Key result
Non-operative management of glenohumeral internal rotation deficit consistently demonstrated significant improvements in internal rotation, though 78% of the overall literature consisted of low-level evidence.
Why the study?
Glenohumeral internal rotation deficit (GIRD) can negatively impact shoulder function particularly in throwing athletes, prompting an evaluation of recent trends in clinical outcomes and evidence quality.
What are the recent trends in clinical outcomes and quality of published evidence pertaining to Glenohumeral internal rotation deficit (GIRD)?
Systematic Review (n=82)
What are the recent trends in clinical outcomes and quality of published evidence pertaining to Glenohumeral internal rotation deficit (GIRD)?
Current literature on GIRD consists mostly of low-level evidence with significant variability in clinical definitions, though non-operative management consistently improves internal rotation.
Non-operative management improves GIRD internal rotation; low-level evidence leaves optimal protocols unresolved.
Background Glenohumeral internal rotation deficit (GIRD) can negatively impact shoulder function particularly in the throwing athlete. Questions/Purpose This study aimed to systematically evaluate recent trends in clinical outcomes and quality of published evidence pertaining to GIRD. Methods A systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, MEDLINE, PubMed Central, and Embase were searched from January 1, 2011, through April 23, 2017, for all articles evaluating GIRD. Two reviewers independently screened articles for eligibility and extracted data for analysis. Results Eighty-two articles were included in the final review. In general, the overall number of articles published increased over time. Two-thirds of all studies were conducted in the USA. Seventy-eight percent ( N = 64) of included studies were level-III to level-V evidence, with no level-I study performed during the study period. Eighty-five percent of studies were either epidemiologic, review, or imaging articles, and only 12% were clinical studies. Significant variability in the clinical definition of GIRD was identified. All studies evaluating non-operative management of GIRD demonstrated significant improvements in internal rotation of the affected extremity. Conclusion Current trends in GIRD-related literature demonstrate limited focus on clinical, therapeutic, or patient-reported outcomes and mostly consist of low-level evidence. There is a lack of consensus in the literature on what clinically constitutes GIRD.
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Kirsch et al. (2019) conducted a systematic review in Glenohumeral internal rotation deficit (GIRD) (n=82). Non-operative and operative management was evaluated on Clinical outcomes and quality of published evidence pertaining to GIRD. Non-operative management of glenohumeral internal rotation deficit consistently demonstrated significant improvements in internal rotation, though 78% of the overall literature consisted of low-level evidence.
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