Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Br J Sports Med. 2011 Jan;45(1):49-56. doi: 10.1136/bjsm.2010.071431. Epub 2010 Jul 20.
A variety of therapeutic interventions is available for restoring motion and diminishing pain in patients with frozen shoulder. An overview article concerning the evidence for the effectiveness of these interventions is lacking.
To provide an evidence-based overview regarding the effectiveness of conservative and surgical interventions to treat the frozen shoulder.
The Cochrane Library, PubMed, Embase, Cinahl and Pedro were searched for relevant systematic reviews and randomised clinical trials (RCTs). Two reviewers independently selected relevant studies, assessed the methodological quality and extracted data. A best-evidence synthesis was used to summarise the results.
Five Cochrane reviews and 18 RCTs were included studying the effectiveness of oral medication, injection therapy, physiotherapy, acupuncture, arthrographic distension and suprascapular nerve block (SSNB).
We found strong evidence for the effectiveness of steroid injections and laser therapy in short-term and moderate evidence for steroid injections in mid-term follow-up. Moderate evidence was found in favour of mobilisation techniques in the short and long term, for the effectiveness of arthrographic distension alone and as an addition to active physiotherapy in the short term, for the effectiveness of oral steroids compared with no treatment or placebo in the short term, and for the effectiveness of SSNB compared with acupuncture, placebo or steroid injections. For other commonly used interventions no or only limited evidence of effectiveness was found. Most of the included studies reported short-term results, whereas symptoms of frozen shoulder may last up to 4 years. High quality RCTs studying long-term results are clearly needed in this field.
对于治疗冻结肩患者的运动障碍和疼痛，有多种治疗干预方法。但缺乏关于这些干预措施有效性的综述文章。
提供关于保守和手术干预治疗冻结肩有效性的循证综述。
检索 Cochrane 图书馆、PubMed、Embase、Cinahl 和 Pedro 以获取相关的系统评价和随机对照试验（RCT）。两名评审员独立选择相关研究，评估方法学质量并提取数据。采用最佳证据综合法总结结果。
纳入了五项 Cochrane 综述和 18 项 RCT，研究了口服药物、注射治疗、物理治疗、针灸、关节造影扩张和肩胛上神经阻滞（SSNB）的有效性。
我们发现短期应用皮质类固醇注射和激光治疗有很强的有效性证据，中期随访时皮质类固醇注射有中度有效性证据。短期应用松动技术有中度有效性证据，关节造影扩张单独应用和作为主动物理治疗的附加治疗在短期内有有效性证据，口服皮质类固醇与不治疗或安慰剂相比在短期内有有效性证据，SSNB 与针灸、安慰剂或皮质类固醇注射相比有有效性证据。对于其他常用的干预措施，没有或只有有限的有效性证据。大多数纳入的研究报告了短期结果，但冻结肩的症状可能持续长达 4 年。因此，该领域显然需要高质量的 RCT 来研究长期结果。
