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Abstract

Therapeutic exercise progression criteria in the management
of rotator cuff tendinopathy: literature review

published in July - August 2023 - in Il Fisioterapista - issue n.4
Massimo Bitocchi

The purpose of this paper is to evaluate statistical data in the available literature regarding the progression criteria of therapeutic exercise in the management of rotator cuff tendinopathy. Therapeutic exercise has fewer adverse events and risks than pharmacological and surgical procedures, which are preferred as secondary options of choice.
Analysis of the included studies showed the predominance of the "pain monitoring" category as the main pivot point through which exercises can progress in difficulty, although other variables were defined in some studies such as, for example, fatigue or self-perception of exercise performance itself. Progressive exercise, especially that with eccentric and aerobic components, appears to be effective in reducing pain and improving function in patients with upper extremity tendinopathies.
In general, Cohen’s “d” obtained small-moderate mean effect sizes for pain during rest/activity/night phases in the short term (0.2/0.24/0.62 respectively), medium term (-0.3/0.06/0.2 respectively) and long term (0.07/-0.06/0.11 respectively). For the outcome function, Cohen’s “d” showed moderate values in the short term (0.37) and long term (0.21), and small values in the medium term (0.1).