Supervised vs. Self-Managed Exercise Therapy for Improving Shoulder Function After Traumatic Dislocation and Sprain: A Systematic Review and Meta-Analysis
Trauma-induced shoulder dislocations and sprains rank among the most common upper extremity injuries, with contact sports accounting for the majority of cases. These injuries often lead to substantial impairments in joint function and long recovery times, requiring targeted therapeutic interventions...
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MDPI AG
2025-01-01
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| author | Daniel Koska Robert Zetzsche Tobias A. Mayer Christian Maiwald |
| author_facet | Daniel Koska Robert Zetzsche Tobias A. Mayer Christian Maiwald |
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| description | Trauma-induced shoulder dislocations and sprains rank among the most common upper extremity injuries, with contact sports accounting for the majority of cases. These injuries often lead to substantial impairments in joint function and long recovery times, requiring targeted therapeutic interventions to restore mobility and prevent recurrent injuries. Given the pivotal role of exercise therapy in restoring shoulder function, this study systematically reviews the literature on the comparative effectiveness of supervised versus self-managed exercise therapy following acute shoulder trauma. PubMed, Cochrane CENTRAL, Embase, Web of Science, and Science Direct were searched up to 13 December 2024. Conservative and post-surgical treatment modes were analyzed separately. Five studies with a total 689 participants were included (conservative: <i>n</i> = 538 across two studies; post-surgical: <i>n</i> = 151 across three studies). Both treatment modes showed similar pooled effects (standardized mean difference, SMD<sub>conservative</sub>: <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mo>−</mo><mn>0.35</mn></mrow></semantics></math></inline-formula>, 95% CI [<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mo>−</mo><mn>1.39</mn></mrow></semantics></math></inline-formula>, 0.69]; SMD<sub>post-surgical</sub>: <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mo>−</mo><mn>0.23</mn></mrow></semantics></math></inline-formula>, 95% CI [<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mo>−</mo><mn>1.21</mn></mrow></semantics></math></inline-formula>, 0.75]), with a marginal improvement in shoulder function favoring supervised therapy. Four studies had some risk of bias, and one had serious risk; GRADE certainty was low. Supervised exercise therapy may offer slightly greater functional improvements over self-managed training, but evidence is limited by heterogeneity and low certainty. Further high-quality trials with standardized protocols and improved adherence tracking are needed to establish more definitive conclusions and guide clinical decision-making. |
| format | Article |
| id | doaj-art-8d3c2d2f3ec84941a3acef41a5c8ddab |
| institution | Kabale University |
| issn | 2075-4663 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Sports |
| spelling | doaj-art-8d3c2d2f3ec84941a3acef41a5c8ddab2025-01-24T13:49:54ZengMDPI AGSports2075-46632025-01-011312310.3390/sports13010023Supervised vs. Self-Managed Exercise Therapy for Improving Shoulder Function After Traumatic Dislocation and Sprain: A Systematic Review and Meta-AnalysisDaniel Koska0Robert Zetzsche1Tobias A. Mayer2Christian Maiwald3Institute of Human Movement Science and Health, Chemnitz University of Technology, 09126 Chemnitz, GermanyInstitute of Human Movement Science and Health, Chemnitz University of Technology, 09126 Chemnitz, GermanyInstitute of Human Movement Science and Health, Chemnitz University of Technology, 09126 Chemnitz, GermanyInstitute of Human Movement Science and Health, Chemnitz University of Technology, 09126 Chemnitz, GermanyTrauma-induced shoulder dislocations and sprains rank among the most common upper extremity injuries, with contact sports accounting for the majority of cases. These injuries often lead to substantial impairments in joint function and long recovery times, requiring targeted therapeutic interventions to restore mobility and prevent recurrent injuries. Given the pivotal role of exercise therapy in restoring shoulder function, this study systematically reviews the literature on the comparative effectiveness of supervised versus self-managed exercise therapy following acute shoulder trauma. PubMed, Cochrane CENTRAL, Embase, Web of Science, and Science Direct were searched up to 13 December 2024. Conservative and post-surgical treatment modes were analyzed separately. Five studies with a total 689 participants were included (conservative: <i>n</i> = 538 across two studies; post-surgical: <i>n</i> = 151 across three studies). Both treatment modes showed similar pooled effects (standardized mean difference, SMD<sub>conservative</sub>: <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mo>−</mo><mn>0.35</mn></mrow></semantics></math></inline-formula>, 95% CI [<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mo>−</mo><mn>1.39</mn></mrow></semantics></math></inline-formula>, 0.69]; SMD<sub>post-surgical</sub>: <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mo>−</mo><mn>0.23</mn></mrow></semantics></math></inline-formula>, 95% CI [<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mo>−</mo><mn>1.21</mn></mrow></semantics></math></inline-formula>, 0.75]), with a marginal improvement in shoulder function favoring supervised therapy. Four studies had some risk of bias, and one had serious risk; GRADE certainty was low. Supervised exercise therapy may offer slightly greater functional improvements over self-managed training, but evidence is limited by heterogeneity and low certainty. Further high-quality trials with standardized protocols and improved adherence tracking are needed to establish more definitive conclusions and guide clinical decision-making.https://www.mdpi.com/2075-4663/13/1/23shoulder dislocationfunctional statusexercise therapysystematic review |
| spellingShingle | Daniel Koska Robert Zetzsche Tobias A. Mayer Christian Maiwald Supervised vs. Self-Managed Exercise Therapy for Improving Shoulder Function After Traumatic Dislocation and Sprain: A Systematic Review and Meta-Analysis Sports shoulder dislocation functional status exercise therapy systematic review |
| title | Supervised vs. Self-Managed Exercise Therapy for Improving Shoulder Function After Traumatic Dislocation and Sprain: A Systematic Review and Meta-Analysis |
| title_full | Supervised vs. Self-Managed Exercise Therapy for Improving Shoulder Function After Traumatic Dislocation and Sprain: A Systematic Review and Meta-Analysis |
| title_fullStr | Supervised vs. Self-Managed Exercise Therapy for Improving Shoulder Function After Traumatic Dislocation and Sprain: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Supervised vs. Self-Managed Exercise Therapy for Improving Shoulder Function After Traumatic Dislocation and Sprain: A Systematic Review and Meta-Analysis |
| title_short | Supervised vs. Self-Managed Exercise Therapy for Improving Shoulder Function After Traumatic Dislocation and Sprain: A Systematic Review and Meta-Analysis |
| title_sort | supervised vs self managed exercise therapy for improving shoulder function after traumatic dislocation and sprain a systematic review and meta analysis |
| topic | shoulder dislocation functional status exercise therapy systematic review |
| url | https://www.mdpi.com/2075-4663/13/1/23 |
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