Reproducibility of exercise interventions in randomized controlled trials for the treatment of rotator cuff-related shoulder pain: a systematic review

Arch Phys Med Rehabil. 2023 Sep 21:S0003-9993(23)00531-2. doi: 10.1016/j.apmr.2023.09.007. Online ahead of print.


Objective: To determine the reproducibility of exercise therapy interventions in randomized clinical trials for rotator cuff-related shoulder pain (RCRSP).

Data sources: Data sources included Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), and SPORTDiscus from studies published from database inception to April 23, 2022.

Study selection: Randomized controlled trials studying the use of exercise therapy for RCRSP.

Data extraction: Two reviewers extracted exercise reporting details from all studies using the Template for Intervention Description and Replication (TIDieR) and the modified Consensus on Exercise Reporting Template (CERT). The same two reviewers assessed risk of bias of all studies using Cochrane Risk of Bias Tool version 2.0.

Data synthesis: For 104 studies meeting inclusion criteria, the average number of items reported on the TIDieR was 5.27 (SD 2.50, range 1-12 out of 12) and 5.09 (SD 4.01, range 0-16 out of 16) on the CERT. Improved reporting over time was seen on both the TIDieR and CERT dating back to 1993 and through April 23, 2022. When comparing groups of studies published before and after the TIDieR (2014) and CERT (2016) were established, a statistically significant increase in median scores was noted on the TIDieR (p=.02) but not the CERT (p=.31). Quality of exercise therapy reporting was highest in studies with "low risk" of bias, and lowest in studies with "high risk" of bias on the RoB-2.

Conclusion: Overall exercise reporting in trials for RCRSP is incomplete despite the development of the TIDieR and CERT checklists. This has implications for translating evidence into practice.

Keywords: Exercise; Pain; Rehabilitation; Rotator Cuff; Shoulder.

Publication types

  • Review