Clinical outcomes of a scapular-focused treatment in patients with subacromial pain syndrome: a systematic review.

OBJECTIVE To systematically review the literature on the clinical outcomes of scapular-focused treatments in participants with subacromial pain syndrome (SPS). DESIGN Systematic literature review. Studies were appraised by two reviewers using the Physiotherapy Evidence Database (PEDro) scale, and a best-evidence synthesis was performed. DATA SOURCES The literature search was conducted in the databases PubMed, Embase and Cinahl up to February 2015. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials evaluating the clinical outcomes of a physiotherapeutic scapular-focused treatment in participants with SPS. RESULTS Four studies were included describing various scapular-focused interventions, including scapular-focused exercise therapy, scapular mobilisation and scapular taping. All included studies had a PEDro score of 6 or higher, indicating low risk of bias. There was moderate evidence that scapular-focused treatment compared with other physiotherapeutic treatment is effective in improving scapular muscle strength in participants with SPS. Conflicting evidence was found for improvements in pain, function and clinical measures of scapular positioning. No evidence was found for improvements in shoulder range of motion or rotator cuff muscle strength. CONCLUSIONS There is some support for the use of scapular-focused exercise therapy in patients with SPS. Owing to the low number of studies, no firm conclusions can be drawn. Therefore, more randomised controlled trials are needed to determine the clinical outcomes of scapular-focused exercise therapy, scapular mobilisation techniques and scapular taping in patients with SPS.