Abstract

Purpose: Posterior shoulder tightness (PST) and Glenohumeral internal rotation deficit (GIRD) can impact shoulder biomechanics and damage shoulder function. Posterior shoulder stretching exercises (PSSEs) are often performed in traditional positions to improve posterior shoulder inflexibility. However, these traditional positions can cause inadequate control of the scapula and glenohumeral rotation. The modified PSSEs through scapular stabilization are preferred as current trends to effective management of the GIRD and PST. However, there is a lack of consensus regarding which type of modified PSSE is more effective on PST and GIRD improvement. Therefore, we aimed to describe the efficacy of modified PSSEs on PST and GIRD in symptomatic and asymptomatic populations to aid clinicians when making decisions for these populations. 
 Methods:A literature search was conducted for a systematic review. Relevant studies were searched from appropriate electronic databases (CINAHL, Cochrane Review, Pubmed (MEDLINE), Web of Science as well as Google Scholar©), and selected the eligible studies for inclusion.
 Results: The present systematic literature search generated 127 relevant citations and 17 articles were included in the final review. As an outcome measure GIRD was assessed in all included studies, whereas PST was assessed in 10 studies.There was high evidence related to the positive effects of both modified cross-body and sleeper stretch to improve GIRD and PST.
 Conclusion: According to this systematic literature review, both modified cross-body and sleeper stretch are effective in the improvement of GIRD and PST. Future research should focus on other specific shoulder diseases and should also recruit specific participants to address the effectiveness of modified PSSEs on GIRD and PST.

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