The effectiveness of surgical vs conservative interventions on pain and function in patients with shoulder impingement syndrome. A systematic review and meta-analysis.
<h4>Objective</h4>To assess the effectiveness of surgical vs conservative interventions on pain and function in patients with subacromial impingement syndrome.<h4>Design</h4>Systematic review and meta-analysis of randomized controlled trials.<h4>Setting</h4>Clinic...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2019-01-01
|
Series: | PLoS ONE |
Online Access: | https://doi.org/10.1371/journal.pone.0216961 |
id |
doaj-a0df826d37d94694a16d722cabf878bd |
---|---|
record_format |
Article |
spelling |
doaj-a0df826d37d94694a16d722cabf878bd2021-03-04T10:30:35ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01145e021696110.1371/journal.pone.0216961The effectiveness of surgical vs conservative interventions on pain and function in patients with shoulder impingement syndrome. A systematic review and meta-analysis.Goris NazariJoy C MacDermidDianne BryantGeorge S Athwal<h4>Objective</h4>To assess the effectiveness of surgical vs conservative interventions on pain and function in patients with subacromial impingement syndrome.<h4>Design</h4>Systematic review and meta-analysis of randomized controlled trials.<h4>Setting</h4>Clinical setting.<h4>Participants</h4>Patients 18 years and older with subacromial impingement syndrome.<h4>Intervention/comparison</h4>Surgical intervention plus postoperative physiotherapy / placebo surgery plus physiotherapy or physiotherapy only.<h4>Main outcome measures</h4>Pain and function.<h4>Results</h4>11 RCTs (n = 919) were included. The pooled results displayed no statistically or clinically different between surgery plus physiotherapy vs physiotherapy alone on pain levels at 3-, 6-months, 5- and 10 years follow up (moderate quality, 3 RCTs, 300 patients, WMD -0.39, 95% CI: -1.02 to 0.23, p = 0.22; moderate quality, 3 RCTs, 310 patients, WMD -0.36, 95% CI: -1.02 to 0.29, p = 0.27; low quality, 1 RCT, 109 patients, WMD -0.30, 95% CI: -1.54 to 0.94, p = 0.64; low quality, 1 RCT, 90 patients, WMD -1.00, 95% CI: -0.24 to 2.24, p = 0.11) respectively. Similarly, the pooled results were not statistically or clinically different between groups for function at 3-, 6-month and 1-year follow ups (very low quality, 2 RCTs, 184 patients, SMD 0.11, 95% CI: -0.57 to 0.79, p = 0.75; moderate quality, 3 RCTs, 310 patients, SMD 0.15, 95% CI: -0.14 to 0.43, p = 0.31; very low quality, 2 RCTs, 197 patients, SMD 0.11, 95% CI: -0.46 to 0.69, p = 0.70) respectively.<h4>Conclusion</h4>The effects of surgery plus physiotherapy compared to physiotherapy alone on improving pain and function are too small to be clinically important at 3-, 6-months, 1-, 2-, 5- and ≥ 10-years follow up.https://doi.org/10.1371/journal.pone.0216961 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Goris Nazari Joy C MacDermid Dianne Bryant George S Athwal |
spellingShingle |
Goris Nazari Joy C MacDermid Dianne Bryant George S Athwal The effectiveness of surgical vs conservative interventions on pain and function in patients with shoulder impingement syndrome. A systematic review and meta-analysis. PLoS ONE |
author_facet |
Goris Nazari Joy C MacDermid Dianne Bryant George S Athwal |
author_sort |
Goris Nazari |
title |
The effectiveness of surgical vs conservative interventions on pain and function in patients with shoulder impingement syndrome. A systematic review and meta-analysis. |
title_short |
The effectiveness of surgical vs conservative interventions on pain and function in patients with shoulder impingement syndrome. A systematic review and meta-analysis. |
title_full |
The effectiveness of surgical vs conservative interventions on pain and function in patients with shoulder impingement syndrome. A systematic review and meta-analysis. |
title_fullStr |
The effectiveness of surgical vs conservative interventions on pain and function in patients with shoulder impingement syndrome. A systematic review and meta-analysis. |
title_full_unstemmed |
The effectiveness of surgical vs conservative interventions on pain and function in patients with shoulder impingement syndrome. A systematic review and meta-analysis. |
title_sort |
effectiveness of surgical vs conservative interventions on pain and function in patients with shoulder impingement syndrome. a systematic review and meta-analysis. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2019-01-01 |
description |
<h4>Objective</h4>To assess the effectiveness of surgical vs conservative interventions on pain and function in patients with subacromial impingement syndrome.<h4>Design</h4>Systematic review and meta-analysis of randomized controlled trials.<h4>Setting</h4>Clinical setting.<h4>Participants</h4>Patients 18 years and older with subacromial impingement syndrome.<h4>Intervention/comparison</h4>Surgical intervention plus postoperative physiotherapy / placebo surgery plus physiotherapy or physiotherapy only.<h4>Main outcome measures</h4>Pain and function.<h4>Results</h4>11 RCTs (n = 919) were included. The pooled results displayed no statistically or clinically different between surgery plus physiotherapy vs physiotherapy alone on pain levels at 3-, 6-months, 5- and 10 years follow up (moderate quality, 3 RCTs, 300 patients, WMD -0.39, 95% CI: -1.02 to 0.23, p = 0.22; moderate quality, 3 RCTs, 310 patients, WMD -0.36, 95% CI: -1.02 to 0.29, p = 0.27; low quality, 1 RCT, 109 patients, WMD -0.30, 95% CI: -1.54 to 0.94, p = 0.64; low quality, 1 RCT, 90 patients, WMD -1.00, 95% CI: -0.24 to 2.24, p = 0.11) respectively. Similarly, the pooled results were not statistically or clinically different between groups for function at 3-, 6-month and 1-year follow ups (very low quality, 2 RCTs, 184 patients, SMD 0.11, 95% CI: -0.57 to 0.79, p = 0.75; moderate quality, 3 RCTs, 310 patients, SMD 0.15, 95% CI: -0.14 to 0.43, p = 0.31; very low quality, 2 RCTs, 197 patients, SMD 0.11, 95% CI: -0.46 to 0.69, p = 0.70) respectively.<h4>Conclusion</h4>The effects of surgery plus physiotherapy compared to physiotherapy alone on improving pain and function are too small to be clinically important at 3-, 6-months, 1-, 2-, 5- and ≥ 10-years follow up. |
url |
https://doi.org/10.1371/journal.pone.0216961 |
work_keys_str_mv |
AT gorisnazari theeffectivenessofsurgicalvsconservativeinterventionsonpainandfunctioninpatientswithshoulderimpingementsyndromeasystematicreviewandmetaanalysis AT joycmacdermid theeffectivenessofsurgicalvsconservativeinterventionsonpainandfunctioninpatientswithshoulderimpingementsyndromeasystematicreviewandmetaanalysis AT diannebryant theeffectivenessofsurgicalvsconservativeinterventionsonpainandfunctioninpatientswithshoulderimpingementsyndromeasystematicreviewandmetaanalysis AT georgesathwal theeffectivenessofsurgicalvsconservativeinterventionsonpainandfunctioninpatientswithshoulderimpingementsyndromeasystematicreviewandmetaanalysis AT gorisnazari effectivenessofsurgicalvsconservativeinterventionsonpainandfunctioninpatientswithshoulderimpingementsyndromeasystematicreviewandmetaanalysis AT joycmacdermid effectivenessofsurgicalvsconservativeinterventionsonpainandfunctioninpatientswithshoulderimpingementsyndromeasystematicreviewandmetaanalysis AT diannebryant effectivenessofsurgicalvsconservativeinterventionsonpainandfunctioninpatientswithshoulderimpingementsyndromeasystematicreviewandmetaanalysis AT georgesathwal effectivenessofsurgicalvsconservativeinterventionsonpainandfunctioninpatientswithshoulderimpingementsyndromeasystematicreviewandmetaanalysis |
_version_ |
1714805738513104896 |