. For variable duration low-grade nonspecific @entity158 , supervised strengthening and stretching leads to similar short-term outcomes as corticosteroid injections or multimodal care. CONCLUSION: The evidence suggests that supervised and home-based progressive shoulder strengthening and stretching are effective for the management of @entity5818 . For low-grade nonspecific @entity158 , supervised strengthening and stretching are equally effective to corticosteroid injections or multimodal care. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42013003928.
