Rotator cuff disorders: a survey of current (2016) UK physiotherapy practice

Abstract

Background

Shoulder pain is a common musculoskeletal presentation, with disorders of the rotator cuff (RC) regarded as the most frequent cause. Conservative treatment is often the initial management; however, findings from a previous survey showed considerable variations in clinical practice, including the use of modalities that are not supported in the literature, suggesting that research is not impacting on practice. The present study aimed to survey current UK physiotherapy practice for the management of RC disorders and to determine whether this has changed over the 5-year period since the last survey was conducted.

Methods

A cross-sectional online survey of UK physiotherapists was conducted.

Results

One hundred and ninety-one respondents completed the survey which showed that advice/education and some form of exercise therapy are most commonly used as a management strategy for RC disorders. There is a lack of agreement however regarding exercise prescription. The survey suggests less use of passive modalities, indicating that practice has advanced over the last 5 years in line with the current evidence.

Conclusions

The present study has highlighted that the clinical practice of the survey respondents was in line with current recommendations from research. Hence, in contrast to the survey conducted 5 years previously, research appears to be impacting on practice, which is a positive finding.

Keywords

knowledge mobilization physiotherapy rotator cuff shoulder pain survey

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References

Urwin

Symmons

Allison

et al.

Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis 1998; 57: 649–655.

Luime

Koes

Hendriksen

et al.

Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol 2004; 33: 73–81.

Van der Windt

Koes

Boeke

et al.

Shoulder disorders in general practice: prognostic indicators of outcome. Br J Gen Pract 1996; 46: 519–523.

Michener

Walsworth

Burnet

. Effectiveness of rehabilitation for patients with subacromial impingement syndrome: a systematic review. J Hand Ther 2004; 17: 152–164.

Linsell

Dawson

Zondervan

et al.

Prevalence and incidence of adults consulting for shoulder conditions in UK primary care; patterns of diagnosis and referral. Rheumatol 2006; 45: 215–221.

Kooijman

Swinkels

van Dijk

et al.

Patients with shoulder syndromes in general and physiotherapy practice: an observational study. BMC Musculoskelet Disord 2013; 14: 128–128.

Winters

Sobel

Groenier

et al.

The long-term course of shoulder complaints: a prospective study in general practice. Rheumatology 1999; 38: 160–163.

Dorrestijn

Stevens

Diercks

et al.

A new interdisciplinary treatment strategy versus usual medical care for the treatment of subacromial impingement syndrome: a randomized controlled trial. BMC Musculoskelet Disord 2007; 8: 15–15.

Hallgren

HCB

Holmgren

Oberg

et al.

A specific exercise strategy reduced the need for surgery in subacromial pain patients. Br J Sports Med 2014; 48: 1431–1436.

10.

Kuhn

. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg 2009; 18: 138–160.

11.

Littlewood

Malliaras

Chance-Larsen

. Therapeutic exercise for rotator cuff tendinopathy: a systematic review of contextual factors and prescription parameters. Int J Rehabil Res 2015; 38: 95–106.

12.

Littlewood

Lowe

Moore

. Rotator cuff disorders: a survey of current UK physiotherapy practice. Shoulder Elbow 2012; 4: 64–71.

13.

Blume

Wang-Price

Trudelle-Jackson

et al.

Comparison of eccentric and concentric exercise interventions in adults with subacromial impingement syndrome. Int J Sports Phys Ther 2015; 10: 441–455.

14.

Mulligan

Huang

Dickson

et al.

The effect of axioscapular and rotator cuff exercise training sequence in patients with subacromial impingement syndrome: a randomized crossover trial. Int J Sports Phys Ther 2016; 11: 94–107.

15.

Littlewood

Bateman

Brown

et al.

A self-managed single exercise programme versus usual physiotherapy treatment for rotator cuff tendinopathy: a randomised controlled trial (the SELF study). Clin Rehabil 2016; 30: 686–696.

16.

Marzetti

Rabini

Piccinini

et al.

Neurocognitive therapeutic exercise improves pain and function in patients with shoulder impingement syndrome: a single-blind randomized controlled clinical trial. Eur J Phys Rehabil Med 2014; 50: 255–264.

17.

Seagger

Wallace

. (i) Degenerative rotator cuff disease and impingement. Orthop Trauma 2011; 25: 1–10.

18.

Bryman

. Social research methods, Fourth edition. New York, NY: Open University Press, 2012.

19.

Peabody

Luck

Glassman

et al.

Comparison of vignettes, standardized patients, and chart abstraction: A prospective validation of 3 methods of measuring quality. JAMA 2000; 283: 1715–1722.

20.

Hegedus

. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. Br J Sports Med 2012; 46: 964–978.

21.

Diercks

Bron

Dorrestijn

et al.

Guideline for diagnosis and treatment of subacromial pain syndrome. Acta Orthop 2014; 85: 314–322.

22.

Cadogan

Laslett

Hing

et al.

Interexaminer reliability of orthopaedic special tests used in the assessment of shoulder pain. Man Ther 2011; 16: 131–135.

23.

Kidd

. Treatment of shoulder pain utilizing mechanical diagnosis and therapy principles. J Man Manip Ther 2013; 21: 168–173.

24.

Lewis

. Masterclass Rotator cuff related shoulder pain: assessment, management and uncertainties. Man Ther 2016; 23: 57–68.

25.

Bouju

Bouilleau

Dubois de Montmarin

et al.

Do subacromial ultrasonography findings predict efficacy of intra-bursal injection? Prospective study in 39 patients. Orthop Traumatol Surg Res 2014; 100: S361–S364.

26.

Daghir

Sookur

Shah

et al.

Dynamic ultrasound of the subacromial-subdeltoid bursa in patients with shoulder impingement: a comparison with normal volunteers. Skeletal Radiol 2012; 41: 1047–1053.

27.

Girish

Lobo

Jacobson

et al.

Ultrasound of the shoulder: asymptomatic findings in men. Am J Roentgenol 2011; 197: 713–719.

28.

Cadogan

Laslett

Hing

et al.

A prospective study of shoulder pain in primary care: prevalence of imaged pathology and response to guided diagnostic blocks. BMC Musculoskelet Disord 2011; 12: 119–119.

29.

Yamamoto

Takagishi

Kobayashi

et al.

Factors involved in the presence of symptoms associated with rotator cuff tears: a comparison of asymptomatic and symptomatic rotator cuff tears in the general population. J Shoulder Elbow Surg 2011; 20: 1133–1137.

30.

Minagawa

Yamamoto

Abe

et al.

Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: from mass-screening in one village. J Orthop 2013; 10: 8–12.

31.

Littlewood

May

Walters

. A review of systematic reviews of the effectiveness of conservative interventions for rotator cuff tendinopathy. Shoulder Elbow 2013; 5: 151–167.

32.

Dong

Goost

Lin

X-B

et al.

Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis. Medicine 2015; 94: e510–e510.

33.

Gebremariam

Hay

van der Sande

et al.

Subacromial impingement syndrome – effectiveness of physiotherapy and manual therapy. Br J Sports Med 2014; 48: 1202–1208.

34.

Abdulla

Southerst

Côté

et al.

Is exercise effective for the management of subacromial impingement syndrome and other soft tissue injuries of the shoulder? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Man Ther 2015; 20: 646–656.

35.

Hanratty

McVeigh

Kerr

et al.

The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. Semin Arthritis Rheum 2012; 42: 297–316.

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