Impingement syndrome is a generic term for rotator cuff lesions encompassing all stages of tendon disease. The fundamental aim of this review was to assess whether the quality of randomised controlled trials (RCT5) on this specific topic has improved during the last 3 years. A computer-aided search of databases was carried out from 2003 to 2005, using a combination of key words. Five RCTs were critically appraised using the PEDro scale and the American College of Sports and Medicine guidelines. The mean quality score of the included trials was 6.2, ranging from 4 to 8 points out of a possible 10. There is moderate evidence that supports the use of therapeutic exercises alone in reducing pain and function, whereas there is limited evidence to support the effectiveness of both manual and exercise therapy in combination. Future studies should better define impingement syndrome, based upon well-designed research methodology and the use of validated measurement tools.

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A brief summary and a critical assessment of this review may be available at DARE