Burger Marlette, Africa Carly, Droomer Kara, Norman Alexa, Pheiffe Chloé, Gericke Anrich, Samsodien Adeeb, Miszewski Natasha
Physiotherapy Division, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
S Afr J Physiother. 2016 Sep 27;72(1):318. doi: 10.4102/sajp.v72i1.318. eCollection 2016.
Subacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain. Limited research has been conducted into the efficacy of corticosteroid injections (CSIs) compared to physiotherapy in the management of SIS.
To critically appraise and establish the best available evidence for the effectiveness of CSI in comparison with physiotherapy for the management of pain, shoulder range of motion (ROM) and shoulder function in patients with SIS.
Seven databases were searched from inception to February 2016, namely PubMed, Science Direct, EBSCO Host: SPORTDiscus, EBSCO Host: CINAHL, Cochrane, Scopus and PEDro. The main search terms were shoulder impingement syndrome and/or subacromial impingement syndrome, corticosteroid injections and/or steroid injections, physical therapy and/or physiotherapy. Only randomised controlled trials (RCTs) were considered for inclusion. The articles were appraised according to the PEDro scale. The Revman Review Manager Software was used to combine the results of shoulder function and the data were illustrated in forest plots.
The PEDro scores of the three RCTs that qualified for this review ranged from 7 to 8/10. There is Level II evidence suggesting that besides a significant improvement in shoulder function in favour of CSI at 6-7 weeks follow-up ( < 0.0001), no evidence was found for the superiority of CSIs compared with physiotherapy for pain, ROM and shoulder function in the short- (1-3 months), mid- (6 months) and long term (12 months).
In patients with SIS only a short term significant improvement in shoulder function was found in favour of CSIs.
肩峰下撞击综合征（SIS）是肩部疼痛最常见的原因之一。与物理治疗相比，关于皮质类固醇注射（CSI）治疗SIS疗效的研究有限。
严格评估并确定CSI与物理治疗相比，在治疗SIS患者疼痛、肩关节活动范围（ROM）和肩部功能方面有效性的最佳现有证据。
检索了从建库至2016年2月的七个数据库，即PubMed、Science Direct、EBSCO Host: SPORTDiscus、EBSCO Host: CINAHL、Cochrane、Scopus和PEDro。主要检索词为肩峰撞击综合征和/或肩峰下撞击综合征、皮质类固醇注射和/或类固醇注射、物理治疗和/或理疗。仅纳入随机对照试验（RCT）。根据PEDro量表对文章进行评估。使用Revman Review Manager软件合并肩部功能结果，并以森林图展示数据。
符合本综述的三项RCT的PEDro评分在7至8/10之间。有II级证据表明，除了在6 - 7周随访时CSI在改善肩部功能方面有显著优势（<0.0001）外，在短期（1 - 3个月）、中期（6个月）和长期（12个月），未发现CSI在疼痛、ROM和肩部功能方面优于物理治疗的证据。
在SIS患者中，仅发现短期内在改善肩部功能方面CSI有显著优势。
