Tambra L. Marik, Shawn C. Roll; Effectiveness of Occupational Therapy Interventions for Musculoskeletal Shoulder Conditions: A Systematic Review. Am J Occup Ther 2016;71(1):7101180020. https://doi.org/10.5014/ajot.2017.023127
Download citation file:
© 2021 American Occupational Therapy Association
People with musculoskeletal disorders of the shoulder commonly experience pain, decreased strength, and restricted range of motion (ROM) that limit participation in meaningful occupational activities. The purpose of this systematic review was to evaluate the current evidence for interventions within the occupational therapy scope of practice that address pain reduction and increase participation in functional activities. Seventy-six studies were reviewed for this study—67 of Level I evidence, 7 of Level II evidence, and 2 of Level III evidence. Strong evidence was found that ROM, strengthening exercises, and joint mobilizations can improve function and decrease pain. The evidence to support physical modalities is moderate to mixed, depending on the shoulder disorder. Occupational therapy practitioners can use this evidence to guide daily clinical decision making.
A combination of exercise (ROM and stretching), joint mobilizations, cryotherapy, and electrotherapy for people with adhesive capsulitis
Early controlled ROM therapy with short-term sling wear for nondisplaced proximal humeral fractures
Graded resistive training specifically of the neck and shoulder region in people with combined neck and shoulder pain
A combination of stretching, strengthening exercises, and joint mobilization techniques for people with general shoulder pain
Exercise (ROM, stretching, and strengthening), neuromuscular reeducation, and joint mobilizations for people with SIS, although steroid injections may provide some additional benefit for pain reduction
A combination of ROM exercises, joint mobilizations, and progressive tendon force exercises of the rotator cuff after rotator cuff repair.
Occupational therapy practitioners should incorporate preparatory interventions into daily clinical practice when providing treatment to people with musculoskeletal shoulder disorders to decrease pain and increase function.
Preparatory evidence-based interventions supported in the current body of literature are exercises, mobilization and manual techniques, and physical modalities (laser, electrotherapy, cryotherapy). The evidence for ultrasound and radio shock-wave therapy is moderate.
Further research is required to measure functional outcomes of combined preparatory interventions with occupation-based interventions.
Evidence-based interventions in this review are specific to musculoskeletal shoulder disorders, and specific intervention recommendations vary depending on the shoulder condition.
This PDF is available to Subscribers Only
For full access to this pdf, sign in to an existing account, or purchase an annual subscription.