Ilbuldu 2004

Methods	RCT Number analysed/randomised: 60/60 Intention‐to‐treat: NR Power analysis: NR Funding source: NR
Participants	Chronic myofascial pain syndrome
Interventions	INDEX TREATMENT Dry needling (dn) upper trapezius COMPARISON TREATMENT Placebo laser CO‐INTERVENTION Paracetamol as needed Treatment schedule: dn once/wk over 4 weeks, placebo laser 3 sessions/wk over 4 weeks Duration of follow‐up: immediate post treatment and 6 months
Outcomes	PAIN INTENSITY (VAS activity 10 cm scale) Baseline mean: dn 7.62, placebo 7.65 End of study mean: dn 4.24, placebo 4.22 Absolute benefit: dn 3.38, placebo 3.43 Reported results: significant differences favouring laser compared with dn and placebo post treatment only SMD ‐0.02 (95% CI random ‐0.64 to 0.60) immediate post treatment SMD 0.01 (95% CI random ‐0.61 to 0.63 at 6 months FUNCTION: Nottingham Health Profile Physical Activity Component (0 to 100) Baseline mean: dn 32.80, placebo 25.59  End of study mean: dn 13.68, placebo 16.08 Absolute benefit: dn 19.12, placebo 9.51 Reported results: significant differences favouring laser compared with dn and placebo SMD 0.22 (95% CI random ‐0.40 to 0.84) immediate post treatment SMD ‐0.14 (95% CI random ‐0.76 to 0.48) at 6 months Adverse effects: NR Costs of care: NR
Notes	‐‐
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not reported
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding (performance bias and detection bias) All outcomes ‐ patient?	High risk	Interventions perceivably different
Blinding (performance bias and detection bias) All outcomes ‐ care provider?	High risk	Not possible
Blinding (performance bias and detection bias) All outcomes ‐ outcome assessor?	High risk	Participant as outcome assessor not blinded
Incomplete outcome data (attrition bias) All outcomes ‐ Drop out rate acceptable?	High risk	Not described, no n's in tables
Incomplete outcome data (attrition bias) All outcomes ‐ Analyzed in the group to which they were allocated?	Unclear risk	Not reported
Selective reporting (reporting bias)	Unclear risk	No protocol
Similarity of baseline characteristics	Low risk	Reported to be similar
Co‐interventions avoided or similar?	Unclear risk	Followed medication use only
Compliance acceptable?	Unclear risk	Not reported
Similar timing of outcome assessment?	Low risk	All assessed immediately post treatment and at 6 months
Fatal Flaw	High risk	Unclear randomisation, allocation concealment; drops‐outs not described; unclear whether ITT done