Aktas 2007.

Methods	Study design: Parallel group RCT Setting: Hospital, Turkey Intervention: Pulsed electromagnetic field plus exercise plus cold pack Control: Sham pulsed electromagnetic field plus exercise plus cold pack Source of Funding: This study was supported by the Department of Physical Medicine and Rehabilitation, Cerrahpasa Medical Faculty, Istanbul University.
Participants	Diagnostic label used by trialists: Subacromial impingement syndrome Criteria for defining the shoulder condition being treated: Diagnosis of shoulder impingement syndrome by: positive impingement test (Neer, Hawkins‐Kennedy, painful arc) positive subacromial injection test Any restriction on duration of symptoms None Inclusion Criteria (not listed above) None Exclusion Criteria (not listed above) Other concomitant shoulder pathologies such as adhesive capsulitis, calcific tendinitis, partial and full‐thickness tears of the rotator cuff, osteoarthritis of the acromioclavicular joint, dislocations, acute traumatic conditions, etc. Cervical pain or other painful conditions such as fibromyalgia Inflammatory or systemic diseases History of gastritis or peptic ulcer that may cause complications with NSAID use Prior applications of any treatment modality such as physiotherapy, corticosteroid injections, and NSAID during the preceding 3 months Malignancy Female patients who might be pregnant Pulmonary disorders and cardiac pace makers Baseline characteristics Intervention: PEMF Number randomised: 20 Number included in analyses: 20 Age: 48 ± 7.9 years old Sex: F/M 15/5 Duration of symptoms: 4.82 ± 3.75 Control: Sham PEMF Number randomised: 20 Number included in analyses: 20 Age: 53.9 ± 11.12 years old Sex: F/M 15/5 Duration of symptoms: 4.80 ± 3.47
Interventions	Intervention: PEMF Description of modality used: Magnetoterapia model MG/3P (Elettromed) Dose: Frequency 50 Hz with a field intensity of 30 G for 25 min per session Method of administration: the switch that allowed the machine to produce waves was set to ‘on' and a U‐shaped applicator 30 x 15 cm in size was used Frequency of administration: 5 sessions per week for 3 weeks Control: Sham PEMF Description of modality used: Magnetoterapia model MG/3P (Elettromed) Dose: none for a 25‐min session Method of administration: the switch that allowed the machine to produce waves was set to ‘off' and a U‐shaped applicator 30 x 15 cm in size was used Frequency: 5 sessions per week for 3 weeks Both Groups Description of modality used Exercise: Codman's pendulum exercises Cold pack: cold pack gel Dose Exercise: 5 min each time Cold pack: 20 min per session Method of administration Cold pack: applied to painful shoulder Frequency Exercise: 5 times per day for 3 weeks Cold pack: 5 times per day for 3 weeks Any additional treatment during trial Restriction of above‐head activities 15 mg daily Meloxicam tablet
Outcomes	Outcomes assessed at 3 weeks Function: Constant total score (0‐100 with higher scores denoting better function) Rest pain: VAS 0‐10 where 0 = no pain and 10 = intolerable pain Pain on motion: VAS 0‐10 where 0 = no pain and 10 = intolerable pain Night pain: VAS 0‐10 where 0 = no pain and 10 = intolerable pain Active range of motion (Constant sub‐score 0‐40, higher = better ROM) Strength (Constant sub‐score 0‐25, higher = better strength)
Notes	Conflict of interest: not reported Funding: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "Patients were randomly divided into two equal groups of 23 patients in a simple systematic manner (x + 1) according to the therapeutic PEMF or sham PEMF application." Comment: There was no information on how the allocation sequence was generated
Allocation concealment (selection bias)	Unclear risk	Quote: "A separate individual was provided the randomization list and informed therapist." Comment: There was no information on how the allocation sequence was concealed
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Quote: "Patients and physicians remained blind to the group allocation throughout the study." Quote: "One group was given PEMF; the other group was given sham PEMF. A magnetic field treatment unit was used with a concealed switch for either the presence or absence of waves when activated by the patient's attendant." Comment: Participants and personnel were blinded
Blinding of outcome assessment (detection bias) Self‐reported outcomes	Low risk	Comment: Blinded participants self‐reported some outcomes
Blinding of outcome assessment (detection bias) Objectively rated outcomes	Low risk	Quotes: "Patients and physicians remained blind to the group allocation throughout the study." Comment: Assessors of objective outcomes were blinded
Incomplete outcome data (attrition bias) All outcomes	Low risk	Quote: "Forty patients completed the study. Three patients from each group could not continue treatment program. Therefore, six patients dropped out of the study." Comment: The rate and reasons for attrition were equal between groups. Also, analysis was based on all randomised participants
Selective reporting (reporting bias)	Unclear risk	Comment: Outcome data were fully reported for all outcomes reported in the methods section of the publication, but without a trial protocol it is unclear whether other outcomes were measured but not reported based on the nature of the results
Other bias	Low risk	Comment: No other sources of bias identified