A systematic review to compare physiotherapy treatment programmes for atraumatic shoulder instability

Jake Griffin (Lead Author), Anju Jaggi, Helena Daniel, Rachel Chester

Research output: Contribution to journalArticlepeer-review

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Background: Optimal physiotherapy treatment is uncertain for atraumatic shoulder instability (ASI), the primary aim of this systematic scoping review was to compare physiotherapy treatment programmes for people with ASI. The secondary aims were to evaluate outcome measures used and to compare the effectiveness of these programmes. 

Methods: CINAHL, EMBASE and Medline databases were searched for studies, except single case studies, published between 1950 and July 2021. 12 critical appraisal items covered three domains; internal validity, transferability to wider population and reporting. 

Results: Ten studies were included; one randomised controlled trial, 6 cohort studies and 3 case series. There were 491 participants. Treatment programmes included education, movement re-education, static posture correction, shoulder muscle strengthening, functional training, and adjuncts. All studies used patient reported outcome measures (PROMs), 7 of which reported a statistically significant improvement (p < 0.05) post-treatment. There was no clear relationship between programmes and outcomes. PROMs specific to shoulder instability were all found to detect statistically significant differences post-treatment. 

Discussion: There does not appear to be one optimal physiotherapy treatment programme for ASI. Future studies should use PROMs that are valid in the shoulder instability population and use more outcome measures that are specific to impairments being targeted. 
Original languageEnglish
Pages (from-to)448-460
Number of pages13
JournalShoulder & Elbow
Issue number4
Early online date18 Feb 2022
Publication statusPublished - Aug 2023


  • atraumatic
  • outcome measures
  • physiotherapy
  • review
  • shoulder
  • shoulder instability

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