An evidence-informed rehabilitation management framework for posterior shoulder tightness: A scoping review

Abstract

Objective: To systematically scope the literature on posterior shoulder tightness (PST) and define a therapist-instructed and therapist-administered management framework. Design: Scoping review. Literature search: We searched MEDLINE, EMBASE, CINAHL, Scopus and Google Scholar from inception to December 2021. Study selection criteria: Peer-reviewed studies written in English, French, Greek, Japanese or Tamil, with extractable pre- and post-intervention data. Physiotherapy interventions amenable for posterior shoulder structural (muscle, capsule) causes of PST within an adult population. Data synthesis: Arksey and O’Malley's framework was implemented and the PRISMA extension for scoping reviews directed our data synthesis. The data charted from each study included authors, title, study year, location, study design; participant number, age, sex; PST intervention and parameters; patient-reported outcomes; and results. Themes were organized into therapist-instructed and therapist-administered rehabilitation strategies, as well as combined treatment methods. Results: Of 2777 articles identified from our search strategy, 21 articles were included. Therapist-instructed interventions included cross-body stretch (CBS), sleeper stretch (SS), a combination of the two and general stretching. Therapist-administered interventions included CBS, SS, instrument-assisted soft tissue mobilization (IASTM), muscle energy techniques, dry needling and Fauls protocol (12 therapist-assisted stretches). Combined interventions of tape with self-stretching and IASTM and stretching were also identified. Conclusion: Based on the current evidence, CBS and SS are the most researched treatments for PST and seem to be effective at improving PST. Furthermore, stabilization of the scapula while performing these stretches optimized the stretch targeted to the PST and ROM benefits for horizontal adduction.