Evidence map›Paper›PMID 42260441›Full record

SynthesisBMC musculoskeletal disorders2026

Exercise interventions for rotator cuff-related shoulder pain in middle-aged and older adults: a systematic review and meta-analysis.

Paulino Vico-Rodríguez, Agustín Aibar-Almazán, Fidel Hita-Contreras, María Auxiliadora Márquez-Apolinario, Julia Gámez-Iruela, Marta Cano-Orihuela, Yolanda Castellote-Caballero

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Paulino Vico-RodríguezDepartment of Health Sciences, Faculty of Health Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain.
Agustín Aibar-AlmazánDepartment of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain. aaibar@ujaen.es.
Fidel Hita-ContrerasDepartment of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain.
María Auxiliadora Márquez-ApolinarioDepartment of Health Sciences, University of Fernando Pessoa-Canarias, Las Palmas de Gran Canaria, Spain.
Julia Gámez-IruelaDepartment of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain.
Marta Cano-OrihuelaDepartment of Health Sciences, Faculty of Health Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, 35017, Spain.
Yolanda Castellote-CaballeroDepartment of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesRotator cuff-related shoulder pain is highly prevalent in middle-aged and older adults and is associated with pain, functional limitations, and reduced quality of life. This systematic review and meta-analysis aimed to evaluate the effectiveness of exercise-based interventions on pain, function, range of motion (ROM), and strength in middle-aged and older adults with rotator cuff-related shoulder pain.

methodsA systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD420251236625). Searches were performed in PubMed, Scopus, Web of Science, PEDro, and Cochrane Library databases for studies published within the last 10 years. Randomized controlled trials including adults with rotator cuff-related shoulder pain were included. A total of 1,152 participants across 21 studies were analyzed. Exercise-based interventions primarily targeted the rotator cuff and scapular stabilizer muscles through strengthening, stretching, stabilization, and neuromuscular exercise programs, and were compared with usual care, other exercise approaches, or adjunct therapies. Functional outcomes were mainly assessed using validated instruments such as SPADI, DASH/QuickDASH, and the Constant-Murley Score. Effect sizes were calculated using standardized mean differences, and heterogeneity was assessed with the I² statistic.

resultsTwenty-one randomized controlled trials were included. Exercise-based interventions produced significant improvements in pain (g = -1.454, p < 0.001), function (g = 0.457, p < 0.001), and ROM (g = -2.477, p < 0.001). Improvements in strength were smaller and did not reach statistical significance (g = 0.229, p = 0.085). Although strengthening exercises showed positive trends across studies, the pooled effect on strength was not statistically significant. High heterogeneity was observed (I² = 95.96%), likely due to differences in intervention protocols, participant characteristics, and outcome assessment methods.

conclusionsExercise-based interventions are effective in reducing pain and improving function and ROM in middle-aged and older adults with rotator cuff-related shoulder pain. However, effects on strength appear more limited. Further high-quality studies using standardized exercise protocols and longer follow-up periods are needed to optimize rehabilitation strategies.

Indexed as

Exercise TherapyRotator CuffRotator Cuff InjuriesShoulder PainAgedHumansMiddle AgedRandomized Controlled Trials as TopicRange of Motion, ArticularTreatment OutcomeExercise therapyMeta-analysisRehabilitationRotator cuff injuriesShoulder injuriesShoulder pain

Identifiers

PMID42260441
PMCPMC13471655

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.