Clinical reasoning to inform the choice of exercises for patients with shoulder dysfunction – evidence and application

SPECIALIST TALK // Karen Ginn, PT, professor, Sydney Medical School, University of Sydney

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Exercise is the mainstay of conservative treatment for shoulder dysfunction. However, evidence to support the efficacy of specific exercises for different categories of shoulder dysfunction is limited leaving clinicians with the dilemma of how to choose effective, efficient exercises for their patients with shoulder dysfunction.

Karen Ginn will explore a rationale, evidence-based approach to determining and progressing patient-specific therapeutic shoulder exercises. The validity and reliability of clinical evidence gained from the patient’s diagnosis, radiographic and physical examination findings will be explored to evaluate their role in informing an evidence-based clinical reasoning process to select appropriate therapeutic exercises. Recent evidence on the function of shoulder muscles, particularly the stabiliser function of the rotator cuff and axioscapular muscles, will also be presented.

Finally a case study of a patient with shoulder pain is presented to illustrate this evidence-based clinical reasoning approach to the selection and progression of a patient-specific exercise programme.