Clinical Value of Scapular-Targeted Rehabilitation Within the Rotator Cuff Care Continuum: A Systematic Review and Meta-analysis of Conservative and Postoperative Evidence.

Abstract

Background Scapular-targeted rehabilitation is increasingly incorporated into the management of rotator cuff-related shoulder disorders; however, its clinical value across both conservative and postoperative stages of care remains uncertain. Objective To evaluate the effectiveness of scapular-targeted rehabilitation on pain, disability, and shoulder function across the rotator cuff care continuum. Methods A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception through May 2026. Eligible studies included adults with rotator cuff-related shoulder pain, subacromial pain syndrome, subacromial impingement syndrome, scapular dyskinesis-associated shoulder disorders, or patients undergoing rehabilitation following rotator cuff repair. Randomized controlled trials were included in quantitative synthesis. Random-effects models were used to pool standardized mean differences (SMDs) or mean differences (MDs) with 95% confidence intervals (CIs). Results Nine studies met the inclusion criteria, comprising seven randomized controlled trials, one propensity score-matched study, and one single-group pre-post study. Meta-analysis demonstrated that scapular-targeted rehabilitation significantly reduced pain compared with control interventions (SMD -0.88, 95% CI -1.71 to -0.06; I²=84.8%) and significantly improved shoulder function measured by the Constant-Murley Score (MD 6.94, 95% CI 0.37 to 13.52; I²=85.7%). Disability outcomes favored scapular-targeted rehabilitation but did not reach statistical significance (SMD -0.47, 95% CI -1.05 to 0.11; I²=72.8%). Postoperative studies generally reported favorable effects on pain, function, and range of motion, although evidence was insufficient for quantitative synthesis. Conclusions Scapular-targeted rehabilitation appears to be a useful adjunct within comprehensive rotator cuff rehabilitation, with evidence supporting improvements in pain and shoulder function. Evidence for disability reduction and postoperative effectiveness remains inconclusive, warranting further high-quality trials across the rotator cuff care continuum.