Effectiveness of Glenohumeral Joint Mobilization on Range of Motion and Pain in Patients With Rotator Cuff Disorders: A Systematic Review and Meta-Analysis

Héctor Gutiérrez-Espinoza; Iván Cuyul-Vásquez; Cristian Olguin-Huerta; Marcelo Baldeón-Villavicencio; Felipe Araya-Quintanilla

doi:10.1016/j.jmpt.2023.05.009

Effectiveness of Glenohumeral Joint Mobilization on Range of Motion and Pain in Patients With Rotator Cuff Disorders: A Systematic Review and Meta-Analysis

J Manipulative Physiol Ther. 2023 Feb;46(2):109-124. doi: 10.1016/j.jmpt.2023.05.009. Epub 2023 Jul 8.

Authors

Héctor Gutiérrez-Espinoza¹, Iván Cuyul-Vásquez², Cristian Olguin-Huerta³, Marcelo Baldeón-Villavicencio¹, Felipe Araya-Quintanilla⁴

Affiliations

¹ School of Physiotherapy, University of the Americas, Quito, Ecuador.
² Therapeutic Process Department, Faculty of Health, Temuco Catholic University, Temuco, Chile.
³ School of Health Sciences, University of Gabriela Mistral, Santiago, Chile.
⁴ School of Kinesiology, Faculty of Dentistry and Sciences of Rehabilitation, San Sebasti an University Santiago, Chile. Electronic address: felipe.arayaq@uss.cl.

PMID: 37422746
DOI: 10.1016/j.jmpt.2023.05.009

Abstract

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 vs other treatments, the mean difference (MD) for shoulder flexion was -3.42° (P = .006), abduction 1.54° (P = .76), external rotation 0.65° (P = .85), and Shoulder and Pain Disability Index score 5.19 points (P = .5), and standard MD for pain intensity was 0.16 (P = .5). At 4 to 5 weeks, for the addition of glenohumeral JM to an exercise program vs exercise program alone, the MD for the visual analog scale was 0.13 cm (P = .51) and the Shoulder and Pain Disability Index score was -4.04 points (P = .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.

Keywords: Meta-Analysis; Musculoskeletal Manipulations; Range of Motion, Articular; Shoulder Pain.

Publication types

Review