OBJECTIVE: To systematically review the effectiveness of electromyographic biofeedback interventions to improve pain and function of patients with shoulder pain. DESIGN: Systematic review of controlled clinical trials. LITERATURE SEARCH: Databases (Medline, Embase, CINAHL, PEDro, CENTRAL, Web of Science, and Scopus) were searched in December 2020. Study selection criteria: Randomized clinical trials that investigated the effects of electromyographic biofeedback for individuals with shoulder pain. Patient-reported pain and functional outcomes were collected and synthesized. Data synthesis: The level of evidence was synthesized using GRADE and standardized mean differences and 95% confidence interval were calculated using a random-effects inverse variance model for meta-analysis. RESULTS: Five studies were included with a total sample of 272 individuals with shoulder pain. Very-low quality of evidence indicated that electromyographic biofeedback was not superior to control for reducing shoulder pain (standardized mean differences -0.21, 95% confidence interval -0.67 to 0.24, p = 0.36). Very-low quality of evidence indicated that electromyographic biofeedback interventions were not superior to control for improving shoulder function (standardized mean differences -0.11, 95% confidence interval -0.41 to 0.19, p = 0.48). CONCLUSION: Electromyographic biofeedback may be not effective for improving shoulder pain and function. However, the limited number of included studies and very low quality of evidence does not support a definitive recommendation about the effectiveness of electromyographic biofeedback to treat individuals with shoulder pain.

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