OBJECTIVE: The purpose of this study was to determine the effectiveness of glenohumeral joint mobilization (JM) on range of motion and pain intensity in patients with rotator cuff (RC) disorders. METHODS: An electronic search was performed in the MEDLINE, CENTRAL, Embase, PEDro, LILACS, CINAHL, SPORTDiscus, and Web of Science databases. The eligibility criteria for selecting studies included randomized clinical trials that investigated the effect of glenohumeral JM techniques with or without other therapeutic interventions on range of motion, pain intensity, and shoulder function in patients older than 18 years with RC disorders. Two authors independently performed the search, study selection, and data extraction, and assessed risk of bias. Grades of Recommendation Assessment, Development and Evaluation ratings were used to evaluate the quality of evidence in this study. RESULTS: Twenty-four trials met the eligibility criteria, and 15 studies were included in the quantitative synthesis. At 4 to 6 weeks, for glenohumeral JM with other manual therapy techniques versus other treatments, the mean difference (MD) for shoulder flexion was -3.42 degrees (p = 0.006), abduction 1.54 degree (p = 0.76), external rotation 0.65 degrees (p = 0.85), and Shoulder and Pain Disability Index score 5.19 points (p = 0.5), and standard MD for pain intensity was 0.16 (p = 0.5). At 4 to 5 weeks, for the addition of glenohumeral JM to an exercise program versus exercise program alone, the MD for the visual analog scale was 0.13 cm (p = 0.51) and the Shoulder and Pain Disability Index score was -4.04 points (p = 0.01). CONCLUSION: Compared with other treatments or an exercise program alone, the addition of glenohumeral JM with or without other manual therapy techniques does not provide significant clinical benefit with respect to shoulder function, range of motion, or pain intensity in patients with RC disorders. The quality of evidence was very low to high according to Grades of Recommendation Assessment, Development and Evaluation ratings.
Reprinted from the Journal of Manipulative and Physiological Therapeutics with copyright permission from the National University of Health Sciences.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher