The Staged Approach for Rehabilitation Classification of Shoulder disorders (STAR-Shoulder) was proposed in 2015 in an effort to better align clinical decision-making regarding treatment/interventions with examination findings related to physical impairment and tissue irritability. Recent studies have demonstrated good reliability and validity of this system. Furthermore, a recent case series demonstrated improved patient outcomes when using the STAR-Shoulder system to guide rehabilitation for patients with shoulder pain.
Similar to other evidence-based treatment classification systems for rehabilitation of low back or neck pain, this system relies more upon identified physical impairments and tissue irritability rather than a pathoanatomic diagnosis to guide clinical decisions related to treatment. Underlying concepts that support the STAR-Shoulder will be reviewed, including tissue irritability and the physical stress theory related to appropriate dosing of tissue loading. Additional topics include optimal clinical tests and measures for shoulder examination and their associated psychometric properties (reliability, sensitivity, specificity, and likelihood ratios). Clinical case examples will illustrate how to effectively integrate the STAR-Shoulder system into the examination/evaluation process.
Upon completion of this course, the participant will be able to:
- Describe positive key findings to assist with ruling in/out glenohumeral instability/hypermobility, glenohumeral hypomobility, neuromuscular weakness, and subacromial pain syndrome.
- Differentiate between levels of tissue irritability (high, moderate, low) based upon patient history and examination findings.
- Apply key concepts of STAR-Shoulder to select intervention strategies that align with identified tissue irritability and key physical impairments.