Scapular Focused Interventions to Improve Shoulder Pain and Function in Adults With Subacromial Pain: A Systematic Review and Meta-Analysis

Physiother Theory Pract. 2018 Sep;34(9):653-670. doi: 10.1080/09593985.2018.1423656. Epub 2018 Jan 19.


The relationship between subacromial pain syndrome (SAPS) and altered scapular movement has been previously reported. The purpose of this review was to determine the effect of interventions that focus on addressing scapular components to improve shoulder pain, function, shoulder range of motion (ROM), and muscle strength in adults with SAPS. Databases searched in September 2016 were: PubMed, the Cochrane Central Register of Controlled Trials [Central], EMBASE [via Ovid] and PEDro. All studies selected for this review were randomized controlled trials. In total, six studies met the inclusion criteria and were included in the meta-analyses. In adults with SAPS, scapular focused interventions significantly improved pain with activities (MD [95% CI] = -0.88 [-1.19 to -0.58], I2 43%) and shoulder function (-11.31 [-17.20 to -5.41] I2 65%) in the short term. No between-group difference in shoulder pain and function were found at follow up (4 weeks). A between-group difference in shoulder abduction ROM in the short term only was found (12.71 [7.15 to 18.26]°, I2 36%). No between-group difference in flexion ROM, supraspinatus muscle strength, pectoralis minor length or forward shoulder posture were found. In conclusion, in adults with SAPS, scapular focused interventions can improve short-term shoulder pain and function.

Keywords: Impingement; randomized controlled trials; scapula.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Biomechanical Phenomena
  • Chi-Square Distribution
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Strength
  • Pectoralis Muscles / physiopathology
  • Physical Therapy Modalities*
  • Range of Motion, Articular
  • Recovery of Function
  • Scapula / physiopathology*
  • Shoulder Impingement Syndrome / diagnosis
  • Shoulder Impingement Syndrome / physiopathology
  • Shoulder Impingement Syndrome / therapy*
  • Shoulder Joint / physiopathology*
  • Shoulder Pain / diagnosis
  • Shoulder Pain / physiopathology
  • Shoulder Pain / therapy*
  • Treatment Outcome