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Background: This study aims to investigate the efficacy of five analgesic strategies combined with conventional physiotherapy program (CPT) in managing chronic shoulder pain. Methods: Two authors independently screened studies, extracted data using a pre-formatted chart, and assessed bias using the Cochrane Risk of Bias tool. A network meta-analysis was performed by the Stata 17.0 and R 4.3.2 software. Results: A total of 14 studies with 862 subjects were identified. These analgesic strategies included extracorporeal shock wave therapy (ESWT), suprascapular nerve block (SSNB), corticosteroid injection (CSI), hyaluronic acid injection (HAI), and kinesio taping (KT). ESWT plus CPT was the most efficient intervention in alleviating pain intensity and improving physical function. SSNB plus CPT was the optimal intervention in improving shoulder mobility. Compared to CPT alone, CSI + CPT only significantly improved the SPADI total score, but showed no difference in pain intensity or shoulder mobility. HAI + CPT showed no significant difference in improving pain intensity, physical function, or shoulder mobility compared to CPT alone. Adding KT to CPT did not yield additional benefits in improving shoulder mobility. Conclusion: Overall, in managing chronic shoulder pain, ESWT + CPT was the most effective intervention for reducing pain intensity and improving physical function. SSNB + CPT was optimal for enhancing shoulder mobility. Future rigorous clinical trials with larger sample sizes and higher methodological rigor are strongly required to confirm the current results. [ABSTRACT FROM AUTHOR]

Introduction: Several clinical studies have demonstrated that brain-computer interfaces (BCIs) controlled functional electrical stimulation (FES) facilitate neurological recovery in patients with stroke. This review aims to evaluate the effectiveness of BCI-FES training on upper limb functional recovery in stroke patients., Methods: PubMed, Embase, Cochrane Library, Science Direct and Web of Science were systematically searched from inception to October 2023. Randomized controlled trials (RCTs) employing BCI-FES training were included. The methodological quality of the RCTs was assessed using the PEDro scale. Meta-analysis was conducted using RevMan 5.4.1 and STATA 18., Results: The meta-analysis comprised 290 patients from 10 RCTs. Results showed a moderate effect size in upper limb function recovery through BCI-FES training (SMD = 0.50, 95% CI: 0.26-0.73, I 2 = 0%, p < 0.0001). Subgroup analysis revealed that BCI-FES training significantly enhanced upper limb motor function in BCI-FES vs. FES group (SMD = 0.37, 95% CI: 0.00-0.74, I 2 = 21%, p = 0.05), and the BCI-FES + CR vs. CR group (SMD = 0.61, 95% CI: 0.28-0.95, I 2 = 0%, p = 0.0003). Moreover, BCI-FES training demonstrated effectiveness in both subacute (SMD = 0.56, 95% CI: 0.25-0.87, I 2 = 0%, p = 0.0004) and chronic groups (SMD = 0.42, 95% CI: 0.05-0.78, I 2 = 45%, p = 0.02). Subgroup analysis showed that both adjusting (SMD = 0.55, 95% CI: 0.24-0.87, I 2 = 0%, p = 0.0006) and fixing (SMD = 0.43, 95% CI: 0.07-0.78, I 2 = 46%, p = 0.02). BCI thresholds before training significantly improved motor function in stroke patients. Both motor imagery (MI) (SMD = 0.41 95% CI: 0.12-0.71, I 2 = 13%, p = 0.006) and action observation (AO) (SMD = 0.73, 95% CI: 0.26-1.20, I 2 = 0%, p = 0.002) as mental tasks significantly improved upper limb function in stroke patients., Discussion: BCI-FES has significant immediate effects on upper limb function in subacute and chronic stroke patients, but evidence for its long-term impact remains limited. Using AO as the mental task may be a more effective BCI-FES training strategy., Systematic Review Registration: Identifier: CRD42023485744, https://www.crd.york.ac.uk/prospero/display&#95;record.php?ID=CRD42023485744., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ren, Li, Gao, Pan, Wang, Yang, Duan, Guo and Zhang.)