Comparison of eccentric and concentric exercise interventions in adults with Subacromial Impingement Syndrome

BACKGROUND: Researchers have demonstrated moderate evidence for the use of exercise in the treatment of subacromial impingement syndrome (SAIS). Recent evidence also supports eccentric exercise for patients with lower extremity and wrist tendinopathies. However, only a few investigators have examined the effects of eccentric exercise on patients with rotator cuff tendinopathy.

OBJECTIVE: To examine the current evidence on the clinical efficacy of taping, either NET or KT, for the treatment of individuals with RC tendinopathy.

STUDY DESIGN: Systematic review and meta-analysis

METHODS: A literature search was conducted in four bibliographical databases to identify randomized controlled trials (RCT) that compared NET or KT to any other intervention or placebo for treatment of RC tendinopathy. Internal validity of RCTs was assessed with the Cochrane Risk of Bias tool. A qualitative or quantitative synthesis of evidence was performed.

RESULTS: Ten trials were included in the present review on overall pain reduction or improvement in function. Most RCTs had a high risk of bias. There is inconclusive evidence for NET, either used alone or in conjunction with another intervention. Based on pooled results of two studies (n=72), KT used alone resulted in significant gain in pain free flexion (MD: 8.7° 95%CI 8.0° to 9.5°) and in pain free abduction (MD: 10.3° 95%CI 9.1° to 11.4°). Based on qualitative analyses, there is inconclusive evidence on the efficacy of KT when used alone or in conjunction with other interventions on overall pain reduction or improvement in function.

CONCLUSION: Although KT significantly improved pain free range of motion, there is insufficient evidence to formally conclude on the efficacy of KT or NET used alone or in conjunction with other interventions in patients with RC tendinopathy.