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. 2015 Jun 15;2015(6):CD007402. doi: 10.1002/14651858.CD007402.pub3

Mahler 2003.

Methods R, DB, AC, parallel groups
Gel applied with gentle massage to affected area 3 times daily, without occlusion, for 10 days
Assessed at baseline, 3, 10 days in clinic and daily patient diary
Participants First‐degree ankle or knee sprains, first‐degree muscle strains and mild‐to‐moderate contusions
n = 100
M 69, F 31
Mean age 32 years
Mean baseline pain with activity ≥ 65 mm
Interventions DHEP lethicin gel, 3 x 5 g (= 65 mg) daily, n = 52
DHEP gel, 3 x 5 g (= 65 mg) daily, n = 48
All participants treated with ice at site of inflammation for first 48 hours, but no immobilisation allowed
Rescue medication: paracetamol 500 mg if strictly necessary
Outcomes PGE: 4‐point scale (responder = "good" or "excellent")
Pain on movement: 100‐mm VAS (mean data)
Adverse events
Withdrawals
Notes Oxford Quality Score: R2, DB2, W1. Total = 5
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk "Computer‐generated randomization list"
Allocation concealment (selection bias) Unclear risk Not described
Blinding (performance bias and detection bias) 
 All outcomes Low risk Pharmaceutically inert colouring agents added to reference formulation so that gels were indistinguishable
Incomplete outcome data (attrition bias) 
 All outcomes Low risk All participants included in responder analysis
Size High risk < 50 participants in each treatment arm