Does manual therapy improve pain, disability, and glenohumeral motion in overhead athletes? Systematic review and meta-analysis

IF 1.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Osteopathic Medicine Pub Date : 2025-01-07 DOI:10.1016/j.ijosm.2025.100747

Sávio Douglas Ferreira Santana , Vander Gava , Valéria Mayaly Alves de Oliveira , Gabriel Alves dos Santos , Tássio Augusto Soares Lima , Danilo Harudy Kamonseki

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引用次数: 0

Abstract

Objectives

To systematically review the effects of manual therapy (MT) on pain intensity, disability, internal rotation (IR), external rotation (ER), and horizontal adduction (HA) range of motion (ROM) in overhead athletes.

Data sources

Databases (Medline, EMBASE, SPORTDiscus, CINAHL, CENTRAL, Web of Science, and SCOPUS) were searched from inception up to May 2023.

Study selection

Randomized controlled trials (RCTs) comparing MT to a non-treatment group or other treatment groups were selected.

Data extraction

Two reviewers independently selected RCTs that investigated the effects of MT on pain intensity, disability, IR, ER, and HA ROM.

Data synthesis

Mean difference or Standardized Mean Differences, along with 95 % confidence intervals, were calculated for the meta-analysis of each outcome of interest. The level of evidence was synthesized using GRADE.

Results

Twelve RCTs were included, with a pooled sample of 401 athletes. MT was not superior (p > 0.05) to no treatment in improving pain, disability, IR ROM, and ER ROM, but it was superior to no treatments in improving HA. MT was not superior (p > 0.05) to other treatments in improving ER ROM and HA ROM, but it was superior other treatments in improving IR ROM and disability. Those findings were based on very low certainty of evidence.

Conclusion

MT may not effectively improve pain and ER ROM. The very low quality of evidence, conflicting findings regarding the effects of MT on disability and IR, and the small, likely clinically irrelevant effects on HA, do not provide sufficient support for a definitive recommendation regarding the effectiveness of MT for treating overhead athletes.

Implications for practice

-
Manual therapy may not effectively improve pain intensity and glenohumeral external rotation range of motion.
-
Manual therapy showed conflicting effects on disability and glenohumeral internal rotation range of motion.
-
Manual therapy showed small and clinically irrelevant effects on horizontal adduction range of motion.
-
No significant difference was observed among different manual therapy techniques.

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手工疗法能改善头顶运动员的疼痛、残疾和肩关节运动吗？系统回顾和荟萃分析

目的系统回顾手疗（MT）对头顶运动员疼痛强度、残疾、内旋（IR）、外旋（ER）和水平内收（HA）活动度（ROM）的影响。数据源数据库（Medline， EMBASE, SPORTDiscus， CINAHL， CENTRAL， Web of Science和SCOPUS）从成立到2023年5月进行了检索。研究选择选择将MT与非治疗组或其他治疗组进行比较的随机对照试验（rct）。数据提取：两位研究者独立选择了调查MT对疼痛强度、残疾、IR、ER和HA rom影响的随机对照试验。数据综合计算了每个结果的平均差异或标准化平均差异，以及95%的置信区间。采用GRADE综合证据水平。结果共纳入12项随机对照试验，共纳入401名运动员。MT并不优越(p >；在改善疼痛、残疾、IR ROM和ER ROM方面优于不治疗，但在改善HA方面优于不治疗。MT并不优越(p >；在改善ER ROM和HA ROM方面优于其他治疗，但在改善IR ROM和残疾方面优于其他治疗。这些发现是基于非常低的证据确定性。结论：MT可能不能有效改善疼痛和ER ROM。关于MT对残疾和IR的影响的证据质量非常低，研究结果相互矛盾，并且对HA的影响很小，可能与临床无关，因此不能为MT治疗头顶运动员有效性的明确推荐提供足够的支持。实践意义-手工疗法可能不能有效改善疼痛强度和肩关节外旋活动范围。-手工疗法对残疾和肩关节内旋活动范围的影响相互矛盾。-手工治疗对水平内收活动范围的影响很小，且与临床无关。不同手法治疗方法间无显著差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Osteopathic Medicine 医学-医学：内科

CiteScore

2.20

自引率

36.80%

发文量

审稿时长

3 months

期刊介绍： The International Journal of Osteopathic Medicine is a peer-reviewed journal that provides for the publication of high quality research articles and review papers that are as broad as the many disciplines that influence and underpin the principles and practice of osteopathic medicine. Particular emphasis is given to basic science research, clinical epidemiology and health social science in relation to osteopathy and neuromusculoskeletal medicine. The Editorial Board encourages submission of articles based on both quantitative and qualitative research designs. The Editorial Board also aims to provide a forum for discourse and debate on any aspect of osteopathy and neuromusculoskeletal medicine with the aim of critically evaluating existing practices in regard to the diagnosis, treatment and management of patients with neuromusculoskeletal disorders and somatic dysfunction. All manuscripts submitted to the IJOM are subject to a blinded review process. The categories currently available for publication include reports of original research, review papers, commentaries and articles related to clinical practice, including case reports. Further details can be found in the IJOM Instructions for Authors. Manuscripts are accepted for publication with the understanding that no substantial part has been, or will be published elsewhere.