Abstract
Objectives
To perform a systematic review of clinical practice guidelines (CPGs) and semantic
analysis of specific clinical recommendations for the management of rotator cuff disorders
in adults.
Data Sources
A systematic bibliographic search was conducted up until May 2018 in Medline, Embase,
and Physiotherapy Evidence Database, or PEDro, databases, in addition to 12 clinical
guidelines search engines listed on the Appraisal of Guidelines for Research and Evaluation
(AGREE) website.
Study Selection
Nine CPGs on the management of rotator cuff disorders in adults or workers, available
in English or French, and published from January 2008 onward, were included and screened
by 2 independent reviewers.
Data Extraction
CPG methodology was assessed with the AGREE II checklist. A semantic analysis was
performed to compare the strength of similar recommendations based on their formulation.
The recommendations were categorized in a standardized manner considering the following
4 levels: “essential,” “recommended,” “may be recommended,” and “not recommended.”
Data Synthesis
Methodological quality was considered high for 3 CPGs and low for 6. All CPGs recommended
active treatment modalities, such as an exercise program in the management of rotator
cuff disorders. Acetaminophen or nonsteroidal anti-inflammatory drug prescriptions
and corticosteroid injections were presented as modalities that may be recommended
to decrease pain. Recommendations related to medical imagery and surgical opinion
varied among the guidelines. The most commonly recommended return-to-work strategies
included intervening early, use of a multidisciplinary approach, and adaptation of
work organization.
Conclusions
Only 3 CPGs were of high quality. The development of more rigorous CPGs is warranted.
Keywords
List of abbreviations:
AGREE (Appraisal of Guidelines for Research and Evaluation), CPG (clinical practice guidelines), MRI (magnetic resonance imaging), RC (rotator cuff), RTW (return to work)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 30, 2020
Footnotes
Supported by the Institut de recherche Robert-Sauvé en santé et en sécurité du travail (grant no. 2016-0029). The funding source had no involvement in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
