A systematic review to compare physiotherapy treatment programmes for atraumatic shoulder instability.

Area of Science:

• Physiotherapy
• Orthopedics
• Rehabilitation Medicine

Background:

• Atraumatic shoulder instability (ASI) lacks defined optimal physiotherapy protocols.
• Understanding current treatment approaches and outcome measures is crucial for improving patient care.

Purpose of the Study:

• To conduct a systematic scoping review comparing physiotherapy treatment programs for individuals with ASI.
• To evaluate the outcome measures utilized in existing studies.
• To compare the effectiveness of different physiotherapy interventions for ASI.

Main Methods:

• Searched CINAHL, EMBASE, and Medline databases (1950-July 2021).
• Included 10 studies (1 RCT, 6 cohort, 3 case series) with 491 participants.
• Appraised studies using 12 critical appraisal items across validity, transferability, and reporting domains.

Main Results:

• Physiotherapy programs included education, movement re-education, posture correction, strengthening, functional training, and adjuncts.
• Seven studies reported statistically significant improvements (p<0.05) using patient-reported outcome measures (PROMs).
• No clear link was found between specific programs and outcomes, though shoulder instability-specific PROMs detected significant differences.

Conclusions:

• A single optimal physiotherapy treatment program for ASI is not evident.
• Future research should prioritize PROMs validated for the shoulder instability population.
• Employing outcome measures specific to targeted impairments is recommended for future studies.