Critérios de retorno ao esporte em atletas com tendinopatia do manguito rotador: Uma revisão integrativa

Abstract

Objective: In an integrative review, the criteria for returning to sport in athletes with rotator cuff tendinopathy (RCT) were searched for application, consistency, and standardization gaps. Methods: A search was conducted by PubMed, SciELO, Cochrane Library, and LILACS with respective DeCS/MeSH descriptors and AND/OR. This study was included when the full-text studies in the previous 5 years in Portuguese or English were published as reports of athletes with RCT, specifying whether researchers published objective discharge/returning to sport criteria. Designs that had been eligible were observational (retrospective/prospective), narrative, and systematic reviews. There were three stages of screening by two independent reviewers. The data retrieved were study design, sample, returning to sport criteria, and outcomes. Results: Out of 101 records, 14 studies were included. The returning to sport criteria grouped into four domains: physical-functional, clinical, temporal/sport-specific, and psychological. The most common criteria were no pain (n=6, clinical), muscle strength adequate (n=5, physical-functional), and range of motion (n=5, physical-functional). Temporal and sport-specific criteria like minimum postoperative period and sport-specific skill level were less frequent (n=2), and psychological variables were identified in merely one study. Validated questionnaires (ASES, UCLA-S, Constant, VAS, KJOC, DASH) were used infrequently and inconsistently. The upper-limb functional tests (CKCUEST, YBT-UQ, medicine ball throw, etc.) were not measured formally as returning to sport criteria. Conclusions: Returning to sport decisions in athletes receiving RCT primarily hinge on traditional clinical parameters (pain, strength, and range of motion), with a weak uniform quantitative standardization. The other notable gaps lie in the inclusion of objective functional measurements and psychological readiness. Needed to confirm threshold parameters and to include shoulder-specific functional tests for better safe and reproducible returning to sport in sport settings are prospective studies.