Effects of Upper Extremity Strength Exercises in Subacromial Impingement Syndrome: A Systematic Review

Abstract

OBJECTIVE: This study aimed to evaluate the effects of upper extremity strengthening exercises in individuals with subacromial impingement syndrome (SAIS). DESIGN: Systematic review. Inclusion criteria were (1) randomized controlled trials (RCTs) and quasi-experimental studies published in English; (2) participants aged 18 years or older diagnosed with subacromial or shoulder impingement syndrome; (3) studies comparing strengthening exercise interventions with other exercise programs, treatment protocols, or standard care. Exclusion criteria included case reports, case series, narrative reviews, editorials, and analytical studies. SETTING: N/A. PATIENTS: Individuals diagnosed with SAIS. INTERVENTIONS: Upper extremity strengthening exercises. MAIN OUTCOME MEASURES: The effects of strengthening exercises on pain, muscle strength, range of motion (ROM), quality of life, and function in individuals with SAIS. RESULTS: A systematic review of 3 electronic databases up to May 2024 identified RCTs investigating strengthening exercises in the management of SAIS. Thirteen studies (n = 914) meeting the prespecified criteria were selected using relevant keywords. These trials assessed pain, muscle strength, quality of life, ROM, and functionality. CONCLUSIONS: This review demonstrates that upper extremity strengthening exercises may reduce shoulder pain, improve ROM, and enhance muscle strength in individuals with SAIS. However, the evidence regarding their effects on functionality and quality of life remains limited, highlighting the need for further high-quality RCTs. Nevertheless, incorporating strengthening exercises into rehabilitation programs is recommended as a potentially effective approach in the management of SAIS.