Dacre 1989.

Methods	Design: parallel‐group, 3‐arm, single‐blind randomised controlled trial (United Kingdom) Interventions: physiotherapy (mobilisation) or local glucocorticoid injection or physiotherapy (mobilisation) plus local glucocorticoid injection for 6 weeks Sample size calculation: not reported Analysis: per‐protocol analysis Source of funding: Arthritis and Rheumatism Council (non‐industry)
Participants	Number of participants: 66 (20, 22 and 20 in each respective group) Baseline characteristics: duration of symptoms not reported Group receiving physiotherapy (mobilisation) Mean age = 53 years; male:female = 9:11 Group receiving local glucocorticoid injection Mean age = 55.8 years; male:female = 11:11 Group receiving physiotherapy (mobilisation) plus local glucocorticoid injection Mean age = 58.8 years; male:female = 8:12 Inclusion criteria Painful stiff shoulder for at least 4 weeks Inability to use the affected arm with restriction of movement and loss of full function Pain at night causing sleep disturbance and inability to lie on the affected side Exclusion criterion Patients with predisposing causes such as stroke, generalised arthritis or cervical spondylosis or a highly localised lesion, such as bicipital tendinitis
Interventions	Physiotherapy (mobilisation) (N = 20) Components of intervention Manual therapy: The method of physical treatment thought most appropriate was delivered (mobilisation was the mainstay treatment) Dosage: not reported Frequency of administration: 4‐6 weeks (4‐6 sessions) Provider: physiotherapist Local glucocorticoid injection (N = 22) Components of intervention: 20 mg triamcinolone with 1 mL 2% lignocaine injected anteriorly around the shoulder joint Dosage: See above Frequency of administration: once Provider: rheumatologist Physiotherapy (mobilisation) plus local glucocortcoid injection (N = 20) Combination of both interventions described above
Outcomes	Outcomes assessed at 6 weeks (end of physiotherapy treatment) and at 6 months. No primary outcome reported by the trialists Pain using a 10‐cm visual analogue scale, with separate scores for day pain, night pain, pain during active movement and pain during passive movement Passive range of motion in complete shoulder abduction, glenohumeral abduction and external rotation using a goniometer, and internal rotation that was quantified by measuring the distance between the spine of C7 and the index finger with the arm fully internally rotated Complications
Notes	Trialists reported means (standard errors) for each group in figure format for day pain, pain on active movement, total abduction and internal rotation, but no data for night pain, pain on passive movement, glenohumeral abduction and external rotation. No numerical data were reported for any outcome. The study authors were contacted in an attempt to access additional data, but attempts have been unsuccessful. DigitizeIt was used to extract data from figures Trialists reported in the Discussion section, "No treatment gave complications"
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "Patients were randomly allocated to receive physiotherapy alone, local steroid injection alone, or a combination of the two" Comment: No information was reported about how the allocation sequence was generated
Allocation concealment (selection bias)	Unclear risk	Comment: No information was reported about how the allocation sequence was concealed
Blinding of participants and personnel (performance bias) All outcomes	High risk	Comment: Given the nature of the interventions, participants were not blind to treatment and may have had different expectations about the benefits of each intervention
Blinding of outcome assessment (detection bias) Self‐reported outcomes	High risk	Comment: Unblinded participants, who may have had different expectations about the benefits of the intervention they received, self‐reported pain
Blinding of outcome assessment (detection bias) Objective outcomes	Low risk	Quote: "Patients were assessed initially, at six weeks, and at six months by an independent observer unaware of the treatment given" Comment: Assessors of the outcome, passive range of motion, were probably blind to treatment
Incomplete outcome data (attrition bias) All outcomes	Low risk	Quote: "Four patients dropped out of the study before completion. They failed to attend for review at six weeks or six months. The analysis was based on 62 patients (34 female, 28 male)" Comment: The number of participants randomly assigned to each group and the number who dropped out of each group were not reported. Also, it is unclear whether failure of participants to attend for review was related to the treatment they received. Despite this, the relatively low dropout rate is unlikely to have biased the results
Selective reporting (reporting bias)	High risk	Comment: Trialists reported means (standard errors) for each group in figure format for day pain, pain on active movement, total abduction and internal rotation, but no data for night pain, pain on passive movement, glenohumeral abduction and external rotation
Other bias	Low risk	Comment: No other sources of bias were identified