Efficacy and Safety of Manipulative Therapy for Frozen Shoulder: a Meta-analysis

Background In recent years, there have been many randomized controlled trials (RCTs) featuring manipulation for frozen shoulder, but there is a lack of new systematic reviews on the efficacy and safety of manipulation for frozen shoulder. Objective To evaluate the efficacy and safety of manipulation in the treatment of frozen shoulder by Meta-analysis, and understand whether "rotation shoulder joint" could affect the effect of manipulative therapy by subgroup. Methods PubMed, Cochrane Library, Embase, Medline, CNKI, China Biomedical Literature Database, Wanfang Data were searched for RCTs on the efficacy and safety of manipulative therapy for frozen shoulder, with manipulative therapy as the intervention of experimental group and non-pharmacological therapy as the intervention of control group from inception to 2023-03-01. Two investigators extracted data and evaluated the quality. Meta-analysis was performed using Revman 5.3 software. Results A total of 12 RCTs were included in this Meta-analysis, with a total of 893 patients with frozen shoulder, including 451 patients in the experimental group and 442 cases in the control group. Results of Meta-analysis showed that the improvement of VAS by manipulative therapy was better than physical therapy, acupuncture therapy and conventional therapy (SMD=1.09, 95%CI=0.81-1.37, P