Summary of findings 3. Low‐level laser therapy (LLLT) plus exercise compared to exercise for adhesive capsulitis (frozen shoulder).
| Low‐level laser therapy (LLLT) plus exercise compared to placebo plus exercise for adhesive capsulitis (frozen shoulder) | ||||||
| Patient or population: patients with adhesive capsulitis (frozen shoulder) Settings: physical therapy clinic in high‐income country Intervention: LLLT plus exercise Comparison: placebo laser therapy plus exercise | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Placebo laser therapy plus exercise | LLLT plus exercise | |||||
| Participant‐reported pain relief ≥ 30% | See comment | See comment | Not estimable | ‐ | See comment | No studies reported this outcome |
|
Overall pain 0‐100 visual analogue scale (lower score = less pain) Follow‐up: at 4th week of treatment |
The mean overall pain in the control group was 51 points | The mean overall pain in the intervention group was 19 points lower (23 to 15 lower) | 63 (1 study) | ⊕⊕⊕⊝ moderate1 | Absolute risk difference 19% (23% to 15% fewer); relative per cent change2 28% (34% to 22% fewer) NNTB = 1 (1 to 2) |
|
| Function Shoulder Disabilty Questionnaire 0‐100 (lower scores = better function) Follow‐up: at 4th week of treatment | The mean function in the control group was 48 points | The mean function in the intervention group was 12 points lower (18 to 6 lower) | 63 (1 study) | ⊕⊕⊕⊝ moderate1 | Absolute risk difference 12% (18% to 6% fewer); relative per cent change3 19% (29% to 10% fewer) NNTB = 2 (2 to 5) |
|
| Global assessment of treatment success | See comment | See comment | Not estimable | ‐ | See comment | No studies reported this outcome |
|
Active shoulder abduction Degrees Follow‐up: 4 weeks |
The mean active shoulder abduction in the control group was 70 degrees | The mean active shoulder abduction in the intervention group was 9 degrees higher (2 to 16 higher) | 63 (1 study) | ⊕⊕⊕⊝ moderate1 | Absolute risk difference 5% (1% to 9% more); relative per cent change415% (3% to 27% more) | |
| Quality of life | See comment | See comment | Not estimable | ‐ | See comment | No studies reported this outcome |
| Adverse events | See comment | See comment | Not estimable | 63 (1 study) | ⊕⊕⊕⊝ moderate1 | No participant reported experiencing any adverse event |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Sample size is small, yielding wide 95% CIs.
2 Baseline mean overall pain score of placebo group was 67.
3 Baseline mean function score of placebo group was 62.
4 Baseline mean active abduction of placebo group was 59.