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The effectiveness of comprehensive physiotherapy compared with corticosteroid injection on pain, disability, treatment effectiveness, and quality of life in patients with subacromial pain syndrome: a parallel, single-blind, randomized controlled trial
Daghiani M, Negahban H, Ebrahimzadeh MH, Moradi A, Kachooei AR, Raeesi J, Divandari A
Physiotherapy Theory and Practice 2023;39(8):1591-1605
clinical trial
8/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Comparing short- and long-term effects of comprehensive physiotherapy (CP) and subacromial corticosteroid injection (SCI) on pain, disability, and quality of life in the patients with subacromial pain syndrome (SAPS). DESIGN: 2x4 randomized controlled trial. PARTICIPANTS: 50 participants with unilateral SAPS. INTERVENTION: Random assignment with allocation concealment into two groups labeled as 12 sessions, supervised CP (n = 22) and 1cc triamhexal SCI (n = 25). OUTCOMES: Visual analog scale (VAS), Shoulder Pain and Disability Index (SPADI), shortened Disabilities of Arm, Shoulder and Hand (Quick-DASH), and Western Ontario Rotator Cuff Index (WORC). Outcomes were gathered pre- and post-intervention, with three- and six-month follow-ups. RESULTS: Variance analysis revealed that there was a significant interaction of group-in-time for SPADI and WORC (p < 0.05) but not for Quick-DASH and VAS (p > 0.05). The independent t-test analysis showed that the mean scores of all outcome measures in CP group were lesser than SCI group via 6 months (p < 0.05), except for the VAS (p > 0.05, mean difference -0.97, 95% confidence interval -2.11 to 0.15). CONCLUSION: CP results in statistically significant and potentially clinically important difference in function and quality of the life at all timeframe. Moreover, there was no between group difference in order to reduce pain.

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