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Shoulder specific exercise therapy is effective in reducing chronic shoulder pain: A network meta-analysis

Author

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  • Anelise Silveira
  • Camila Lima
  • Lauren Beaupre
  • Judy Chepeha
  • Allyson Jones

Abstract

Background: Exercise therapy (ET) is frequently an early treatment of choice when managing shoulder pain, yet evidence on its efficacy to expedite recovery is inconsistent. Moreover, the value of adding adjunct therapies (i.e. injections, manual therapy, electrotherapy) to ET is currently unclear. This study combined both direct and indirect evidence across studies on the effectiveness of ET with/without adjunct therapies compared to usual medical care for adults with chronic shoulder pain. Methods and findings: Using a network meta-analysis, randomized control trials comparing ET along with adjunct therapies were identified in MEDLINE, Embase, CINAHL, Sportdiscus, CENTRAL, Conference Proceedings Citation Index-Science, clinicaltrials.gov, and association websites. Outcomes included pain, range of motion (ROM), and health-related quality of life (HRQL) measures in adult patients with chronic shoulder pain. Data analysis used a Frequentist hierarchical model. CINeMA tool assessed the confidence in the results and Cochrane Risk of Bias tool assessed quality of studies. Conclusion(s): Shoulder-specific ET provided pain relief up to 52 weeks. Adjunct therapies to shoulder-specific ET added little value in reducing pain. The quality of evidence varied between moderate and very low.

Suggested Citation

  • Anelise Silveira & Camila Lima & Lauren Beaupre & Judy Chepeha & Allyson Jones, 2024. "Shoulder specific exercise therapy is effective in reducing chronic shoulder pain: A network meta-analysis," PLOS ONE, Public Library of Science, vol. 19(4), pages 1-19, April.
    • Handle: RePEc:plo:pone00:0294014
    DOI: 10.1371/journal.pone.0294014
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    References listed on IDEAS

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    1. Theodoros Papakonstantinou & Adriani Nikolakopoulou & Julian P. T. Higgins & Matthias Egger & Georgia Salanti, 2020. "CINeMA: Software for semiautomated assessment of the confidence in the results of network meta‐analysis," Campbell Systematic Reviews, John Wiley & Sons, vol. 16(1), March.
    2. Georgia Salanti & Cinzia Del Giovane & Anna Chaimani & Deborah M Caldwell & Julian P T Higgins, 2014. "Evaluating the Quality of Evidence from a Network Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(7), pages 1-14, July.
    3. Silles, Mary A., 2009. "The causal effect of education on health: Evidence from the United Kingdom," Economics of Education Review, Elsevier, vol. 28(1), pages 122-128, February.
    4. Adriani Nikolakopoulou & Julian P T Higgins & Theodoros Papakonstantinou & Anna Chaimani & Cinzia Del Giovane & Matthias Egger & Georgia Salanti, 2020. "CINeMA: An approach for assessing confidence in the results of a network meta-analysis," PLOS Medicine, Public Library of Science, vol. 17(4), pages 1-19, April.
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