| Methods |
Randomised controlled trial
Blinding: both patients and outcome assessors were blinded
Loss to follow‐up: Four patients withdrew before study completion: 1(6%) in lidocaine groups, 2(12%) in intra‐articular group, 1(6%) in intrabursal group.
Appropriate statistical analysis: yes, intention to treat analysis. |
| Participants |
48 patients
Inclusion criteria: Total passive range of motion < 50 percent of normal, shoulder pain less than 6 months, pain worse at night,
no effusion in glenohumeral joint, no history of recent trauma and no previous injections in involved shoulder, no history of allergy to local anaesthetics or steroids.
Exclusion criteria included:
polyarthritis or neurologic diseases which may lead to shoulder pain, cervical radiculopathy, evidence of alternative cause of shoulder pain revealed in shoulder x‐rays including osteoarthritis, fracture, metastases, accromioclavicular pathology |
| Interventions |
Group 1(16 patients): intra‐articular (anterior approach) methyl prednisolone 40mg 1ml and lidocaine 2ml 1%
Group 2(16 patients): Subacromial bursa methylpredisolone and lidocaine
Group 3(8 patients): intra‐articular lidocaine 3ml 1%
Group 4(8 patients): intra‐bursal lidocaine 3ml 1%
Each patient received 3 injections in same location at intervals of one week and all patients received same home exercise program and standardized weekly physical therapy treatment for 11 weeks consisting of ultrasound and therapeutic exercises. All were adivsed to continue NSAIDs. |
| Outcomes |
Assessed at baseline, weekly for 11 weeks, week 15 and 6 months.
1) Pain on a 6‐ point rating scale (0=none and 5=extreme)
2) Shoulder passive range of motion expressed as the sum of shoulder motion in 3 planes (internal rotation‐ external rotation, flexion‐ extension, adduction‐ abduction). |
| Notes |
Met inclusion criteria for review but insufficient data presented (ie. no measure of variance or data from which it could be calculated), therefore not included in meta‐analysis.
Concluded no significant difference between groups for pain or range of movement. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment? |
Unclear risk |
B ‐ Unclear |
