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. 2020 Dec 16;3(12):e2029581. doi: 10.1001/jamanetworkopen.2020.29581

Table 1. Main Characteristics of Populations, Interventions, and Outcome Measures of Included Randomized Trials.

Source Participants, No. (participants who completed study, No.) Mean age, y Duration of symptoms Participants per treatment group, No. (participants per treatment group who completed study, No.) Treatment duration (follow-up) Outcome measures
Arslan and Celiker,21 2001a 20 (20) 56 Mean, 4.1 mo

  • IA corticosteroid; n = 10 (10)

  • Physiotherapy (hot pack, ultrasound, exercises) with NSAID; n = 10 (10)

  • Both groups received 12-wk home exercise program

 Single IA corticosteroid injection; physiotherapy not stated for how long, likely 12 wk (0, 2, and 12 wk)

  • AROM (ABD, FL, ER, and IR)

  • PROM (ABD, FL, ER, and IR)

  • Pain (VAS, 0-10), unspecified
Bal et al,22 2008a 80 individuals with 82 shoulders (64) 56.6 Range, 6 wk-6 mo

  • IA corticosteroid; n = 40 (40)

  • Sham injection (normal saline); n = 40 (24)

  • Both groups received 12-wk home exercise program

 Single IA corticosteroid or normal saline injection (0, 2, and 12 wk)

  • PROM (ABD, FL, ER, and IR)

  • Night pain (VAS, 0-100)

  • Functional disability (SPADI)

  • Treatment effectiveness (UCLA end-result score)
Binder et al,55 1986 40 (unknown) 54.8 Mean (range), 5.5 mo (1-12 mo)

  • Oral corticosteroid; n = 20 (unknown)

  • No treatment; n = 20 (unknown)

  • Both groups received home exercise program, which entailed 2-3 min of movement every hour

 Oral prednisolone for 6 wk (0, 2, 4, and 6 wk then monthly to 8 mo)

  • Pain (VAS, 0-10), at rest, at night, on movement

  • PROM (ABD, FL, and ER)
Blockey et al,56 1954 32 (30) 55 Mean, 5.6 mo

  • Oral corticosteroid; n = 16 (14)

  • Oral placebo; n = 16 (16)

  • Both groups received home exercises for 4 wk; patients who still had restricted ROM at 4 wk underwent MUA and further 4 wk treatment with oral corticosteroid or placebo, according to initial treatment allocation

 Oral corticosteroid or placebo for 4 weeks (0, 1, 4, 5, 8, and 18 wk)

  • Pain (0-3) at rest and on movement”

  • ROM (total ABD, scapulohumeral ABD, total rotation), unclear whether active or passive
Buchbinder et al,57 2004 50 (46) 54.3 Mean, 23.3 wk

  • Oral corticosteroid; n = 24 (24)

  • Oral placebo; n = 26 (22)

  • Both groups received home exercise program of an unknown duration

 Oral corticosteroid or placebo for 3 weeks (0, 3, 6, and 12 wk)

  • Pain (VAS, 0-10) at night and activity-related

  • Functional disability (SPADI, Croft, DASH)

  • Function (HAQ)

  • QoL (SF-36)

  • Patient-rated improvement

  • AROM (ABD, FL, ER, and IR)
Buchbinder et al,58 2004 46 (46) 57.3 Mean (range), 116 d (96-402 d)

  • Arthrographic distension with IA corticosteroid; n = 25 (25)

  • Arthrography only (placebo); n = 21 (21)

  • Both groups received home exercise program of an unknown duration

 Single injection (0, 3, 6, and 12 wk)

  • Functional Disability (SPADI and PET)

  • Pain (SPADI and VAS, 0-10), overall (unspecified)

  • AROM (ABD, FL, ER, and IR)
Bulgen at al, 23 1984a 45 (42) 55.8 Mean (range), 4.8 mo (1-12 mo)

  • IA corticosteroid; n = 11

  • Mobilizations; n = 11

  • Ice with PNF; n = 12

  • No treatment; n = 8

  • All groups received home exercise program of unknown duration

 IA corticosteroid once weekly for 6 wk; mobilizations, ice. and PNF three times weekly for 6 wk (0, 1, 2, 3, 4, 5, 6, 7, 8, and 12 wk, 4, 5, and 6 mo)

  • Pain (VAS, 0-10) at rest, at night, on movement

  • PROM (ABD, FL, and ER)
Calis et al,24 2006a 95 shoulders (unknown) 56.9 >1 mo

  • IA sodium hyaluronate; n = 27 (unknown)

  • IA corticosteroid; n = 26 (unknown)

  • Physiotherapy (hot pack, US, TENS, stretching); n = 22 (unknown)

  • No treatment; n = 20 (unknown)

  • All groups received home exercise program of unknown duration

 IA sodium hyaluronate injection once weekly for 2 wk; single IA corticosteroid injection; physiotherapy for 10 d (0, 15 d, 3 mo)

  • Pain (VAS, 0-10), unspecified

  • PROM (ABD and ER)

  • Function (CM)
Carette et al,25 2003a 93 (77) 55.3 Mean, 21.1 wk, everyone <1 y

  • IA corticosteroid IA with physiotherapy; n = 22 (20)

  • IA corticosteroid; n = 25 (16)

  • IA placebo with physiotherapy; n = 27 (23)

  • IA placebo n = 23 (22)

  • All groups received 3-mo home exercise program; physiotherapy included TENS, mobilizations, exercises, and ice for patients with acute disease and US, mobilizations, exercise, and ice for those with chronic disease

 Single injections of IA corticosteroid and placebo; supervised physiotherapy 3 sessions weekly for 4 wk (0, 6 wk, 3 mo, 6 mo, 1 y)

  • Functional disability (SPADI)

  • Pain (SPADI, 0-100), unspecified

  • QoL (SF-36)

  • AROM and PROM (ABD, FL, and ER)
Cheing et al,59 2008 74 (70) 33-90, unknown mean Mean (range), 7.2 mo (1-24 mo)

  • EA; n = 25 (24)

  • IFE; n = 24 (23)

  • No treatment; n = 25 (23)

  • EA and IFE groups received 6-mo home exercise program

 10 sessions during 4 wk for EA and IFE (0, 1 mo, 3 mo, 6 mo)

  • Function (CM)

  • Pain (VAS, 0-10), unspecified
Chen et al,60 2014 40 (34) 53.4 >3 mo

  • Oral corticosteroid; n = 20 (17)

  • ESWT; n = 20 (17)

  • Both groups received home exercise program of unknown duration

 Oral corticosteroid for 4 wk; 3 sessions of ESWT during 4 wk (0, 2, 4, 6, and 12 wk)

  • Function (CM and OSS)

  • AROM, from CM (ABD, FL, ER, and IR)

  • Pain (CM), unspecified
Cho et al,26 2016a 126 (110) 56.6 Mean, 5 mo

  • IA corticosteroid; n = 42 (36)

  • SA corticosteroid; n = 42 (37)

  • IA with SA corticosteroid, n = 42 (37)

  • All groups received home exercise program of unknown duration

 Single injections (0, 3, 6, and 12 wk)

  • Function (ASES shoulder score)

  • Pain (VAS. 0-10) with movement

  • PROM (ABD, FL, ER, and IR)
Dacre et al,27 1989a 66 (62) 54.9 >4 wk

  • IA corticosteroid; n = 22 (22)

  • Physiotherapy (mobilizations); n = 22 (20)

  • IA corticosteroid with physiotherapy; n = 22 (20)

  • No home exercise program

 Supervised physiotherapy for 4-6 wk (0, 6 wk, 6 mo)

  • Pain (VAS. 0-10) day, night, and with movement

  • PROM (ABD, ER, and IR)
Dahan et al,61 1999 34 (27) 52 Mean, 1 y

  • Suprascapular nerve block with bupivacaine; n = 17 (15)

  • Placebo injection; n = 17 (12)

  • Both groups received home exercise program of unknown duration

 3 injections over 2 weeks

  • Pain (VAS, 0-10, MPQ short-form, Present Pain Index)

  • Function (SST)

  • AROM (ABD and FL)

  • PROM (ABD, FL and ER)
De Carli et al,62 2012 46 (44) 55.5 Mean, 3 mo

  • MUA with ACR; n = 25 (23)

  • IA corticosteroid; n = 21 (21)

  • IA corticosteroid group received both supervised physiotherapy and home exercise program; MUA with ACR group started active strengthening 5 wk postoperation

 Single MUA with ACR; IA corticosteroid once weekly for 3 wk (0, 3, 6 , and 12 wk, 6 and 12 mo)

  • Function (CM, UCLA, ASES, and SST)

  • PROM (ABD, FL, ER, and IR)

  • Treatment satisfaction (VAS)
Dehghan et al,28 2013a 75 (59); patients had diabetes 54 Not stated

  • NSAID (naproxen, 1g/d); n = 35 (28)

  • IA corticosteroid; n = 40 (29)

  • Both groups received home exercise program of unknown duration

 Single injection of IA corticosteroid; NSAID of unknown duration (0, 2, 6, 12, and 24 wk)

  • Pain (VAS, 0-10), unspecified

  • ROM (ABD, FL, ER, and IR), unknown if active or passive
Gallacher et al,63 2018 50 (39) 53.9 >3 mo

  • Arthrographic distension with IA corticosteroid; n = 25 (20)

  • ACR with IA corticosteroid; n = 25 (19)

  • Both groups received home exercises and what authors described as standard physiotherapy regimen of unknown duration

 Single treatment (0, 6 wk, 3 mo, 6 mo)

  • Function (OSS)

  • QoL (EQ-5D)

  • PROM (ABD, FL, and ER)

  • Complications
Gam et al,29 1998a 22 (20) 53 Median, 5 mo

  • IA corticosteroid; n = 9 (8)

  • IA corticosteroid with arthrographic distension; n = 13 (12)

  • No home exercise program

 1 injection weekly for 6 wk or until no symptoms (0, 3, 6, and 12 wk)

  • Pain (VAS, 0-10), at rest and with movement

  • PROM (FL, EXT, ABD, ELE, and ER)

  • Use of analgesics
Hsieh et al,64 2012 70 (63) 54.5 Mean, 4.5 mo

  • IA sodium hyaluronate with physiotherapy (heat, electrotherapy, exercises); n = 35 (32)

  • Physiotherapy; n = 35 (31)

  • No home exercise program

 Injection weekly for 3 wk; physiotherapy for 3 mo (0, 6, and 12 wk)

  • AROM and PROM (FL, ABD, ER, and IR)

  • Pain (VAS, 0-100), unspecified

  • Functional disability (SPADI and SDQ)

  • QoL (SF-36)
Jacobs et al,65 2009 53 (51) 57 Median, 17.5 mo

  • MUA; n = 28 (26)

  • IA corticosteroid with arthrographic distension; n = 25 (25)

  • Both groups received home exercise program of unknown duration

 Single MUA; 3 IA corticosteroid injections over 18 wk (0, 2, 6, and 12 wk, 6, 9 , 12, 18, and 24 mo)

  • Function (CM)

  • Pain (VAS, 0-100), unspecified

  • QoL (SF-36)
Jacobs et al,66 1991 47 individuals with 50 shoulders (35) 53.4 Median (range), 6 mo (1-24 mo)

  • Arthrographic distension; n = 14 (unknown)

  • IA corticosteroid; n = 15 (unknown)

  • Arthrographic distension with IA corticosteroid; n = 18 (unknown)

  • All groups received home exercise program of unknown duration

 As many as 3 injections over 12 wk (0, 6, 12, 16)

  • AROM (ABD, FL, and ER)

  • PROM (ABD, FL, and ER)

  • Strength (dynamometry)

  • Pain with daily activities (0-5) and with movement (0-3)

  • Use of analgesics
Jones and Chattopadhyay,67 1999 30 (30) 56.5 Not stated

  • Suprascapular nerve block; n = 15 (15)

  • IA corticosteroid; n = 15 (15)

  • Both groups received home exercise program of unknown duration

 Single suprascapular nerve block; ≤3 IA corticosteroid injections (0, 1, 3, 7, and 12 wk)

  • Pain (VAS. 0-5), unspecified

  • ROM (ABD, ER, and IR), unknown if active or passive
Khallaf et al,30 2018a 40 (unknown) 47.3 Mean, 1.5 mo

  • IA corticosteroid; n = 20 (unknown)

  • SA corticosteroid; n = 20 (unknown)

  • Both groups received 12-wk home exercise program

 Single injection (0 and 12 wk)

  • Pain (VAS, 0-10), unspecified

  • Functional disability (SPADI)

  • AROM (FF, ER, IR, and EXT)

  • PROM (FF, ER, IR, and EXT)
Khan et al,68 2005 36 (35) Unknown Not stated

  • Physiotherapy (exercises, TENS, and IRR); n = 18 (unknown)

  • Physiotherapy with arthrographic distension and IA corticosteroid; n = 18 (unknown)

 8 wk (0, 1, 2, 3, 4, 5, 6, 7, and 8 wk)

  • Pain (VAS, 0-100), unspecified

  • PROM (ABD, ER, and IR)
Kim et al,69 2017 40 (30) 55.2 Mean, 4 mo

  • IA sodium hyaluronate; n = 20 (16)

  • IA sodium hyaluronate with IA tramadol; n = 20 (14)

  • Both received home exercise program of unknown duration

 IA sodium hyaluronate weekly injections for 5 wk; IA tramadol for 3 wk (0, 1, 2, 3, 4, and 6 wk)

  • Pain (VAS 0-10), unspecified

  • Functional disability (SPADI)

  • PROM (ABD, FL, ER, and IR)
Kivimäki and Pohjolainen,70 2001 30 (24) 51 Mean (range), 7 mo (3-18 mo)

  • MUA with IA corticosteroid n = 15 (13)

  • MUA; n = 15 (11)

  • No home exercise program

 Single treatment (0, 1 d, 4 mo)

  • PROM (ABD, FL, ER, and IR)
Kivimäki et al,71 2007 125 (83) 53 Mean, 7.2 mo

  • MUA; n = 65 (38)

  • No treatment; n = 60 (45)

  • Both groups received home exercise program of unknown duration

 Single MUA (0, 6 wk, 3, 6, and 12 mo)

  • PROM (ABD, FL, ER, and IR)

  • Pain (VAS, 0-10), unspecified

  • Functional disability (modified SDQ)

  • Function (working ability, 0-10)

  • Use of analgesics
Klç et al,72 2015 41 (41) 58.4 >1 mo

  • Suprascaular nerve block with physiotherapy; n = 19 (19)

  • Physiotherapy; n = 22 (22)

  • Physiotherapy included hot packs, exercises, stretching, TENS, and US; both groups received home exercise program of unknown duration

 Physiotherapy, 5 sessions a week for 3 weeks; single suprascapular nerve block (0, 3, and 7 wk)

  • Pain (BPI-SF)

  • Function (CM)
Koh et al,31 2013a 68 (unknown) 54.4 Mean, 6 mo

  • Bee venom acupuncture with physiotherapy; n = 22 (unknown)

  • Higher dose bee venom acupuncture with physiotherapy; n = 23 (unknown)

  • Sham injection (normal saline) with physiotherapy; n = 23 (unknown)

  • Physiotherapy included TENS, TDP, and mobilizations; all groups received 2-mohome exercise program

 16 sessions during 2 mo (0, 2, 4, 8, and 12 wk)

  • Disability (SPADI)

  • Pain (VAS, 0-10), at rest, at night, and with movement

  • AROM (FL, EXT, ABD, ADD, and ER)

  • PROM (FL, EXT, ABD, ADD, and ER)
Kraal et al,32 2018a 21 (15) 51.9 >3 mo

  • IA corticosteroid with physiotherapy (mobilizations, stretching, ice and hot packs, and massage); n = 10 (unknown)

  • IA corticosteroid; n = 11 (unknown)

  • No home exercise program

 Single injection but second given if no improvement at 6 wk; physiotherapy twice weekly ≤3 mo (0, 6, 12, and 26 wk)

  • Functional disability (SPADI)

  • Pain (NPRS, 0-10), mean and at night

  • QoL (SF-36)

  • PROM (ABD and ER)

  • Patient satisfaction (0-5)
Lee et al,33 1974a 65 (unknown) 57.3 Between 3 mo and 5 y

  • Physiotherapy (heat and exercises); n = 17 (unknown)

  • Analgesics; n = 15 (unknown)

  • IA corticosteroid with physiotherapy (heat and exercises) n = 15 (unknown)

  • Bicep tendon corticosteroid with physiotherapy (heat and exercises) n = 18 (unknown)

 Details regarding number of injections and duration of physiotherapy and analgesics not given (0, 1, 2, 3, 4, 5, and 6 wk)

  • AROM (ABD)

  • PROM (ABD, ER, and IR)
Lee et al,34 2017a 64 (64) 54.9 Mean, 8 mo

  • IA corticosteroid; n = 32 (32)

  • IA corticosteroid with arthrographic distension; n = 32 (32)

  • Both groups received 6-wk home exercise program

 Single injection (0, 3, 6, and 12 wk)

  • Pain (VAS, 0-10), global

  • Functional disability (SPADI)

  • PROM (ABD, FL, EXT, ER, and IR)
Lee et al,35 2017a 30 (unknown) 58.7 Not stated

  • ESWT with physiotherapy (hot packs, US, and electrotherapy); n = 15 (unknown)

  • Physiotherapy (hot packs, US, and electrotherapy); n = 15 (unknown)

  • No home exercise program

 Both treatments 3 times weekly for 4 wk (0 and 4 wk)

  • Pain (VAS, 0-10), unspecified

  • ROM (FL, ER), unknown if active or passive
Lim et al,73 2014 68 (62) 53.8 Mean, 7.3 mo

  • IA corticosteroid; n = 34 (33)

  • IA sodium hyaluronate; n = 34 (29)

  • Both groups received home exercise program

 Single injection of IA corticosteroid; 3 injections sodium hyaluronate (0, 2, and 12 wk)

  • Pain (VAS, 0-10), unspecified

  • Function (ASES and CM)

  • AROM (FL, ER, and IR)
Lo et al,36 2020a 21 (unknown) 59.6 Everyone >3 mo

  • Electroacupuncture with physiotherapy; n = 11 (unknown)

  • Sham electroacupuncture with physiotherapy; n = 10 (unknown)

  • Physiotherapy included hot packs, exercises, and ice packs

 18 sessions during 6-9 wk (0, 1, 3, and 6 mo)

  • Pain (VAS, 0-10), with movement

  • AROM (FL, EXT, ABD, ADD, ER, and IR)

  • PROM (FL, EXT, ABD, ADD, ER, and IR)

  • Functional disability (SPADI)
Lorbach et al,74 2010 40 (unknown) 51 Mean, 11 mo

  • IA corticosteroid; n = 20 (unknown)

  • Oral corticosteroid; n = 20 (unknown)

  • Both groups received supervised physiotherapy (unspecified) and 8-wk home exercise program

 IA corticosteroid 3 injections during 8 wk; oral corticosteroid for 25 d (0, 4, 8, and 12, 6 and 12 mo)

  • Function (CM, SST, and VAS)

  • Pain (VAS, 0-10, reversed), unspecified

  • PROM (FL, ER, and IR)

  • Patient satisfaction (VAS)
Ma et al,37 2006a 75 (unknown) 54.8 Mean, 25.8 wk, everyone >3 mo

  • Physiotherapy; n = 30 (unknown)

  • Acupuncture; n = 30 (unknown)

  • Physiotherapy with acupuncture; n = 15 (unknown)

  • Physiotherapy included hot pack, mobilizations, and exercises; no home exercise program

 Acupuncture twice weekly for 4 wk; physiotherapy 5 times weekly for 4 wk (0, 2, and 4 wk)

  • Pain (VAS, 0-10), at rest and with movement

  • AROM (ABD, FL, EXT, ER, and IR)

  • PROM (ABD, FL, EXT, ER, and IR)

  • QoL (SF-36)
Maryam et al,38 2012a 87 (69) 53.6 Mean, 5.8 mo, everyone <1 y

  • Physiotherapy; n = 27 (8)

  • IA corticosteroid with physiotherapy; n = 29 (14)

  • IA corticosteroid; n = 31 (14)

  • Physiotherapy included TENS, exercises, and ice; all groups received home exercise program of unknown duration

 Single injection of IA corticosteroid single injection; 10 sessions of physiotherapy (0 and 6 wk)

  • Functional disability (SPADI)

  • Pain (SPADI, 0-100), unspecified

  • AROM (ABD, FL, and ER)

  • PROM (ABD, FL, and ER)
Mukherjee et al,75 2017 60 (56) 50.4 Mean, 6.3 mo

  • ACR; n = 30 (28)

  • IA corticosteroid; n = 30 (28)

  • Both groups received home exercise program of unknown duration

 Single treatment (0, 4, 8, 12, 16, and 20 wk)

  • Pain (VAS, 0-10), unspecified

  • PROM (ABD, EXT, ER, and IR)

  • Function (CM)
Mun and Baek,76 2016 136 (121) 53 Mean, 6.5 mo, everyone >3 mo

  • Arthrographic distension with IA corticosteroid and MUA; n = 67 (60)

  • IA corticosteroid; n = 69 (61)

  • Both groups received supervised exercises for 1 mo followed by home exercise program of unknown duration

 Single injection (0, 2, 6, 12, 24, and 48 wk)

  • Pain (VAS, 0-10), unspecified

  • Function (CM)

  • Satisfaction (VAS)

  • PROM (FL, ER, and IR)
Oh et al,39 2011a 71 (58) 57 Mean, 6.6 mo

  • IA corticosteroid; n = 37 (31)

  • SA corticosteroid; n = 34 (27)

  • Both groups received home exercise program of unknown duration

 Single injection (0, 3, 6, and 12 wk)

  • Pain (VAS, 0-10), unspecified

  • Function (CM)

  • PROM (ABD, ER, and IR)
Park and Hwnag,40 2000a 55 56.5 Not stated

  • IA corticosteroid with arthrographic distension; n = 28 (unknown)

  • IA corticosteroid; n = 27 (unknown)

  • Unclear whether home exercise program was used

 Single injection (0, 1 wk, 1 mo)

  • Pain (VAS, 0-10)

  • AROM (ABD, FL, ER, and IR)

  • Cyriax stages of arthritis
Park et al,77 2013 90 (90) 55.8 Mean (range), 5.3 mo (3-9 mo)

  • Arthrographic distension with sodium hyaluronate; n = 45 (45)

  • IA corticosteroid n = 45 (45)

  • Both groups received home exercise program of unknown duration

 3 injections during 4 wk (0, 2, and 6 wk)

  • Functional Disability (SPADI)

  • Pain (VAS and SPADI)

  • PROM (ABD, FL, and ER)

  • Complications
Park et al,78 2014 53 (unknown) 56 Range, 3-9 mo

  • Arthrographic distension with IA corticosteroid, intensive mobilization, and general physiotherapy; n = 16 (unknown)

  • Arthrographic distension with IA corticosteroid and general physiotherapy; n = 12 (unknown)

  • Intensive mobilization with general physiotherapy; n = 14 (unknown)

  • General physiotherapy; n = 11 (unknown)

  • General physiotherapy included hot packs, TENS, and US; all groups received home exercise program of unknown duration

 All treatments twice weekly for 4 wk (0 and 4 wk)

  • Pain (VAS, 0-10), unspecified

  • Functional disability (SPADI)

  • Function (CM)

  • AROM (ABD, FL, ER, and IR)
Park et al,41 2015 30 (unknown) 53.5 Not stated

  • ESWT with physiotherapy; n = 15 (unknown)

  • Physiotherapy; n = 15 (unknown)

  • Physiotherapy included hot packs, US, and electrotherapy; no home exercise program

 Twice weekly for 6 wk (0 and 4 wk)

  • Pain (VAS, 0-10), unspecified

  • Function (patient-specific functional scales)
Prestgaard et al,42 2015a 122 (114) 54.5 Mean (range), 15 wk (1-6 mo)

  • IA corticosteroid; n = 42 (39)

  • IA with rotator interval corticosteroid; n = 40 (39)

  • Sham injection (IA with rotator interval local anesthetic); n = 40 (36)

  • No home exercise program

 Single injection (0, 3, 6, 12, and 26 wk)

  • Pain (VAS, 0-10), general and at night

  • Shoulder disability (SPADI)

  • AROM (ABD, FL, and ER)

  • Use of analgesics

  • QoL (EQ-5D)
Pushpasekaran et al,79 2017 85 (80) 56.3 Mean (range), 15.2 mo (2.5-49 mo)

  • IA corticosteroid; n = 43 (40)

  • 3-site injection (IA, SA, and subcoracoid); n = 42 (40)

  • Both groups received NSAIDs, physiotherapy (US), and 4-wk home exercise program for prior to intervention

 2 treatments during 3 wk (0, 3, and 6 wk, 6 mo)

  • Function (CM)
Quaraishi et al,80 2007 36 individuals with 38 shoulders (33) 55.2 Mean (range), 33.7 wk (12-76 wk)

  • Arthrographic distension; n = 19 (18)

  • MUA with IA corticosteroid n = 17 (15)

  • Both groups received home exercise program of unknown duration

 Single treatment (0, 2 mo, 6 mo)

  • Pain (VAS, 0-10), unspecified

  • Function (CM)

  • PROM (ABD, FL, ER, and IR)

  • Satisfaction
Ranalletta et al,43 2015a 74 (69) 63.4 Mean, 12 wk, everyone >1 mo

  • IA corticosteroid; n = 36 (34)

  • NSAID; n = 38 (35)

  • Both groups received supervised exercises and 12-wk home exercise program

 Single IA corticosteroid injection; NSAID twice a day for unknown duration (0, 2, 4, 8, and 12)

  • Pain (VAS, 0-10), overall

  • Function (ASES and CM)

  • Functional disability (qDASH)

  • PROM (ABD, FL, EXT, ER, and IR)
Reza et al,44 2013a 100 (100) 59.5 Mean, 115 d, everyone >3 mo

  • IA corticosteroid; n = 50 (50)

  • Arthrographic distention with IA corticosteroid; n = 50 (50)

  • Both groups received home exercise program of unknown duration

 Single injection (0, 2 d, 12 wk)

  • Pain (VAS, 0-10), unspecified

  • ROM (ABD, FL, EXT, ER, and IR) unknown whether active or passive
Rizk et al,45 1991a 48 (44) 55 Mean (range), 13.2 wk (8-18 wk)

  • IA corticosteroid; n = 16 (15)

  • Intrabursal (SA) corticosteroid; n = 16 (14)

  • IA LA; n = 8 (8)

  • Intrabursal (SA) LA; n = 8 (7)

  • All groups received home exercise program of unknown duration

 3 injections during 2 wk (weekly 0-11 wk, 15 wk, and 6 mo)

  • PROM (total ROM)

  • Pain (VAS, 0-5), unspecified
Roh et al,46 2011a 50 (45); patients with diabetes 54.9 Mean (range), 6.4 wk (4 wk-6 mo)

  • IA corticosteroid; n = 25 (23)

  • No treatment; n = 25 (22)

  • Both groups received home exercise program of unknown duration

 Single injection (0, 4, 12, and 24 wk)

  • PROM (FL, ER, and IR)

  • Pain (VAS, 0-10), unspecified

  • Function (ASES)
Rouhani et al,81 2016 72 (64) 52.8 Not stated

  • Calcitonin nasal spray with physiotherapy (details not stated); n = 36 (32)

  • Placebo spray with physiotherapy (details not stated); n = 36 (32)

  • Both groups received oral NSAIDs

 Calcitonin and placebo spray for 6 weeks (0 and 6 wk)

  • Pain (VAS, 0-10), overall and at night

  • Functional disability (DASH and SPADI)

  • QoL (HAQ)

  • PROM (ABD, FL, and ER)
Ryans et al,47 2005a 80 (78) 54.1 Mean, 10.4 wk, everyone >4 wk

  • IA corticosteroid with physiotherapy; n = 20 (20)

  • IA corticosteroid; n = 20 (19)

  • IA placebo (normal saline) with physiotherapy; n = 20 (20)

  • IA placebo; n = 20 (19)

  • Physiotherapy included PNF, mobilizations, electrotherapy, and exercises; all groups received home exercise program of unknown duration

 Single injection; physiotherapy of unknown duration (0, 6, and 16 wk)

  • AROM (ABD, FL, ER, and IR)

  • PROM (ABD, FL, ER, and IR)

  • Pain (VAS, 0-100), at rest

  • Function (VAS and HAQ)

  • Functional disability (SDQ)

  • QoL (SF-36)
Schröder et al,82 2017 60 (60) 53.5 Mean, 15.6 mo

  • Acupuncture; n = 30 (30)

  • Sham acupuncture; n = 30 (30)

  • No home exercise program

 Single session (baseline and postsession)

  • Function (CM)

  • Pain (CM, 0-15)
Schydlowsky et al,83 2012 18 (14) 51 Everyone >3 wk

  • IA adalimumab; n = 10 (6)

  • IA corticosteroid; n = 8 (8)

  • No home exercise program

 1 injection every 2 wk to 3 injections (0, 2, 4, 8, 12, and 24 wk)

  • Function (CM)

  • Functional disability (SPADI)

  • AROM (ABD, FL, and ER)

  • PROM (ABD, FL, and ER)

  • Pain (SRQ)
Sharma et al,48 2016a 106 (87) 53 Median (range), 6.8 mo (2-37 mo)

  • IA corticosteroid; n = 36 (34)

  • IA corticosteroid with arthrographic distension; n = 34 (32)

  • Treatment as usual (physiotherapy, analgesia, or no treatment); n = 36 (21)

  • No home exercise program

 4 injections during 1 mo (0, 4 and 8 wk, 12 mo)

  • Functional disability (SPADI)

  • Pain (NRS, 0-10), mean

  • PROM (ABD, and ER, IR)
Shin and Lee,49 2013a 191 (158) 55.7 >3 mo, mean 7.2 mo

  • SA corticosteroid; n = 49 (41)

  • IA corticosteroid; n = 48 (42)

  • SA with IA corticosteroid; n = 47 (39)

  • NSAID; n = 49 (36)

  • All groups received home exercise program of >3-mo duration

 Single SA and IA injection; oral NSAID for 6 wk (0, 2, 4, 8, 16, and 24 wk)

  • Function (ASES)

  • Pain (VAS, 0-10), unspecified

  • Treatment satisfaction (VAS)

  • AROM (FL, ER, and IR)
Sun et al,84 2001 35 (30) 56.3 Mean, 6.5 mo

  • No treatment; n = 22 (18)

  • Acupuncture; n = 13 (12)

  • Both groups received supervised exercises for 6 wk and home exercise program of unknown duration

 Acupuncture twice weekly for 6 wk (0, 6, 20 wk)

  • Function (CM)
Sun et al,50 2018a 97 (77) 53.9 Mean, 15.2 wk, everyone <9 mo

  • IA corticosteroid; n = 30 (24)

  • SA corticosteroid; n = 34 (26)

  • Rotator interval corticosteroid; n = 33 (27)

  • All groups received home exercise program of unknown duration

 Single injection (0, 4, 8, and 12 wk)

  • Pain (VAS, 0-10), unspecified

  • Function (CM)

  • Functional disability (DASH)

  • PROM (ABD, FL, ER, and IR)
Tveitå et al,51 2008a 76 (69) 51.5 Mean, 7 mo, everyone 3 mo-2 y

  • Arthrographic distension with IA corticosteroid; n = 39 (36)

  • IA corticosteroid; n = 37 (33)

  • No home exercise program

 3 injection during 4 wk (0 and 10 wk)

  • Functional disability (SPADI)

  • AROM (ABD, FL, ER, and IR)

  • PROM (ABD, FL, ER, and IR)
Vahdatpour et al,52 2014a 40 (36) 58.2 Not stated

  • ESWT; n = 20 (19)

  • Sham ESWT; n = 20 (17)

  • All patients had a single IA corticosteroid injection at time of inclusion in the study and received home exercise program

 Once weekly for 4 wk (0, 4 and 12 wk, 6 mo)

  • Pain (SPADI 0-100), unspecified

  • Functional disability (SPADI)

  • PROM (ABD, FL, EXT, ER, and IR)
van der Windt,53 et al 1998a 109 (103) 58.5 82 with <6 mo; 27 with >6 mo

  • Physiotherapy (mobilizations and exercises) n = 56 (54)

  • IA corticosteroid; n = 53 (49)

  • Physiotherapy group received ice and hot packs and electrotherapy at the physiotherapist’s discretion; no home exercise program

 Physiotherapy for 6 wk; IA corticosteroid as many as 3 injections during 6 wk (0, 3, 7, 13,26, and 52 wk)

  • Satisfaction (0-5)

  • Pain (VAS, 0-100), during day and at night

  • Functional disability (SDQ)

  • PROM (ABD and ER)
Widiastuti-Samekto and Sianturi,85 2004 28 (27) 40-69 Range, 1-6 mo

  • IA corticosteroid with physiotherapy; n = 13 (13)

  • Oral corticosteroid with physiotherapy; n = 15 (14)

  • Physiotherapy was supervised and included 20 sessions of mobilizations and ice and hot packs; no home exercise program

 Single IA corticosteroid injection; oral corticosteroid for 3 wk (0, 1, 2, and 3 wk)

  • Treatment success (90% improvement in ABD and ER PROM)

  • Pain (VAS, 0-10), unspecified
Yoon et al,54 2016a 90 (86) 55 Mean, 9 mo

  • IA corticosteroid; n = 30 (29)

  • SA corticosteroid; n = 30 (29)

  • Arthrographic distension with IA corticosteroid; n = 30 (28)

  • All groups received home exercise program of unknown duration

 Single injection (0, 1, 3, and 6 mo)

  • Pain (VAS, 0-10), unspecified

  • Function (SST and CM)

  • PROM (FL, ER, and IR)

Abbreviations: ABD, abduction; ACR, arthroscopic capsular release; AROM, active range of movement; ASES, American Shoulder and Elbow Surgeons questionnaire; BPI-SF, Brief Pain Inventory–Short Form; CM, Constant-Murley score; DASH, Disabilities of the Arm, Shoulder, and Hand questionnaire; EA, electroacupuncture; ELE, elevation; EQ-5D, Euro-Qol–5 Dimensions questionnaire; ER, external rotation; ESWT, extracorporeal shock wave therapy; EXT, extension; FL, flexion; HAQ, Health Assessment Questionnaire; IA, intra-articular; IFE, interferential electrotherapy; IR, internal rotation; IRR, infrared radiotherapy; LA, local anesthetic; MPQ, McGill Pain Questionnaire; MUA, manipulation under anesthesia; NPRS, numerical pain rating scale; NSAID, nonsteroidal anti-inflammatory drug; OSS, Oxford Shoulder Score; PET, problem elicitation technique; PNF, proprioceptive neuromuscular facilitations; PROM, passive range of movement; qDASH, quick DASH; QoL, quality of life; SA, subacromial; SDQ, Shoulder Disabilities Questionnaire; SF-36, 36-item short-form survey; SPADI, Shoulder Pain and Disability Index; SRQ, self-reporting questionnaire; SST, Simple Shoulder Test; TDP, transcutaneous infrared thermotherapy; TENS, transcutaneous electrical nerve stimulation; UCLA, University of California Los Angeles questionnaire; US, ultrasound; VAS, visual analog scale.

a

Studies included in meta-analyses.