Abstract
Background Glenohumeral instability is a highly prevalent pathology, but there is no effective management of this injury, with a great controversy about the most effective treatment for this injury to allow the complete recovery of the patients. For these reasons, the main aim was to summarise the evidence about the effectiveness of a therapeutic exercise program in patients who suffer glenohumeral instability. Methods the search string was ‘exercise’ OR ‘rehabilitation’ AND ‘shoulder instability’ OR ‘glenohumeral instability’ OR ‘recurrent shoulder dislocation’ with the filters of title and abstract in the databases PubMed, Scopus, Embase, and PEDro. Randomised controlled trials including adults with a diagnosis of glenohumeral instability, investigating the effects of an exercise program compared to a control group were selected; two independent reviewers performed data synthesis. Results Five studies, comprising 304 participants were included in the meta-analysis showing large effects in the WOSI scale (standardised mean difference = 3.12, 95% CI 2.12 to 4.12), favouring exercise interventions in those articles that take a conservative approach. However, alluding to post-surgical rehabilitation, the meta-analysis did not show relevant differences between exercise and standard care groups in the ASES scale (standardised mean difference = 0.14, 95% CI −0.24 to 0.52). Conclusion Supervised therapeutic exercise programs effectively treat glenohumeral instability and improve some symptoms of this pathology. Programs based on scapular motor control and muscle strengthening should be offered as a good evidence-based treatment. Nonetheless, the lack of studies and the heterogeneity of the protocols make further research necessary to obtain solid evidence. Registration PROSPERO ID CRD42024404457
Published Version
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