Table 2. Results of Pairwise Comparisons of Interventions of the Included Studies.
| Source | Pain | Function | ROM ER | ROM ABD | ROM FL | Satisfaction or QoL |
|---|---|---|---|---|---|---|
| Arthrographic distension with IA corticosteroid vs IA corticosteroid only | ||||||
| Jacobs et al,41 1991 | NA | NA | No change at 4 mo | No change at 4 mo | No change at 4 mo | NA |
| Gam et al,29 1998 | No change at 3, 6, or 12 wk | NA | No change at 3 and 6 wk; increase at 12 wk | No change at 3, 6, or 12 wk | Increase at 3, 6, and 12 wk | NA |
| Tveitå et al,51 2008 | NA | No change at 10 wk | No change at 10 wk | No change at 10 wk | No change at 10 wk | NA |
| Reza et al,44 2013 | Decrease at 12 wk | NA | Increase at 12 wk | Increase at 12 wk | Increase at 12 wk | NA |
| Sharma et al,48 2016 | No change at 4 or 8 wk | No change at 4, 8, or 12 mo | No change at 4 or 8 wk | No change at 4 or 8 wk | NA | NA |
| Park and Hwnag,40 2000 | No change at 1 or 4 wk | NA | No change at 1 or 4 wk | Increase at 1 wk; no change at 4 wk | Increase at 1 and 4 wk | NA |
| Yoon et al,54 2016 | Increase at 4 wk; no change at 12 wk or 6 mo | Increase at 4 wk and 12 wk; no change at 6 mo | Increase at 4 wk; no change at 12 wk or 6 mo | NA | Increase at 4 wk; no change at 12 wk or 6 mo | NA |
| Lee et al,34 2017 | No change at 3, 6, or 12 wk | No change at 3, 6, or 12 wk | No change at 3, 6, or 12 wk | No change at 3, 6, or 12 wk | No change at 3, 6, or 12 wk | NA |
| Quality of evidence | Decrease at early short-term (high)a; decrease at late short-term (high)a | No change at early short-term (moderate)a; no change at late short-term (high)a | No change at early short-term (high)a; no change at late short-term (high)a | No change at early short-term; no change at late short-term | Increase at early short-term; no change at late short-term | NA |
| Physiotherapy vs no treatment or placebo | ||||||
| Calis et al,24 2006 | No change at 2 or 12 wk | Decrease at 2 and 12 wk | Increase at 2 and 12 wk | Increase at 2 and 12 wk | NA | NA |
| Carette et al,25 2003 | No change at 6 wk, 12 wk, 6 mo, or 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo | No change at 6 wk, 6 mo, or 12 mo; increase at 12 wk | No change at 6 wk, 12 wk, 6 mo, or 12 mo |
| Bulgen et al,23 1986 | No change at 6 wk or 6 mo | NA | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | NA |
| Lee et al,33 1974 | NA | NA | Increase at 1-6 wk | Increase at 1-6 wk | NA | NA |
| Quality of evidence | No change at early short-term | NA | Increase at early short-term (moderate)a,b | No change at early short-term | NA | NA |
| IA corticosteroid vs IA no treatment or placebo | ||||||
| Bal et al,22 2008 | No change at 2 wk or 12 wk | Increase at 2 wk; no change at 12 wk | No change at 2 wk or 12 wk | Increase at 2 wk; no change at 12 wk | No change at 2 wk or 12 wk | NA |
| Calis et al,24 2006 | No change at 2 wk; decrease at 12 wk | No change at 2 wk; increase at 12 wk | No change at 2 or 12 wk | No change at 2 wk; increase at 12 wk | NA | NA |
| Carette et al,25 2003 | Decrease at 6 and 12 wk; no change at 6 or 12 mo | Increase at 6 and 12 wk; no change at 6 or 12 mo | Increase at 6 and 12 wk; no change at 6 or 12 mo | No change at 6 wk, 6 mo, or 12 mo; increase at 12 wk | No change at 6 wk, 6 mo, or 12 mo; increase at 12 wk | No change at 6 wk, 12 wk, 6 mo, or 12 mo |
| Bulgen et al,23 1986 | No change at 6 wk or 6 mo | NA | Increase at 6 wk; no change at 6 mo | Increase at 6 wk; no change at 6 mo | Increase at 6 wk; no change at 6 mo | NA |
| Dehghan et al,28 2013 | No change at 2, 6, 12, or 24 wk | NA | No change at 2, 6, 12, or 24 wk | No change at 2, 6, 12, or 24 wk | No change at 2, 6, 12, or 24 wk | NA |
| Ranalletta et al,43 2015 | Decrease at 2, 4, and 8 wk; no change at 12 wk | Increase at 2, 4, 8, and 12 wk | Increase at 2 wk; no change at 4, 8, or 12 wk | Increase at 2, 4, 8, and 12 wk | Increase at 2, 4, 8, and 12 wk | NA |
| Roh et al,46 2011 | Decrease at 4 wk; no change at 12 wk or 6 mo | Increase at 12 wk; no change at 4 wk or 6 mo | No change at 4 wk, 12 wk, or 6 mo | NA | No change at 4 wk or 6 mo; increase at 12 wk | NA |
| Sharma et al,48 2016 | Decrease at 4 and 8 wk | Increase at 4 and 8 wk; no change at 12 mo | Increase at 4 and 8 wk | Increase at 4 and 8 wk | NA | NA |
| Shin and Lee,49 2013 | Decrease at 2, 4, and 8 wk and 4 mo; no change at 6 mo | Increase at 2, 4, and 8 wk and 4 mo; no change at 6 mo | Increase at 2, 4, and 8 wk and 4 mo; no change at 6 mo | NA | Increase at 2, 4, and 8 wk and 4 mo; no change at 6 mo | NA |
| Rizk et al,45 1991 | No change at 1-11 wk and 4 and 6 mo | NA | No change at 11 wk or 6 mo | No change at 11 wk or 6 mo | No change at 11 wk or 6 mo | NA |
| Ryans et al,47 2005 | No change at 6 wk or 4 mo | No change at 6 wk or 4 mo | No change at 6 wk or 4 mo | No change at 6 wk or 4 mo | NA | NA |
| Prestgaard et al,42 2015 | Decrease at 6 and 12 wk; no change at 3 wk or 6 mo | Increase at 3, 6, and 12 wk; no change at 6 mo | Increase at 6 and 12 wk; no change at 3 wk or 6 mo | No change at 3, 6, or 12 wk or 6 mo | Increase at 6 and 12 wk; no change at 3 wk or 6 mo | Increase at 6 and 12 wk; no change at 3 wk or 6 mo |
| Quality of evidence | Decrease at early short-term (high)a,b; decrease at late short-term (moderate)a,b; no change at mid-term (moderate)a | Increase at early short-term (moderate)a,b; increase at late short-term (moderate)a,b; increase at mid-term (moderate)a | Increase at early short-term (high)a; increase at late short-term (high)a; no change at mid-term (moderate)a | No change at early short-term; increase at late short-term; no change at mid-term | Increase at early short-term; increase at late short-term; no change at mid-term | No change at early short-term; no change at mid-term |
| IA corticosteroid with physiotherapy vs no treatment or placebo | ||||||
| Ryans et al,47 2005 | No change at 6 wk or 4 mo | Increase at 6 wk; no change at 4 mo | No change at 6 wk or 4 mo | NA | NA | NA |
| Carette et al,25 2003 | Decrease at 6 and 12 wk; no change at 6 or 12 mo | Increase at 6 and 12 wk; no change at 6 or 12 mo | Increase at 6 wk, 12 wk, and 6 mo; no change at 12 mo | Increase at 6 wk, 12 wk, and 6 mo; no change at 12 mo | Increase at 6 wk, 12 wk, and 6 mo; no change at 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo |
| Lee et al,33 1974 | NA | NA | Increase at 1-6 wk | Increase at 1-6 wk | NA | NA |
| Quality of evidence | NA | NA | Increase at early short-term (high)a,b | NA | NA | NA |
| IA corticosteroid vs physiotherapy | ||||||
| Arslan and Celiker,21 2001 | No change at 2 or 12 wk | NA | No change at 2 or 12 wk | No change at 2 or 12 wk | No change at 2 or 12 wk | NA |
| Bulgen at al,23 1984 | No change at 6 wk or 6 mo | NA | Increase at 6 wk; no change at 6 mo | Increase at 6 wk; no change at 6 mo | Increase at 6 wk; no change at 6 mo | NA |
| Carette et al,25 2003 | Decrease at 6 wk; no change at 12 wk, 6 mo, or 12 mo | Increase at 6 wk; No change at 12 wk, 6 mo, or 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo |
| Calis et al,24 2006 | No change at 2 or 12 wk | No change at 2 or 12 wk | Decrease at 2 or 12 wk | No change at 2 or 12 wk | NA | NA |
| van der Windt et al,53 1998 | Decrease at 3, 7, and 13 wk and 6 and 12 mo | Increase at 3, 7, and 13 wk and 6 and 12 mo | Increase at 3 wk, 7 wk, and 6 mo | No change at 3 wk, 7 wk, and 6 mo | NA | NA |
| Dacre et al,27 1989 | No change at 6 wk or 6 mo | NA | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | NA | NA |
| Maryam et al,38 2012 | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | NA |
| Ryans et al,47 2005; with home exercise | No change at 6 wk or 4 mo | No change at 6 wk or 4 mo | No change at 6 wk or 4 mo | NA | NA | NA |
| Quality of evidence | No change at early short-term (moderate)a; decrease at late short-term (high)a,b; no change at mid-term (low) | Increase at early short-term (moderate)a,b; no change at late short-term (moderate)a; increase at mid-term (moderate)a | No change at early short-term (moderate)a; no change at late short-term (high)a; Increase at mid-term (moderate)a | No change at early short-term; no change at late short-term; no change at mid-term | No change at early short-term; no change at late short-term; no change at mid-term | NA |
| IA corticosteroid with physiotherapy vs IA corticosteroid only | ||||||
| Kraal et al,32 2018 | No change at 6 wk, 12 wk, or 6 mo | Increase at 6 wk; no change at 12 wk or 6 mo | Increase at 6 wk and 12 wk; no change at 6 mo | Increase at 6 wk and 12 wk; no change at 6 mo | Increase at 6 wk; no change at 12 wk or 6 mo | No change at 6 wk, 12 wk, or 6 mo |
| Dacre et al,27 1989 | No change at 6 wk or 6 mo | NA | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | NA | NA |
| Maryam et al,38 2012 | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | NA |
| Carette et al,25 2003 | No change at 6 wk, 12 wk, 6 mo, or 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo | Increase at 6 wk, 12 wk, and 6 mo; no change at 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo |
| Ryans et al,47 2005 | No change at 6 wk or 4 mo | No change at 6 wk or 4 mo | No change at 6 wk or 4 mo | NA | NA | NAs |
| Quality of evidence | No change at early short-term (moderate)a; no change at mid-term (moderate)a | No change at early short-term (low)a; no change at mid-term (high)a | Increase at early short-term (moderate)a,b; no change at mid-term (high)a | No change at early short-term; no change at mid-term | Increase at early short-term; no change at mid-term | No change at early short-term; no change at late short-term; no change at mid-term |
| IA corticosteroid with physiotherapy vs physiotherapy only | ||||||
| Carette et al,25 2003 | Decrease at 6 wk; no change at 12 wk, 6 mo, or 12 mo | Increase at 6 wk; no change at 12 wk, 6 mo, or 12 mo | Increase at 6 wk, 12 wk, and 6 mo; no change at 12 mo | Increase at 6 and 12 wk; no change at 6 or 12 mo | Increase at 6 and 12 wk; no change at 6 mo or 12 mo | No change at 6 wk, 12 wk, 6 mo, or 12 mo |
| Dacre et al,27 1989 | No change at 6 wk or 6 mo | NA | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | NA | NA |
| Maryam et al,38 2012 | Decrease at 6 wk; no change at 6 mo | Increase at 6 wk; no change at 6 mo | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | No change at 6 wk or 6 mo | NA |
| Ryans et al,47 2005 | No change at 6 wk or 4 mo | Increase at 6 wk; no change at 4 mo | No change at 6 wk or 4 mo | NA | NA | NA |
| Lee et al,33 1974 | NA | NA | No change at 1, 3, 4, 5, or 6 wk; increase at 2 wk | No change at 1, 3, 4, 5, or 6 wk; increase at 2 wk | NA | NA |
| Quality of evidence | No change at early short-term (moderate)a; No change at mid-term (moderate)a | Increase at early short-term (low)a,b; no change at mid-term (low)a | No change at early short-term (moderate)a; no change at mid-term (high)a | No change at early short-term; no change at mid-term | No change at mid-term | NA |
| IA corticosteroid vs SA corticosteroid | ||||||
| Sun et al,50 2018 | Decrease at 4, 8, and 12 wk | Increase at 4, 8, and 12 wk | Increase at 4, 8, and 12 wk | Increase at 4, 8, and 12 wk | Increase at 4, 8, and 12 wk | NA |
| Khallaf et al,30 2018 | No change at 12 wk | No change at 12 wk | No change at 12 wk | No change at 12 wk | No change at 12 wk | NA |
| Yoon et al,54 2016 | No change at 4 wk, 12 wk, or 6 mo | No change at 4 wk, 12 wk, or 6 mo | No change at 4 wk, 12 wk, or 6 mo | NA | No change at 4 wk, 12 wk, or 6 mo | NA |
| Oh et al,39 2011 | Decrease at 3 wk; no change at 6 wk or 12 wk | No change at 3 wk, 6 wk, or 12 wk | No change at 3 wk, 6 wk, or 12 wk | No change at 3 wk, 6 wk, or 12 wk | NA | NA |
| Shin and Lee,49 2013 | No change at 2 wk, 4 wk, 8 wk, 4 mo, or 6 mo | No change at 2 wk, 4 wk, 8 wk, 4 mo, or 6 mo | No change at 2 wk, 4 wk, 8 wk, 4 mo, or 6 mo | NA | No change at 2 wk, 4 wk, 8 wk, 4 mo, or 6 mo | No change at 2 wk, 4 wk, 8 wk, 4 mo, or 6 mo |
| Cho et al,26 2016 | Decrease at 12 wk | Increase at 12 wk | No change at 12 wk | No change at 12 wk | No change at 12 wk | NA |
| Rizk et al,45 1991 | No change at 1-11 wk, 4 mo, or 6 mo | NA | No change at 11 wk or 6 mo | No change at 11 wk or 6 mo | No change at 11 wk or 6 mo | NA |
| Quality of evidence | Decrease at early short-term (moderate)a; no change at late short-term (moderate)a; no change at mid-term (moderate)a | No change at early short-term (high)a; increase at late short-term (high)a | No change at early short-term (high)a; no change at late short-term (high)a; no change at mid-term (high)a | Inconclusive at late short-term; no change at late short-term | No change at early short-term; no change at late short-term; No change at mid-term | NA |
| Acupuncture with physiotherapy vs physiotherapy only, with or without placebo acupuncture | ||||||
| Lo et al,36 2020 | No change at 4 wk, 12 wk, or 6 mo | No change at 4 wk, 12 wk, or 6 mo | No change at 4 wk, 12 wk, or 6 mo | No change at 4 wk, 12 wk, or 6 mo | No change at 4 wk, 12 wk, or 6 mo | NA |
| Koh et al,31 2013 | No change at 2, 4, or 12 wk; increase at8 wk, | No change at 2 or 4 wk; increase at 8 and 12 wk | No change at 2, 4, 8, or 12 wk | No change at 2, 4, 8, or 12 wk | No change at 2, 4, 8, or 12 wk | NA |
| Ma et al,37 2006 | Decrease at 4 wk | NA | No change at 4 wk | No change at 4 wk | No change at 4 wk | NA |
| Quality of evidence | No change at early short-term (low)a | NA | No change at early short-term (high)a | No change at early short-term; no change at late short-term | No change at early short-term; no change at late short-term | NA |
| ESWT with physiotherapy vs physiotherapy only with or without sham ESWT | ||||||
| Vahdatpour et al,52 2014 | Decrease at 4 wk, 12 wk, and 6 mo | Increase at 4 wk, 12 wk, and 6 mo | Increase at 4 wk, 12 wk, and 6 mo | Increase at 4 wk, 12 wk, and 6 mo | Increase at 4 wk, 12 wk, and 6 mo | NA |
| Lee et al,35 2017 | Decrease at 4 wk | NA | Increase at 4 wk | NA | Increase at 4 wk | NA |
| Park et al,77 2015 | Decrease at 4 wk | Increase at 4 wk | NA | NA | NA | NA |
| Quality of evidence | Decrease at early short-term (very low)c | NA | NA | NA | Increase at early short-term | NA |
Abbreviations: ABD, abduction; ER, external rotation; ESWT, extracorporeal shock wave therapy; FL, flexion; IA, intra-articular; NA, not applicable; QoL, quality of life; ROM, range of movement; SA, subacromial.
a
Meta-analysis undertaken.
b
Results of meta-analysis clinically and statistically significant.
c
Meta-analysis abandoned because of very high statistical inconsistency (I2 > 75%).