J Sport Rehabil. 2020 Jul 31;30(1):136-151. doi: 10.1123/jsr.2019-0400.
Proprioception deficits contribute to persistent and recurring physical disability, particularly with shoulder disorders. Proprioceptive training is thus prescribed in clinical practice. It is unclear whether nonsurgical rehabilitation can optimize shoulder proprioception.
To summarize the available evidence of conservative rehabilitation (ie, nonsurgical) on proprioception among individuals with shoulder disorders.
PubMed, Web of Science, and EBSCO were systematically searched, from inception until November 24, 2019. Selected articles were systematically assessed, and the methodological quality was established using the Dutch Cochrane Risk of Bias Tool and the Newcastle-Ottawa Quality Assessment Scale. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were utilized for this review. The conservative treatments were categorized as follows: (1) conventional therapy, (2) proprioceptive training, (3) elastic kinesiology tape, and (4) other passive therapies.
Twelve articles were included, yielding 58 healthy control shoulders and 362 shoulders affected by impingement syndrome, glenohumeral dislocations, nonspecific shoulder pain, rotator cuff dysfunction, or subluxation poststroke. The level of agreement between the evaluators was excellent (84.9%), and the studies were evaluated to be of fair to excellent quality (risk of bias: 28.5%-100%). This review suggests, with moderate evidence, that proprioceptive training (upper-body wobble board or flexible foil training) can improve proprioception in the midterm. No decisive evidence exists to suggest that conventional therapy is of added value to enhance shoulder proprioception. Conflicting evidence was found for the improvement of proprioception with the application of elastic kinesiology tape, while moderate evidence suggests that passive modalities, such as microcurrent electrical stimulation and bracing, are not effective for proprioceptive rehabilitation of the shoulder.
Proprioceptive training demonstrates the strongest evidence for the effective rehabilitation of individuals with a shoulder proprioceptive deficit. Elastic kinesiology tape does not appear to affect the sense of shoulder proprioception. This review suggests a possible specificity of training effect with shoulder proprioception.
本体感觉缺陷会导致持续性和复发性的身体残疾，尤其是肩部疾病。因此，在临床实践中会进行本体感觉训练。目前尚不清楚非手术康复是否可以优化肩部本体感觉。
总结现有的关于肩部疾病患者的保守治疗（即非手术）对本体感觉的影响的证据。
从建库到 2019 年 11 月 24 日，系统地检索了 PubMed、Web of Science 和 EBSCO 数据库。对选定的文章进行了系统评估，并使用荷兰 Cochrane 偏倚风险工具和纽卡斯尔-渥太华质量评估量表来确定方法学质量。本综述遵循了系统评价和荟萃分析的 Preferred Reporting Items 指南。保守治疗被分为以下几类：（1）常规治疗，（2）本体感觉训练，（3）弹性肌内效贴，和（4）其他被动治疗。
纳入了 12 篇文章，共纳入了 58 个健康对照组肩部和 362 个患有撞击综合征、肩关节脱位、非特异性肩部疼痛、肩袖功能障碍或脑卒中后半脱位的肩部。评估者之间的一致性非常好（84.9%），且这些研究的质量被评估为从低到高（偏倚风险：28.5%-100%）。本综述表明，本体感觉训练（上半身平衡板或柔性箔训练）在中期可以改善本体感觉，证据质量为中等。目前没有确凿的证据表明常规治疗对增强肩部本体感觉有额外的价值。弹性肌内效贴对改善本体感觉的效果存在矛盾的证据，而中等质量的证据表明，被动治疗方法，如微电流电刺激和支具，对肩部本体感觉的康复没有效果。
本体感觉训练对肩部本体感觉缺陷患者的康复效果最强。弹性肌内效贴似乎不会影响肩部本体感觉。本综述提示肩部本体感觉的康复可能具有训练效应的特异性。
