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Electromyographic Activity of Shoulder Girdle Muscles in Patients with Symptomatic and Asymptomatic Rotator Cuff Tears: A Systematic Review and Meta-Analysis

Peter Spall, PT, MPhty (OMT), Daniel Cury Ribeiro, PT, PhD, Gisela Sole, PT, PhD

Setting the scene:

Rotator cuff tears are a common cause for shoulder dysfunction and can have significant impact on the individual, with decreased function during activities of daily living, ability to work. Rotator cuff tears are managed with surgical repair and rehabilitation or conservatively with physical therapy. Electromyography (EMG) has been used to objectively measure shoulder muscle activation during both isometric and functional tasks to determine differences between participants with symptomatic and asymptomatic rotator cuff tears compared with healthy control subjects. The identification of different shoulder muscle activity patterns could enhance our understanding of the consequences of rotator cuff tears and help to guide more targeted conservative management and postoperative rehabilitation. The purpose of this review was to summarize current evidence by comparing EMG activity of patients with symptomatic rotator cuff tears with healthy controls or to individuals with asymptomatic rotator cuff tears.

What did they do?

Databases searched included PubMed, Scopus, Ovid Medline, and Web of Science. The article search followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta- Analyses) guidelines. 9 studies were included in this review. Methodological quality was assessed with a modified Critical Appraisal Skills Programme score and meta-analyses were performed when 2 or more studies explored the same outcome measures. The result showed that the subjects with rotator cuff tears may have developed compensatory strategies, for example with greater cocontraction for the latissimus dorsi and duration for upper trapezius activity, supporting a hypothesis that muscle activity may be redistributed to uninjured muscles of the axioscapular muscles or antagonists. Current evidence for muscle activation patterns for individuals with full rotator cuff tears is limited.

Takeaway message:

future studies are recommended to match controls, calculate sample size, determine reliability of EMG testing, and report shoulder pain during testing and report the location. Severity and subgrouping types of tears may need to be considered when reporting EMG outcomes for these help therapists tailor a more control targeted rehabilitation.

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