Progressive exercise not superior to best practice advice in rotator cuff disorders: Lancet

The primary outcome was the Shoulder Pain and Disability Index (SPADI) score over 12 months, analysed on an intention-to-treat basis (statistical significance set at 1%).

The results of the study are as follows:

• Over 12 months, SPADI data were available for 166 (95%) patients in the progressive exercise group, 164 (94%) in the best practice advice group, 177 (97%) in the corticosteroid injection then progressive exercise group, and 175 (98%) in the corticosteroid injection then best practice advice group.
• No evidence of a difference was found in SPADI score between progressive exercise and best practice advice when analysed over 12 months.
• Also, no evidence of a difference was found between corticosteroid injection compared with no injection when analysed over 12 months.
• No serious adverse events were reported.

The researchers concluded that progressive exercise was similar to a best practice advice session with a physiotherapist in improving shoulder pain and function. And subacromial corticosteroid injection provided no long-term benefit in patients with rotator cuff disorders.

Reference:

Progressive exercise compared with best practice advice, with or without corticosteroid injection, for the treatment of patients with rotator cuff disorders (GRASP): a multicentre, pragmatic, 2 × 2 factorial, randomised controlled trial by Hopewell S et. al published in the Lancet.

DOI: https://doi.org/10.1016/S0140-6736(21)00846-1