1. Efficacy of different analgesic strategies combined with conventional physiotherapy program for treating chronic shoulder pain: a systematic review and network meta-analysis.
- Author
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Yang, Fangjie, Li, Xinmin, Wang, Jing, Gao, Qian, Pan, Mengyang, Duan, Zhenfei, Ren, Chunlin, Guo, Pengxue, and Zhang, Yasu
- Subjects
CHRONIC pain treatment ,SHOULDER pain treatment ,PHYSICAL therapy ,MEDICAL information storage & retrieval systems ,STATISTICAL models ,ADRENOCORTICAL hormones ,RESEARCH funding ,TAPING & strapping ,HYALURONIC acid ,TREATMENT effectiveness ,META-analysis ,DESCRIPTIVE statistics ,SEVERITY of illness index ,ANALGESICS ,SYSTEMATIC reviews ,MEDLINE ,ROTATIONAL motion ,INJECTIONS ,COMBINED modality therapy ,PAIN management ,MEDICAL databases ,ONLINE information services ,DATA analysis software ,CONFIDENCE intervals ,ULTRASONIC therapy ,RANGE of motion of joints ,NERVE block - Abstract
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]
- Published
- 2024
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