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

Daniel Koska1, Robert Zetzsche1, Tobias A Mayer1

  • 1Institute of Human Movement Science and Health, Chemnitz University of Technology, 09126 Chemnitz, Germany.

Sports (Basel, Switzerland)
|January 24, 2025
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Summary

Supervised exercise therapy may offer slight benefits for shoulder function after trauma compared to self-managed programs. However, current evidence is limited by low certainty and requires further high-quality trials for definitive conclusions.

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exercise therapyfunctional statusshoulder dislocationsystematic review

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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.