Supervised vs. Self-Managed Exercise Therapy for Improving Shoulder Function After Traumatic Dislocation and Sprain:...

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation

Background:

• Trauma-induced shoulder dislocations and sprains are common, particularly in contact sports.
• These injuries significantly impair shoulder function and prolong recovery, necessitating effective rehabilitation.
• Exercise therapy is crucial for restoring shoulder mobility and preventing re-injury.

Purpose of the Study:

• To systematically review the comparative effectiveness of supervised versus self-managed exercise therapy for acute shoulder trauma.
• To analyze outcomes separately for conservative and post-surgical treatment groups.

Main Methods:

• Systematic literature search of major databases (PubMed, Cochrane, Embase, Web of Science, Science Direct) up to December 13, 2024.
• Inclusion of five studies (689 participants) analyzing conservative (n=538) and post-surgical (n=151) cases.
• Pooled effect analysis using standardized mean difference (SMD) and assessment of risk of bias and GRADE certainty.

Main Results:

• Both supervised and self-managed exercise therapy showed similar pooled effects in conservative and post-surgical groups.
• A marginal improvement in shoulder function was observed favoring supervised therapy, though not statistically significant.
• Four studies had some risk of bias, and one had a serious risk, leading to low GRADE certainty.

Conclusions:

• Supervised exercise therapy may offer slightly better functional outcomes than self-managed training for shoulder trauma.
• The current evidence is limited by study heterogeneity, risk of bias, and low certainty.
• High-quality trials with standardized protocols and adherence tracking are needed to guide clinical practice.