J Manipulative Physiol Ther 2017 (Jun); 40 (5): 293319 ~ FULL TEXT
Cheryl Hawk, DC, PhD, Amy L. Minkalis, DC, MS, Raheleh Khorsan, MA,
Clinton J. Daniels, DC, MS, Dennis Homack, DC, MS, Jordan A. Gliedt, DC,
Julie A. Hartman, DC, MS, Shireesh Bhalerao, DC, MCR
Texas Chiropractic College,
OBJECTIVE: The purpose of this review was to evaluate the effectiveness of conservative nondrug, nonsurgical interventions, either alone or in combination, for conditions of the shoulder.
METHODS: The review was conducted from March 2016 to November 2016 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and was registered with PROSPERO. Eligibility criteria included randomized controlled trials (RCTs), systematic reviews, or meta-analyses studying adult patients with a shoulder diagnosis. Interventions qualified if they did not involve prescription medication or surgical procedures, although these could be used in the comparison group or groups. At least 2 independent reviewers assessed the quality of each study using the Scottish Intercollegiate Guidelines Network checklists. Shoulder conditions addressed were shoulder impingement syndrome (SIS), rotator cuff-associated disorders (RCs),
adhesive capsulitis (AC), and nonspecific shoulder pain.
RESULTS: Twenty-five systematic reviews and 44 RCTs met inclusion criteria. Low- to moderate-quality evidence supported the use of manual therapies for all 4 shoulder conditions. Exercise, particularly combined with physical therapy protocols, was beneficial for shoulder impingement syndrome (SIS) and adhesive capsulitis (AC). For SIS, moderate evidence supported several passive modalities. For RC, physical therapy protocols were found beneficial but not superior to surgery in the long term. Moderate evidence supported extracorporeal shockwave therapy for calcific tendinitis RC. Low-level laser was the only modality for which there was moderate evidence supporting its use for all 4 conditions.
CONCLUSION: The findings of this literature review may help inform practitioners who use conservative methods (eg, doctors of chiropractic, physical therapists, and other manual therapists) regarding the levels of evidence for modalities used for common shoulder conditions.
KEYWORDS: Chiropractic; Conservative Treatment; Manual Therapy; Shoulder; Spinal Manipulation
From the FULL TEXT Article:
Painful conditions of the shoulder are the third leading musculoskeletal complaint in primary care, with a point prevalence as high as 26%.  Two-thirds (67%) of adults experience shoulder pain at some time in their life,  and prevalence is highest in middle age (4065 years).  Chronic shoulder pain characterizes a substantial subset of those with shoulder conditions because only 50% of patients recover within 6 months of onset. 
Disorders of the rotator cuff, including shoulder impingement syndrome (SIS), are among the most common causes of shoulder pain.  Other conditions include those that are unspecified and adhesive capsulitis (AC). [5, 6] Primary treatment options considered in usual care typically consist of analgesics or exercises and progress to secondary and tertiary options of steroid injections or surgery if necessary. [7, 8] Compared with more conservative treatments, surgery is likely more costly and risky.  The utilization of arthroscopic interventions for the shoulder has quickly increased in recent decades, with an estimated complication rate of 4.8%10.6%.  Additionally, there are some negative effects of glucocorticoid injections on cellular characteristics and mechanical properties of tendons, especially when used for long-term treatment. 
Patients pursuing treatment for shoulder pain seek care from manual therapy (MT) providers such as physical therapists, chiropractic practitioners, and others who use conservative interventions such as mobilization and manipulation. A study conducted in the Netherlands reported that shoulder complaints constituted 9.8% of physical therapy (PT) patients,  and in a survey of chiropractic practice in Australia, 12% of patients presented with shoulder pain. 
Reviews of MTs (eg, manipulation and mobilization) and multimodal treatments have found favorable effects supporting their use for the management of shoulder conditions.  However, clinical trials studying these treatments are inconsistently conducted, tend to have low to moderate levels of scientific rigor, and infrequently collect long-term outcomes. Therefore, evidence is still inconclusive regarding the appropriate use of many MTs for shoulder conditions. Furthermore, evidence is inconclusive regarding other nondrug, nonsurgical interventions that are commonly combined and employed in multimodal management in clinical practice. [13, 14] The purpose of this review was to evaluate the evidence for conservative nondrug, nonsurgical interventions, either alone or in combination, for conditions of the shoulder.
This review evaluated the evidence for a variety of nondrug, nonsurgical interventions for the treatment of shoulder disorders commonly seen in practice. The disorders focused on in our overall findings were categorized as rotator cuff conditions (calcific or noncalcific), AC, SIS, and SP.
Rotator Cuff-Associated Disorders
We found variable-quality (low to high) evidence that MT, including manipulation and mobilization, may be effective either alone or when combined with exercise or passive modalities. A moderate level of evidence was reported in doses ranging from 10 to 24 sessions for the effectiveness of PT alone or when combined with active LLLT; however, surgery may be of more benefit in the mid- to long term. Also, there is moderate evidence to suggest diathermy 3 times per week for 4 weeks is effective in the short and long term. Studies consistently reported the effectiveness of high-energy ESWT for calcific but not noncalcific tendinitis. Treatment for calcific tendinitis was reported at approximately once per week for 24 weeks. Insufficient evidence exists to conclude on the effectiveness of KT or TENS for this type of shoulder pain.
Mostly moderate-quality evidence suggests that manual mobilization techniques are beneficial when used alone or in combination with exercise for primary AC in the short and long term. In general, PT (312 weeks) was an effective treatment, but studies indicated enhanced improvement when combined with injections and whole-body cryotherapy. Low to moderate evidence indicated the effectiveness of LLLT alone over a period of 6 days or paired with an injection or exercise in the short and long term.
Shoulder Impingement Syndrome
We found moderate evidence that MWM twice per week for 2 weeks provided more relief than a sham treatment. In general, studies reported improved outcomes with MT interventions; however, the benefits seemed to be as effective when combining MT with other treatments such as SMT, exercise, and KT. Moderate-quality studies also reported similar effectiveness for MT compared with injections and surgery for shoulder impingement. MT doses varied from 1 to 3 times per week for 36 weeks. Inconsistencies were found for KT and ESWT treatments, but LLLT (10 sessions) and PEMF with exercise (3 times per week for 3 weeks) and supervised or home exercises (6 weeks) were effective. There was inconclusive evidence for microcurrent and TENS.
The evidence for SMT was inconclusive and unfavorable for 1 treatment, but favorable for multiple treatment sessions in the short and long term. A high-quality review indicated that when compared with usual care, TMT accelerated recovery and improved pain and function immediately and for up to 1 year. Limited evidence exists for the effectiveness of mobilization or manipulation techniques combined with soft tissue release and exercise; additionally, mobilization was not found effective when administered alone. Massage therapy was reported to have significant immediate and short-term effects over inactive treatment for pain, but not compared with active therapies for pain or function. We found inconclusive but favorable evidence for PT combined with MT at 1 treatment per week for 12 weeks and a single treatment of both MWM and MWM with KT. There was moderate evidence of the effectiveness of interferential and conventional LLLT at 3 treatments per week for a total of 10.
All nondrug, nonsurgical treatments included in this review are within the scope of chiropractic practice. Our findings on the effectiveness of these treatments have similarities and distinctions from previously published systematic reviews. Comparison results include those from Green et al,  who concluded that exercise was beneficial for short-term recovery and long-term functional improvement for RC, as well as an additional benefit when adding mobilization to exercise. Their results regarding laser therapy also paralleled ours in that it was more effective than placebo for AC.  For SIS, 2 reviews [95, 96] reported that MT combined with exercise was effective. Bronfort et al  concluded that combining MT with medical care was beneficial, and another review  found evidence to suggest massage was superior to no treatment. Our results contrasted with several reviews that reported that passive therapies such as LLLT and PEMF were not effective or that results were inconclusive for the treatment of RCs, AC, and SIS. [14, 64, 95, 98] Additionally, 1 review determined that the evidence for MT was conflicting for the treatment of SIS and SP and that it was not more effective when compared with other interventions for AC.  Another review reported MT was inconclusive but favorable for RCs.  The differences noted in our systematic review are likely due to the inclusion of more recent studies, as all of the mentioned reviews included studies that are about 10 years or older.
Other systematic reviews have also been conducted evaluating manipulation, mobilization, and multimodal (nondrug, nonsurgical) treatments for shoulder conditions. [15, 16, 23] These reviews found favorable results suggesting these interventions, mostly highlighting multimodal care, are beneficial for pain and function; however, the results are based on mostly low-level evidence from case reports and series. Although reviews report clinical use of multimodal treatments, a description is still lacking regarding what multi-modal components of chiropractic care are appropriate for specific shoulder conditions. Even when a specific diagnosis is made, there are typically other regions and structures involved either contributing to or exacerbating the condition. Therefore, checking adjacent areas for concomitant disorders such as joint dysfunction, myofascial adhesions, or scapular dyskinesis may be justification for the use of multimodal treatments to address all issues involved.
Limitations and Future Study Recommendations
Although we identified 44 relevant RCTs and 25 SRs, they covered such a wide variety of interventions and several different conditions that still the overall quantity and quality of evidence was at best moderate for any 1 intervention. Furthermore, the heterogeneity of protocols and procedures used makes generalizations difficult and did not allow for pooling of results. In particular, wide ranges of dosages were found for most treatments (number of treatments and interval of care), also making it difficult to draw conclusions about optimal dosage, in most cases. It is also possible that some studies were missed, despite the reference tracking and hand searching in addition to the formal literature search.
Additional research is needed concerning the use of various combinations of interventions, as well as the value of single modalities. Studies should clearly describe treatment protocols, including frequency, intensity, and duration.
The findings of this literature review may help inform practitioners who use conservative methods (eg, doctors of chiropractic, physical therapists, and other manual therapists) regarding the levels of evidence for nondrug, nonsurgical interventions used for common shoulder conditions. The evidence found ranged from low to moderate supporting the use of MTs and/or modalities for the conditions SIS, RC, AC, and SP. Exercise, particularly provided as part of PT protocols, was found to be beneficial for SIS and AC. For SIS, moderate evidence was found supporting the use of KT, LLLT, ESWT, and PEMF. For RCs, PT protocols were found to be helpful, although they may not be superior to surgery in the long term. ESWT was supported by moderate evidence only for calcific tendinitis RCs. Of all the modalities studied, LLLT appears to be the only 1 with moderate evidence supporting its use for all the conditions studied.
Manual therapy is beneficial for common shoulder conditions.
Low-level laser therapy is beneficial for common shoulder conditions.
Exercise protocols are beneficial for SIS and AC.
Linaker, CH and Walker-Bone, K.
Shoulder disorders and occupation.
Best Pract Res Clin Rheumatol. 2015; 29: 405423
Struyf, F, Geraets, J, Noten, S, Meeus, M, and Nijs, J.
A multivariable prediction model for the chronification of non-traumatic shoulder pain:
A systematic review.
Pain Physician. 2016; 19: 110
Bussieres, AE, Peterson, C, and Taylor, JA.
Diagnostic Imaging Practice Guidelines for
Musculoskeletal Complaints in Adults
An Evidence-Based Approach: Part 2: Upper Extremity Disorders
J Manipulative Physiol Ther 2008 (Jan); 31 (1): 2-32
Saltychev, M, Aarimaa, V, Virolainen, P, and Laimi, K.
Conservative treatment or surgery for shoulder impingement: Systematic review
and meta-analysis (provisional abstract).
Disabil Rehabil. 2014; 37: 18
Page, MJ, Green, S, Kramer, S, Johnston, RV, McBain, B.
Electrotherapy modalities for adhesive capsulitis (frozen shoulder).
Cochrane Database Syst Rev. 2014; 10: CD011324
Page, MJ, Green, S, Kramer, S et al.
Manual therapy and exercise for adhesive capsulitis (frozen shoulder).
Cochrane Database Syst Rev. 2014; 8: CD011275
House, J and Mooradian, A.
Evaluation and management of shoulder pain in primary care clinics. (quiz 1136-1127)
South Med J. 2010; 103: 11291135
Mitchell, C, Adebajo, A, Hay, E, and Carr, A.
Shoulder pain: Diagnosis and management in primary care.
BMJ. 2005; 331: 11241128
Pauzenberger, L, Grieb, A, Hexel, M, Laky, B, Anderl, W.
Infections following arthroscopic rotator cuff repair: incidence,
risk factors, and prophylaxis.
Knee Surg Sports Traumatol Arthrosc. 2017; 25: 595601
Dean, BJ, Lostis, E, Oakley, T, Rombach, I, Morrey, ME, and Carr, AJ.
The risks and benefits of glucocorticoid treatment for tendinopathy:
A systematic review of the effects of local glucocorticoid on tendon.
Semin Arthritis Rheum. 2014; 43: 570576
Kooijman, MK, Barten, DJ, Swinkels, IC et al.
Pain intensity, neck pain and longer duration of complaints predict poorer outcome
in patients with shoulder painA systematic review.
BMC Musculoskelet Disord. 2015; 16: 288
Pribicevic, M, Pollard, H, and Bonello, R.
An epidemiologic survey of shoulder pain in chiropractic practice in Australia.
J Manip Physiol Ther. 2009; 32: 107117
Brantingham, JW, Cassa, TK, Bonnefin, D et al.
Manipulative Therapy for Shoulder Pain and Disorders:
Expansion of a Systematic Review
J Manipulative Physiol Ther 2011 (Jun); 34 (5): 314346
Green, S, Buchbinder, R, and Hetrick, S.
Physiotherapy interventions for shoulder pain.
Cochrane Database Syst Rev. 2003; 2: CD004258
McHardy, A, Hoskins, W, Pollard, H, Onley, R, and Windsham, R.
Chiropractic treatment of upper extremity conditions: A systematic review.
J Manip Physiol Ther. 2008; 31: 146159
Pribicevic, M, Pollard, H, Bonello, R, and de Luca, K.
A systematic review of manipulative therapy for the treatment of shoulder pain.
J Manip Physiol Ther. 2010; 33: 679689
Desjardins-Charbonneau, A, Roy, JS, Dionne, CE, Fremont, P.
The efficacy of manual therapy for rotator cuff tendinopathy:
A systematic review and meta-analysis.
J Orthop Sports Phys Ther. 2015; 45: 330350
Furlan, AD, Malmivaara, A, Chou, R et al.
2015 Updated method guideline for systematic reviews in the Cochrane Back and Neck Group.
Spine (Phila Pa 1976). 2015; 40: 16601673
Harbour, R and Miller, J.
A new system for grading recommendations in evidence based guidelines.
BMJ. 2001; 323: 334336
Bronfort G, Haas M, Evans R, Leininger B, Triano J.
Effectiveness of Manual Therapies: The UK Evidence Report
Chiropractic & Osteopathy 2010 (Feb 25); 18 (1): 3
Clar C, Tsertsvadze A, Court R, Hundt G, Clarke A, Sutcliffe P.
Clinical Effectiveness of Manual Therapy for the Management of
Musculoskeletal and Non-Musculoskeletal Conditions:
Systematic Review and Update of UK Evidence Report
Chiropractic & Manual Therapies 2014 (Mar 28); 22 (1): 12
R. Bryans, P. Decina, M. Descarreaux, et al.,
Evidence-Based Guidelines for the Chiropractic Treatment of Adults With Neck Pain
J Manipulative Physiol Ther 2014 (Jan); 37 (1): 4263
Brantingham, JW, Cassa, TK, Bonnefin, D et al.
Manipulative and multimodal therapy for upper extremity and temporomandibular disorders:
A systematic review.
J Manip Physiol Ther. 2013; 36: 143201
Al Dajah, SB.
Soft tissue mobilization and PNF improve range of motion and minimize pain level
in shoulder impingement.
J Phys Ther Sci. 2014; 26: 18031805
Damian, M and Zalpour, C.
Trigger point treatment with radial shock waves in musicians with nonspecific
shoulder-neck pain: Data from a special physio outpatient clinic for musicians.
Med Probl Perform Art. 2011; 26: 211217
Kumar, N, Nehru, A, and Rajalakshmi, D.
Effect of taping as a component of conservative treatment for
subacromial impingement syndrome.
Health. 2012; 4: 237241
Muth, S, Barbe, MF, Lauer, R, and McClure, PW.
The effects of thoracic spine manipulation in subjects with signs
of rotator cuff tendinopathy.
J Orthop Sports Phys Ther. 2012; 42: 10051016
Shrivastava, A, Shyam, AK, Sabnis, S, and Sancheti, P.
Randomised controlled study of Mulligan's vs. Maitland's mobilization technique
in adhesive capsulitis of shoulder joint.
Indian J Physiother Occup Ther. 2011; 5: 1215
Djordjevic, OC, Vukicevic, D, Katunac, L, and Jovic, S.
Mobilization with movement and kinesiotaping compared with a supervised exercise
program for painful shoulder: Results of a clinical trial.
J Manip Physiol Ther. 2012; 35: 454463
Yang, JL, Chen, SY, Hsieh, CL, and Lin, JJ.
Effects and predictors of shoulder muscle massage for patients with
posterior shoulder tightness.
BMC Musculoskelet Disord. 2012; 13: 46
Desmeules, F, Boudreault, J, Roy, JS, Dionne, CE, Fremont, P, and MacDermid, JC.
Efficacy of transcutaneous electrical nerve stimulation for rotator cuff tendinopathy:
A systematic review.
Physiotherapy. 2016; 102: 4149
Desjardins-Charbonneau, A, Roy, JS, Dionne, CE, and Desmeules, F.
The efficacy of taping for rotator cuff tendinopathy: A systematic review and meta-analysis.
Int J Sports Phys Ther. 2015; 10: 420433
Huisstede, BMA, Koes, BW, Gebremariam, L, Keijsers, E, and Verhaar, JAN.
Current evidence for effectiveness of interventions to treat rotator cuff tears.
Man Ther. 2011; 16: 217230
Huisstede, BM, Gebremariam, L, van der Sande, R, Hay, EM, and Koes, BW.
Evidence for effectiveness of extracorporal shock-wave therapy (ESWT) to treat calcific
and non-calcific rotator cuff tendinosisA systematic review.
Man Ther. 2011; 16: 419433
Louwerens, JK, Sierevelt, IN, van Noort, A, and van den Bekerom, MP.
Evidence for minimally invasive therapies in the management of chronic calcific
tendinopathy of the rotator cuff: A systematic review and meta-analysis.
J Shoulder Elb Surg. 2014; 23: 12401249
Louwerens, JK, Veltman, ES, van Noort, A, and van den Bekerom, MP.
The effectiveness of high-energy extracorporeal shockwave therapy versus
ultrasound-guided needling versus arthroscopic surgery in the management of chronic
calcific rotator cuff tendinopathy: A systematic review.
Arthroscopy. 2016; 32: 165175
A systematic review of shockwave therapies in soft tissue conditions:
Focusing on the evidence.
Br J Sports Med. 2014; 48: 15381542
Verstraelen, FU, In den Kleef, NJ, Jansen, L, and Morrenhof, JW.
High-energy versus low-energy extracorporeal shock wave therapy for calcifying
tendinitis of the shoulder: Which is superior? A meta-analysis.
Clin Orthop Relat Res. 2014; 472: 28162825
Favejee, MM, Huisstede, BM, and Koes, BW.
Frozen shoulder: The effectiveness of conservative and surgical
Br J Sports Med. 2011; 45: 4956
Jain, TK and Sharma, NK.
The effectiveness of physiotherapeutic interventions in treatment of frozen
shoulder/adhesive capsulitis: A systematic review (Provisional abstract).
J Back Musculoskelet Rehabil. 2014; 27: 247273
Noten, S, Meeus, M, Stassijns, G, Van, GF, Verborgt, O, and Struyf, F.
Efficacy of different types of mobilization techniques in patients with primary
adhesive capsulitis of the shoulder: A systematic review.
Arch Phys Med Rehabil. 2016; 97: 815825
Chang, KV, Hung, CY, Wu, WT, Han, DS, Yang, RS, and Lin, CP.
Comparison of the effectiveness of suprascapular nerve block with physical therapy,
placebo, and intra-articular injection in management of chronic shoulder pain:
A meta-analysis of randomized controlled trials.
Arch Phys Med Rehabil. 2016; 97: 13661380
Peek, AL, Miller, C, and Heneghan, NR.
Thoracic manual therapy in the management of non-specific shoulder pain:
A systematic review.
J Man Manipulative Ther. 2015; 23: 176187
Kong, LJ, Zhan, HS, Cheng, YW, Yuan, WA, Chen, B, and Fang, M.
Massage therapy for neck and shoulder pain: A systematic review and meta-analysis
Database Abstr Rev Effects. 2013; : 110
Wang, TL, Fu, BM, Ngai, G, and Yung, P.
Effect of isokinetic training on shoulder impingement.
Genet Mol Res. 2014; 13: 744757
Goldgrub, R, Cote, P, Sutton, D et al.
The effectiveness of multimodal care for the management of soft tissue injuries of
the shoulder: A systematic review by the Ontario Protocol for Traffic Injury
Management (OPTIMa) collaboration.
J Manipulative Physiol Ther. 2016; 39: 121139.e121
Yu, H, Cote, P, Shearer, HM et al.
Effectiveness of passive physical modalities for shoulder pain:
Systematic review by the Ontario Protocol for Traffic Injury Management collaboration.
Phys Ther. 2015; 95: 306318
Lee, SY, Cheng, BJ, and Grimmer, SK.
The midterm effectiveness of extracorporeal shockwave therapy in the management of
chronic calcific shoulder tendinitis.
Ann Acad Med Singap. 2011; 40: S213
Szczurko, O, Cooley, K, Mills, EJ, Zhou, Q, Perri, D, and Seely, D.
Naturopathic treatment of rotator cuff tendinitis among Canadian postal workers:
A randomized controlled trial.
Arthritis Rheum. 2009; 61: 10371045
Ioppolo, F, Tattoli, M, Di, SL et al.
Clinical improvement and resorption of calcifications in calcific tendinitis of
the shoulder after shock wave therapy at 6 months' follow-up:
A systematic review and meta-analysis.
Arch Phys Med Rehabil. 2013; 94: 16991706
Abrisham, SM, Kermani-Alghoraishi, M, Ghahramani, R, Jabbari, L, Jomeh, H, and Zare, M.
Additive effects of low-level laser therapy with exercise on subacromial syndrome:
A randomised, double-blind, controlled trial.
Clin Rheumatol. 2011; 30: 13411346
Efficacy of microcurrent electrical stimulation on pain, proprioception accuracy
and functional disability in subacromial impingement: Randomized controlled trial.
Indian J Physiother Occup Ther. 2012; 6: 1518
Cook, C, Learman, K, Houghton, S, Showalter, C, and OHalloran, B.
The addition of cervical unilateral posterior-anterior mobilisation in the treatment
of patients with shoulder impingement syndrome: A randomised clinical trial.
Man Ther. 2014; 19: 1824
Delgado-Gil, JA, Prado, RE, Rodrigues-de-Souza, DP, Cleland, JA.
Effects of mobilization with movement on pain and range of motion in patients
with unilateral shoulder impingement syndrome: A randomized controlled trial.
J Manip Physiol Ther. 2015; 38: 245252
Engebretsen, K, Grotle, M, Bautz-Holter, E, Ekeberg, OM, Juel, NG, and Brox, JI.
Supervised exercises compared with radial extracorporeal shock-wave therapy
for subacromial shoulder pain: 1-Year results of a single-blind randomized controlled trial.
Phys Ther. 2011; 91: 3747
Galace-de Frietas, D, Lima, MR, Beretta, MF et al.
Pulsed electromagnetic field in patients with shoulder impingement syndrome.
J Appl Res. 2013; 13: 2833
Granviken, F and Vasseljen, O.
Home exercises and supervised exercises are similarly effective for people
with subacromial impingement: A randomised trial.
J Physiother. 2015; 61: 135141
Haik, MN, Alburquerque, SF, Silva, CZ, Siqueira-Junior, AL, Ribeiro, IL.
Scapular kinematics pre- and post-thoracic thrust manipulation in individuals with
and without shoulder impingement symptoms: a randomized controlled study.
J Orthop Sports Phys Ther. 2014; 44: 475487
Kardouni, JR, Pidcoe, PE, Shaffer, SW et al.
Thoracic spine manipulation in individuals with subacromial impingement syndrome
does not immediately alter thoracic spine kinematics, thoracic excursion,
or scapular kinematics: A randomized controlled trial.
J Orthop Sports Phys Ther. 2015; 45: 527538
Kardouni, JR, Shaffer, SW, Pidcoe, PE, Finucane, SD, Cheatham, SA, and Michener, LA.
Immediate changes in pressure pain sensitivity after thoracic spinal manipulative
therapy in patients with subacromial impingement syndrome: A randomized controlled study.
Man Ther. 2015; 20: 540546
Kaya, DO, Baltaci, G, Toprak, U, and Atay, AO.
The clinical and sonographic effects of kinesiotaping and exercise in comparison
with manual therapy and exercise for patients with subacromial impingement syndrome:
a preliminary trial.
J Manip Physiol Ther. 2014; 37: 422432
Kocyigit, F, Akalin, E, Gezer, NS, Orbay, O, Kocyigit, A, and Ada, E.
Functional magnetic resonance imaging of the effects of low-frequency transcutaneous
electrical nerve stimulation on central pain modulation:
A double-blind, placebo-controlled trial.
Clin J Pain. 2012; 28: 581588
Kromer, TO, Bie, RA, and Bastiaenen, CH.
Physiotherapy in patients with clinical signs of shoulder impingement syndrome:
A randomized controlled trial.
J Rehabil Med. 2013; 45: 488497
Rhon, DI, Boyles, RB, and Cleland, JA.
One-year outcome of subacromial corticosteroid injection compared with manual
physical therapy for the management of the unilateral shoulder impingement syndrome:
A pragmatic randomized trial.
Ann Intern Med. 2014; 161: 161169
Senbursa, G, Baltaci, G, and Atay, OA.
The effectiveness of manual therapy in supraspinatus tendinopathy.
Acta Orthop Traumatol Turc. 2011; 45: 162167
Shakeri, H, Keshavarz, R, Arab, AM, and Ebrahimi, I.
Clinical effectiveness of kinesiological taping on pain and pain-free shoulder
range of motion in patients with shoulder impingement syndrome:
A randomized, double blinded, placebo-controlled trial.
Int J Sports Phys Ther. 2013; 8: 800810
Shakeri, H, Keshavarz, R, Arab, AM, and Ebrahimi, I.
Therapeutic effect of kinesio-taping on disability of arm, shoulder, and hand
in patients with subacromial impingement dyndrome: A randomized clinical trial.
J Novel Physiother. 2013; 3: 15
Simsek, HH, Balki, S, Keklik, SS, Ozturk, H, and Elden, H.
Does kinesio-taping in addition to exercise therapy improve the outcomes in
subacromial impingement syndrome? A randomized, double-blind, controlled clinical trial.
Acta Orthop Traumatol Turc. 2013; 47: 104110
Yavuz, F, Duman, I, Taskaynatan, MA, and Tan, AK.
Low-level laser therapy versus ultrasound therapy in the treatment of subacromial
impingement syndrome: A randomized clinical trial.
J Back Musculoskelet Rehabil. 2014; 27: 315320
Chen, CY, Hu, CC, Weng, PW et al.
Extracorporeal shockwave therapy improves short-term functional outcomes of
shoulder adhesive capsulitis.
J Shoulder Elb Surg. 2014; 23: 18431851
Doner, G, Guven, Z, Atalay, A, and Celiker, R.
Evaluation of Mulligan's technique for adhesive capsulitis of the shoulder.
J Rehabil Med. 2013; 45: 8791
Hsieh, LF, Hsu, WC, Lin, YJ, Chang, HL, Chen, CC, and Huang, V.
Addition of intra-articular hyaluronate injection to physical therapy program
produces no extra benefits in patients with adhesive capsulitis of the shoulder:
A randomized controlled trial.
Arch Phys Med Rehabil. 2012; 93: 957964
Klc, Z, Filiz, MB, Cakr, T, and Toraman, NF.
Addition of suprascapular nerve block to a physical therapy program produces
an extra benefit to adhesive capsulitis: A randomized controlled trial.
Am J Phys Med Rehabil. 2015; 94: 912920
Ma, SY, Je, HD, Jeong, JH, Kim, HY, and Kim, HD.
Effects of whole-body cryotherapy in the management of adhesive capsulitis of the shoulder.
Arch Phys Med Rehabil. 2013; 94: 916
Maryam, M, Zahra, K, Adeleh, B, and Morteza, Y.
Comparison of corticosteroid injections, physiotherapy, and combination therapy
in treatment of frozen shoulder.
Pak J Med Sci. 2012; 28
Shi, H, Fang, JQ, Li, BW, Cong, WJ, Zhang, Y, and Chen, L.
Efficacy assessment for different acupuncture therapies in the treatment of frozen shoulder.
World J Acupuncture-Moxibustion. 2012; 22: 611
Smitherman, JA, Struk, AM, Cricchio, M et al.
Arthroscopy and manipulation versus home therapy program in treatment of adhesive
capsulitis of the shoulder: a prospective randomized study.
J Surg Orthop Adv. 2015; 24: 6974
Eslamian, F, Shakouri, SK, Ghojazadeh, M, Nobari, OE.
Effects of low-level laser therapy in combination with physiotherapy in
the management of rotator cuff tendinitis.
Lasers Med Sci. 2012; 27: 951958
Kolk, A, Auw-Yang, KG, Tamminga, R, and Hoeven, H.
Radial extracorporeal shock-wave therapy in patients with chronic rotator
cuff tendinitis: A prospective randomised double-blind placebocontrolled multicentre trial.
Bone Joint J. 2013; 95B: 15211526
Kukkonen, J, Joukainen, A, Lehtinen, J et al.
Treatment of non-traumatic rotator cuff tears: A randomised controlled trial
with one-year clinical results.
Bone Joint J Am. 2014; 96: 7581
Kukkonen, J, Joukainen, A, Lehtinen, J et al.
Treatment of nontraumatic rotator cuff tears: A randomized controlled trial
with two years of clinical and imaging follow-up.
J Bone Joint Surg Am. 2015; 97: 17291737
Liu, S, Zhai, L, Shi, Z, Jing, R, Zhao, B, and Xing, G.
Radial extracorporeal pressure pulse therapy for the primary long bicipital
tenosynovitis: A prospective randomized controlled study.
Ultrasound Med Biol. 2012; 38: 727735
Moosmayer, S, Lund, G, Seljom, US et al.
Tendon repair compared with physiotherapy in the treatment of rotator cuff tears:
A randomized controlled study in 103 cases with a five-year follow-up.
J Bone Joint Surg Am. 2014; 96: 15041514
Rabini, A, Piazzini, DB, Bertolini, C et al.
Effects of local microwave diathermy on shoulder pain and function in patients
with rotator cuff tendinopathy in comparison to subacromial corticosteroid injections:
A single-blind randomized trial.
J Orthop Sports Phys Ther. 2012; 42: 363370
Tornese, D, Mattei, E, Bandi, M, Zerbi, A, Quaglia, A.
Arm position during extracorporeal shock wave therapy for calcifying tendinitis
of the shoulder: A randomized study.
Clin Rehabil. 2011; 25: 731739
Bron, C, Gast, A, Dommerholt, J, Stegenga, B, Wensing, M.
Treatment of myofascial trigger points in patients with chronic shoulder pain:
A randomized, controlled trial.
BMC Med. 2011; 9: 8
Montes-Molina, R, Prieto-Baquero, A, Martνnez-Rodriguez, ME.
Interferential laser therapy in the treatment of shoulder pain and
disability from musculoskeletal pathologies: A randomised comparative study.
Physiotherapy. 2012; 98: 143150
Riley, SP, Cote, MP, Leger, RR et al.
Short-term effects of thoracic spinal manipulations and message conveyed
by clinicians to patients with musculoskeletal shoulder symptoms:
A randomized clinical trial.
J Man Manipulative Ther. 2015; 23: 311
Teys, P, Bisset, L, Collins, N, Coombes, B, and Vicenzino, B.
One-week time course of the effects of Mulligan's Mobilisation with Movement
and taping in painful shoulders.
Man Ther. 2013; 18: 372377
Abdelshafi, ME, Yosry, M, Elmulla, AF, Al-Shahawy, EA, Adou Aly.
Relief of chronic shoulder pain: A comparative study of three approaches.
Middle East J Anaesthesiol. 2011; 21: 8392
Bialoszewski, D and Zaborowski, G.
Usefulness of manual therapy in the rehabilitation of patients with
chronic rotator cuff injuries: Preliminary report.
Ortop Traumatol Rehabil. 2011; 13: 920
Bansal, K and Padamkumar, S.
A comparative study between the efficacy of therapeutic utrasound and
soft tissue massage (deep friction massage) in supraspinatus tendinitis.
Indian J Physiother Occup Ther. 2011; 5: 8084
Chauhan, V, Saxena, S, and Grover, S.
Effect of deep transverse friction massage and capsular stretching in
idiopathic adhesive capsulitis.
Indian J Physiother Occup Ther. 2011; 5: 185188
Sun, WP, Han, SL, and Jun, HK.
The effectiveness of intensive mobilization techniques combined with
capsular distension for adhesive capsulitis of the shoulder.
J Phys Ther Sci. 2014; 26: 17671770
Faber, E, Kuiper, JI, Burdorf, A, Miedema, HS, and Verhaar, JA.
Treatment of impingement syndrome: A systematic review of the effects on
functional limitations and return to work.
J Occup Rehabil. 2006; 16: 725
Michener, LA, Walsworth, MK, and Burnet, EN.
Effectiveness of rehabilitation for patients with subacromial impingement syndrome:
A systematic review.
J Hand Ther. 2004; 17: 152164
Ho, CY, Sole, G, and Munn, J.
The effectiveness of manual therapy in the management of musculoskeletal disorders
of the shoulder: A systematic review.
Man Ther. 2009; 14: 463474
Chronic pediatric asthma and chiropractic spinal manipulation:
A prospective clinical series and randomized clinical pilot study.
J Manip Physiol Ther. 2002; 25: 540541
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