Physical Therapy Management of Nontraumatic Shoulder Problems Lacks High-Quality Clinical Practice Guidelines: A...

Area of Science:

• Orthopedics
• Physical Therapy
• Evidence-Based Practice

Background:

• Nontraumatic shoulder pain disorders are common and impact quality of life.
• Clinical practice guidelines (CPGs) are essential for evidence-based physical therapy management.
• The quality of existing CPGs for this condition requires critical appraisal.

Purpose of the Study:

• To systematically appraise the quality of clinical practice guidelines (CPGs) for the physical therapy management of nontraumatic shoulder pain disorders.
• To identify strengths and weaknesses of current CPGs using a standardized instrument.

Main Methods:

• A systematic review of CPGs was conducted.
• Two independent reviewers searched 7 databases and 7 gray literature sources.
• The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument was used by three independent reviewers to rate guideline quality.

Main Results:

• Nine CPGs were included, focusing on rotator cuff disorders, frozen shoulder, or general soft tissue shoulder diagnoses.
• Only 3 of the 9 CPGs were judged as high quality, and all high-quality guidelines were over 5 years old.
• CPGs scored highest in "scope and purpose" and "clarity of presentation" but poorly in "applicability" and "editorial independence".

Conclusions:

• There is a significant lack of high-quality, contemporary CPGs to guide physical therapy management of nontraumatic shoulder pain.
• Current guidelines demonstrate limitations in applicability and editorial independence, necessitating the development of updated, high-quality resources.