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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Evidence reviews for interventions for shoulder pain after stroke - NCBI Bookshelf</title>
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<meta name="citation_keywords" content="Stroke Rehabilitation">
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<meta name="citation_keywords" content="Stroke">
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<meta name="citation_keywords" content="Subarachnoid Hemorrhage">
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<meta name="citation_keywords" content="Shoulder Pain">
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<meta name="citation_keywords" content="Transcutaneous Electric Nerve Stimulation">
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<meta name="citation_keywords" content="Electric Stimulation Therapy">
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<meta name="citation_keywords" content="Acupuncture Therapy">
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after stroke" /></a></div><div class="bkr_bib"><h1 id="_NBK602206_"><span itemprop="name">Evidence reviews for interventions for shoulder pain after stroke</span></h1><div class="subtitle">Stroke rehabilitation in adults</div><p><b>Evidence review O</b></p><p><i>NICE Guideline, No. 236</i></p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2023 Oct</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-5464-3</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2023.</div></div><div class="bkr_clear"></div></div><div id="niceng236er22.s1"><h2 id="_niceng236er22_s1_">1. Managing post-stroke shoulder pain</h2><div id="niceng236er22.s1.1"><h3>1.1. Review question</h3><p>In people with shoulder pain after stroke, what is the clinical and cost effectiveness of transcutaneous electrical nerve stimulation, acupuncture, functional electrical stimulation and intra-articular steroid injection in reducing pain?</p><div id="niceng236er22.s1.1.1"><h4>1.1.1. Introduction</h4><p>Shoulder pain is very common after a stroke, in particular among individuals with arm weakness. This pain can be disabling and can prevent or interrupt rehabilitation programmes. While there is extensive literature on the management of shoulder pain in the healthy adult population, there is little research and clinical guidance for the management of post-stroke shoulder pain. Shoulder pain in this clinical cohort is complex and multifactorial in aetiology, and there has been an increase in treatment options such as electrical stimulation becoming available over the past few years. Despite this, a lack of national clinical standards means that current clinical practice tends to be more reactive rather than proactive, and clinicians may be uncertain which physical or pharmacological intervention may be the most appropriate for their patient.</p></div><div id="niceng236er22.s1.1.2"><h4>1.1.2. Summary of the protocol</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab1"><a href="/books/NBK602206/table/niceng236er22.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab1" rid-ob="figobniceng236er22tab1"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab1/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab1/?report=previmg" alt="Table 1. PICO characteristics of review question." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab1"><a href="/books/NBK602206/table/niceng236er22.tab1/?report=objectonly" target="object" rid-ob="figobniceng236er22tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICO characteristics of review question. </p></div></div><p>For full details see the review protocol in <a href="#niceng236er22.appa">Appendix A</a>.</p></div><div id="niceng236er22.s1.1.3"><h4>1.1.3. Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>. Methods specific to this review question are described in the review protocol in <a href="#niceng236er22.appa">Appendix A</a> and the methods document.</p><p>Declarations of interest were recorded according to <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s conflicts of interest policy</a>.</p></div><div id="niceng236er22.s1.1.4"><h4>1.1.4. Effectiveness evidence</h4><div id="niceng236er22.s1.1.4.1"><h5>1.1.4.1. Included studies</h5><p>Twenty eight randomised controlled trial studies (32 papers) were included in the review;<sup><a class="bibr" href="#niceng236er22.ref2" rid="niceng236er22.ref2">2</a>–<a class="bibr" href="#niceng236er22.ref9" rid="niceng236er22.ref9">9</a>, <a class="bibr" href="#niceng236er22.ref14" rid="niceng236er22.ref14">14</a>–<a class="bibr" href="#niceng236er22.ref17" rid="niceng236er22.ref17">17</a>, <a class="bibr" href="#niceng236er22.ref21" rid="niceng236er22.ref21">21</a>–<a class="bibr" href="#niceng236er22.ref24" rid="niceng236er22.ref24">24</a>, <a class="bibr" href="#niceng236er22.ref26" rid="niceng236er22.ref26">26</a>, <a class="bibr" href="#niceng236er22.ref27" rid="niceng236er22.ref27">27</a>, <a class="bibr" href="#niceng236er22.ref33" rid="niceng236er22.ref33">33</a>, <a class="bibr" href="#niceng236er22.ref34" rid="niceng236er22.ref34">34</a>, <a class="bibr" href="#niceng236er22.ref36" rid="niceng236er22.ref36">36</a>, <a class="bibr" href="#niceng236er22.ref37" rid="niceng236er22.ref37">37</a>, <a class="bibr" href="#niceng236er22.ref39" rid="niceng236er22.ref39">39</a>–<a class="bibr" href="#niceng236er22.ref41" rid="niceng236er22.ref41">41</a>, <a class="bibr" href="#niceng236er22.ref45" rid="niceng236er22.ref45">45</a>, <a class="bibr" href="#niceng236er22.ref46" rid="niceng236er22.ref46">46</a>, <a class="bibr" href="#niceng236er22.ref48" rid="niceng236er22.ref48">48</a>–<a class="bibr" href="#niceng236er22.ref52" rid="niceng236er22.ref52">52</a></sup> these are summarised in <a class="figpopup" href="/books/NBK602206/table/niceng236er22.tab2/?report=objectonly" target="object" rid-figpopup="figniceng236er22tab2" rid-ob="figobniceng236er22tab2">Table 2</a> below. Evidence from these studies is summarised in the clinical evidence summary below (<a class="figpopup" href="/books/NBK602206/table/niceng236er22.tab3/?report=objectonly" target="object" rid-figpopup="figniceng236er22tab3" rid-ob="figobniceng236er22tab3">Table 3</a>).</p><p>The following interventions were compared:
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<ul><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation (TENS) compared to:
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<ul class="circle"><li class="half_rhythm"><div>Neuromuscular electrical stimulation (NMES)<sup><a class="bibr" href="#niceng236er22.ref6" rid="niceng236er22.ref6">6</a>, <a class="bibr" href="#niceng236er22.ref52" rid="niceng236er22.ref52">52</a></sup></div></li><li class="half_rhythm"><div>Nerve blocks (local anaesthetic)<sup><a class="bibr" href="#niceng236er22.ref9" rid="niceng236er22.ref9">9</a></sup></div></li><li class="half_rhythm"><div>Usual care or no treatment<sup><a class="bibr" href="#niceng236er22.ref52" rid="niceng236er22.ref52">52</a></sup></div></li></ul></div></li><li class="half_rhythm"><div>Functional electrical stimulation (FES) compared to:
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<ul class="circle"><li class="half_rhythm"><div>Usual care or no treatment<sup><a class="bibr" href="#niceng236er22.ref21" rid="niceng236er22.ref21">21</a></sup></div></li></ul></div></li><li class="half_rhythm"><div>Neuromuscular electrical stimulation (NMES) compared to:
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<ul class="circle"><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation (TENS)<sup><a class="bibr" href="#niceng236er22.ref6" rid="niceng236er22.ref6">6</a>, <a class="bibr" href="#niceng236er22.ref52" rid="niceng236er22.ref52">52</a></sup></div></li><li class="half_rhythm"><div>Devices – slings<sup><a class="bibr" href="#niceng236er22.ref5" rid="niceng236er22.ref5">5</a></sup></div></li><li class="half_rhythm"><div>Placebo/sham<sup><a class="bibr" href="#niceng236er22.ref7" rid="niceng236er22.ref7">7</a>, <a class="bibr" href="#niceng236er22.ref23" rid="niceng236er22.ref23">23</a></sup></div></li><li class="half_rhythm"><div>Usual care or no treatment<sup><a class="bibr" href="#niceng236er22.ref40" rid="niceng236er22.ref40">40</a>, <a class="bibr" href="#niceng236er22.ref45" rid="niceng236er22.ref45">45</a>, <a class="bibr" href="#niceng236er22.ref52" rid="niceng236er22.ref52">52</a></sup></div></li></ul></div></li><li class="half_rhythm"><div>Devices – tape compared to:
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<ul class="circle"><li class="half_rhythm"><div>Placebo/sham<sup><a class="bibr" href="#niceng236er22.ref16" rid="niceng236er22.ref16">16</a>, <a class="bibr" href="#niceng236er22.ref17" rid="niceng236er22.ref17">17</a>, <a class="bibr" href="#niceng236er22.ref33" rid="niceng236er22.ref33">33</a>, <a class="bibr" href="#niceng236er22.ref48" rid="niceng236er22.ref48">48</a></sup></div></li><li class="half_rhythm"><div>Usual care or no treatment<sup><a class="bibr" href="#niceng236er22.ref15" rid="niceng236er22.ref15">15</a>, <a class="bibr" href="#niceng236er22.ref34" rid="niceng236er22.ref34">34</a></sup></div></li></ul></div></li><li class="half_rhythm"><div>Devices – slings compared to:
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<ul class="circle"><li class="half_rhythm"><div>Neuromuscular electrical stimulation (NMES)<sup><a class="bibr" href="#niceng236er22.ref5" rid="niceng236er22.ref5">5</a></sup></div></li><li class="half_rhythm"><div>Usual care or no treatment<sup><a class="bibr" href="#niceng236er22.ref27" rid="niceng236er22.ref27">27</a>, <a class="bibr" href="#niceng236er22.ref41" rid="niceng236er22.ref41">41</a></sup></div></li></ul></div></li><li class="half_rhythm"><div>Devices – braces compared to:
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<ul class="circle"><li class="half_rhythm"><div>Usual care or no treatment<sup><a class="bibr" href="#niceng236er22.ref14" rid="niceng236er22.ref14">14</a></sup></div></li></ul></div></li><li class="half_rhythm"><div>Acupuncture/dry needling compared to:
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<ul class="circle"><li class="half_rhythm"><div>Placebo/sham<sup><a class="bibr" href="#niceng236er22.ref24" rid="niceng236er22.ref24">24</a></sup></div></li><li class="half_rhythm"><div>Usual care or no treatment<sup><a class="bibr" href="#niceng236er22.ref8" rid="niceng236er22.ref8">8</a>, <a class="bibr" href="#niceng236er22.ref26" rid="niceng236er22.ref26">26</a>, <a class="bibr" href="#niceng236er22.ref50" rid="niceng236er22.ref50">50</a>, <a class="bibr" href="#niceng236er22.ref51" rid="niceng236er22.ref51">51</a></sup></div></li></ul></div></li><li class="half_rhythm"><div>Electroacupuncture compared to:
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<ul class="circle"><li class="half_rhythm"><div>Placebo/sham<sup><a class="bibr" href="#niceng236er22.ref37" rid="niceng236er22.ref37">37</a></sup></div></li></ul></div></li><li class="half_rhythm"><div>Intra-articular medicine injections – Corticosteroids compared to:
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<ul class="circle"><li class="half_rhythm"><div>Placebo/sham<sup><a class="bibr" href="#niceng236er22.ref22" rid="niceng236er22.ref22">22</a>, <a class="bibr" href="#niceng236er22.ref36" rid="niceng236er22.ref36">36</a></sup></div></li></ul></div></li><li class="half_rhythm"><div>Nerve blocks (local anaesthetic) compared to:
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<ul class="circle"><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation (TENS)<sup><a class="bibr" href="#niceng236er22.ref9" rid="niceng236er22.ref9">9</a></sup></div></li><li class="half_rhythm"><div>Placebo/sham<sup><a class="bibr" href="#niceng236er22.ref2" rid="niceng236er22.ref2">2</a>, <a class="bibr" href="#niceng236er22.ref39" rid="niceng236er22.ref39">39</a></sup></div></li></ul></div></li></ul></p><p>No relevant clinical studies including the following interventions were identified:
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<ul><li class="half_rhythm"><div>Devices – supports and other devices</div></li><li class="half_rhythm"><div>Intra-articular medicine injections – saline</div></li><li class="half_rhythm"><div>Injections into other sites (for example: bursae) – corticosteroids and saline</div></li></ul></p><div id="niceng236er22.s1.1.4.1.1"><h5>Population and concomitant therapy factors</h5><p>The populations included in the review were somewhat similar. There was a mixture of studies investigating the use of interventions in different time periods after stroke, mostly including people in the subacute or chronic time periods. The majority of studies excluded people with previous shoulder pathology, while others did not state whether they were excluded. No study reported specifically including people with previous shoulder pathology.</p><p>Concomitant therapy use varied between studies. In the majority of cases, physiotherapy including exercise with or without manual therapy was available with the therapy being of varied intensity. In some cases, occupational therapy and speech and language therapy were provided as required. In others, additional pharmacological therapy, including paracetamol, non-steroidal anti-inflammatory drugs and opioids for pain relief and occasionally antispasticity medication, such as tizanidine were available.</p></div><div id="niceng236er22.s1.1.4.1.2"><h5>Inconsistency</h5><p>The majority of outcomes included evidence from one study only. Where outcomes included multiple studies, some showed inconsistency that could not be resolved by sensitivity analysis or subgroup analysis. In the majority of cases, there were less than four studies, which meant that valid subgroups could not be formed.</p></div><div id="niceng236er22.s1.1.4.1.3"><h5>Background rate of oral drug use</h5><p>When investigating the studies, the possibility of study enrichment through inclusion criteria specifying previous oral medication use was considered. Most studies did not report specific response criteria, while the others that discussed this possibility did not specifically include or exclude people based on this. Instead, they provided the opportunity to use oral pain relief medication to all participants. In some studies, this appeared to be provided to all participants, while in others only some of the participants received therapy. A series of sensitivity analyses were conducted investigating this and did not find that considering this resolved heterogeneity.</p><p>See also the study selection flow chart in <a href="#niceng236er22.appc">Appendix C</a>, study evidence tables in <a href="#niceng236er22.appd">Appendix D</a>, forest plots in <a href="#niceng236er22.appe">Appendix E</a>, and GRADE tables in <a href="#niceng236er22.appf">Appendix F</a>.</p></div></div><div id="niceng236er22.s1.1.4.2"><h5>1.1.4.2. Excluded studies</h5><p>Two Cochrane reviews, Ada 2005<sup><a class="bibr" href="#niceng236er22.ref1" rid="niceng236er22.ref1">1</a></sup> and Price 2000<sup><a class="bibr" href="#niceng236er22.ref35" rid="niceng236er22.ref35">35</a></sup> were identified but were not included in the review. The reasons included reviewing a different population and not investigating the effect of the intervention on pain<sup><a class="bibr" href="#niceng236er22.ref1" rid="niceng236er22.ref1">1</a></sup> and including people where it was not explicitly stated they had shoulder pain and not including all of the comparisons stated in the protocol<sup><a class="bibr" href="#niceng236er22.ref35" rid="niceng236er22.ref35">35</a></sup>. In these cases, the citation list was checked and all relevant studies were included in the review.</p><p>See the excluded studies list in <a href="#niceng236er22.appj">Appendix J</a>.</p></div></div><div id="niceng236er22.s1.1.5"><h4>1.1.5. Summary of studies included in the effectiveness evidence</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab2"><a href="/books/NBK602206/table/niceng236er22.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab2" rid-ob="figobniceng236er22tab2"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab2/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab2/?report=previmg" alt="Table 2. Summary of studies included in the evidence review." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab2"><a href="/books/NBK602206/table/niceng236er22.tab2/?report=objectonly" target="object" rid-ob="figobniceng236er22tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the evidence review. </p></div></div><p>See <a href="#niceng236er22.appd">Appendix D</a> for full evidence tables.</p><div id="niceng236er22.s1.1.5.1"><h5>1.1.5.1. Summary matrices</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab3"><a href="/books/NBK602206/table/niceng236er22.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab3" rid-ob="figobniceng236er22tab3"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab3/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab3/?report=previmg" alt="Table 3. Summary matrix of the protocol interventions compared to placebo/sham." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab3"><a href="/books/NBK602206/table/niceng236er22.tab3/?report=objectonly" target="object" rid-ob="figobniceng236er22tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Summary matrix of the protocol interventions compared to placebo/sham. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab4"><a href="/books/NBK602206/table/niceng236er22.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab4" rid-ob="figobniceng236er22tab4"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab4/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab4/?report=previmg" alt="Table 4. Summary matrix of the protocol interventions compared to usual care or no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab4"><a href="/books/NBK602206/table/niceng236er22.tab4/?report=objectonly" target="object" rid-ob="figobniceng236er22tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">Summary matrix of the protocol interventions compared to usual care or no treatment. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab5"><a href="/books/NBK602206/table/niceng236er22.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab5" rid-ob="figobniceng236er22tab5"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab5/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab5/?report=previmg" alt="Table 5. Summary matrix of the protocol interventions compared to each other." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab5"><a href="/books/NBK602206/table/niceng236er22.tab5/?report=objectonly" target="object" rid-ob="figobniceng236er22tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">Summary matrix of the protocol interventions compared to each other. </p></div></div></div></div><div id="niceng236er22.s1.1.6"><h4>1.1.6. Summary of the effectiveness evidence</h4><div id="niceng236er22.s1.1.6.1"><h5>1.1.6.1. Transcutaneous electrical nerve stimulation (TENS) compared to neuromuscular electrical stimulation (NMES) and usual care or no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab6"><a href="/books/NBK602206/table/niceng236er22.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab6" rid-ob="figobniceng236er22tab6"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab6/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab6/?report=previmg" alt="Table 6. Clinical evidence summary: transcutaneous electrical nerve stimulation (TENS) compared to neuromuscular electrical stimulation (NMES)." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab6"><a href="/books/NBK602206/table/niceng236er22.tab6/?report=objectonly" target="object" rid-ob="figobniceng236er22tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: transcutaneous electrical nerve stimulation (TENS) compared to neuromuscular electrical stimulation (NMES). </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab7"><a href="/books/NBK602206/table/niceng236er22.tab7/?report=objectonly" target="object" title="Table 7" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab7" rid-ob="figobniceng236er22tab7"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab7/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab7/?report=previmg" alt="Table 7. Clinical evidence summary: transcutaneous electrical nerve stimulation (TENS) compared to usual care or no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab7"><a href="/books/NBK602206/table/niceng236er22.tab7/?report=objectonly" target="object" rid-ob="figobniceng236er22tab7">Table 7</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: transcutaneous electrical nerve stimulation (TENS) compared to usual care or no treatment. </p></div></div></div><div id="niceng236er22.s1.1.6.2"><h5>1.1.6.2. Functional electrical stimulation (FES) compared to usual care or no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab8"><a href="/books/NBK602206/table/niceng236er22.tab8/?report=objectonly" target="object" title="Table 8" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab8" rid-ob="figobniceng236er22tab8"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab8/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab8/?report=previmg" alt="Table 8. Clinical evidence summary: functional electrical stimulation (FES) compared to usual care or no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab8"><a href="/books/NBK602206/table/niceng236er22.tab8/?report=objectonly" target="object" rid-ob="figobniceng236er22tab8">Table 8</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: functional electrical stimulation (FES) compared to usual care or no treatment. </p></div></div></div><div id="niceng236er22.s1.1.6.3"><h5>1.1.6.3. Neuromuscular electrical stimulation (NMES) compared to placebo/sham and usual care or no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab9"><a href="/books/NBK602206/table/niceng236er22.tab9/?report=objectonly" target="object" title="Table 9" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab9" rid-ob="figobniceng236er22tab9"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab9/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab9/?report=previmg" alt="Table 9. Clinical evidence summary: neuromuscular electrical stimulation (NMES) compared to placebo/sham." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab9"><a href="/books/NBK602206/table/niceng236er22.tab9/?report=objectonly" target="object" rid-ob="figobniceng236er22tab9">Table 9</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: neuromuscular electrical stimulation (NMES) compared to placebo/sham. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab10"><a href="/books/NBK602206/table/niceng236er22.tab10/?report=objectonly" target="object" title="Table 10" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab10" rid-ob="figobniceng236er22tab10"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab10/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab10/?report=previmg" alt="Table 10. Clinical evidence summary: neuromuscular electrical stimulation (NMES) compared to usual care or no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab10"><a href="/books/NBK602206/table/niceng236er22.tab10/?report=objectonly" target="object" rid-ob="figobniceng236er22tab10">Table 10</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: neuromuscular electrical stimulation (NMES) compared to usual care or no treatment. </p></div></div></div><div id="niceng236er22.s1.1.6.4"><h5>1.1.6.4. Devices - tape compared to placebo/sham and usual care or no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab11"><a href="/books/NBK602206/table/niceng236er22.tab11/?report=objectonly" target="object" title="Table 11" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab11" rid-ob="figobniceng236er22tab11"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab11/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab11/?report=previmg" alt="Table 11. Clinical evidence summary: devices – tape compared to placebo/sham." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab11"><a href="/books/NBK602206/table/niceng236er22.tab11/?report=objectonly" target="object" rid-ob="figobniceng236er22tab11">Table 11</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: devices – tape compared to placebo/sham. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab12"><a href="/books/NBK602206/table/niceng236er22.tab12/?report=objectonly" target="object" title="Table 12" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab12" rid-ob="figobniceng236er22tab12"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab12/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab12/?report=previmg" alt="Table 12. Clinical evidence summary: devices – tape compared to usual care or no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab12"><a href="/books/NBK602206/table/niceng236er22.tab12/?report=objectonly" target="object" rid-ob="figobniceng236er22tab12">Table 12</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: devices – tape compared to usual care or no treatment. </p></div></div></div><div id="niceng236er22.s1.1.6.5"><h5>1.1.6.5. Devices - slings compared to neuromuscular electrical stimulation (NMES) and usual care or no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab13"><a href="/books/NBK602206/table/niceng236er22.tab13/?report=objectonly" target="object" title="Table 13" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab13" rid-ob="figobniceng236er22tab13"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab13/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab13/?report=previmg" alt="Table 13. Clinical evidence summary: devices – slings compared to neuromuscular electrical stimulation (NMES)." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab13"><a href="/books/NBK602206/table/niceng236er22.tab13/?report=objectonly" target="object" rid-ob="figobniceng236er22tab13">Table 13</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: devices – slings compared to neuromuscular electrical stimulation (NMES). </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab14"><a href="/books/NBK602206/table/niceng236er22.tab14/?report=objectonly" target="object" title="Table 14" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab14" rid-ob="figobniceng236er22tab14"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab14/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab14/?report=previmg" alt="Table 14. Clinical evidence summary: devices – slings compared to usual care or no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab14"><a href="/books/NBK602206/table/niceng236er22.tab14/?report=objectonly" target="object" rid-ob="figobniceng236er22tab14">Table 14</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: devices – slings compared to usual care or no treatment. </p></div></div></div><div id="niceng236er22.s1.1.6.6"><h5>1.1.6.6. Devices - braces compared to usual care or no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab15"><a href="/books/NBK602206/table/niceng236er22.tab15/?report=objectonly" target="object" title="Table 15" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab15" rid-ob="figobniceng236er22tab15"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab15/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab15/?report=previmg" alt="Table 15. Clinical evidence summary: devices – braces compared to usual care or no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab15"><a href="/books/NBK602206/table/niceng236er22.tab15/?report=objectonly" target="object" rid-ob="figobniceng236er22tab15">Table 15</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: devices – braces compared to usual care or no treatment. </p></div></div></div><div id="niceng236er22.s1.1.6.7"><h5>1.1.6.7. Acupuncture/dry needling compared to placebo/sham and usual care or no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab16"><a href="/books/NBK602206/table/niceng236er22.tab16/?report=objectonly" target="object" title="Table 16" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab16" rid-ob="figobniceng236er22tab16"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab16/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab16/?report=previmg" alt="Table 16. Clinical evidence summary: acupuncture/dry needling compared to placebo/sham." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab16"><a href="/books/NBK602206/table/niceng236er22.tab16/?report=objectonly" target="object" rid-ob="figobniceng236er22tab16">Table 16</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: acupuncture/dry needling compared to placebo/sham. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab17"><a href="/books/NBK602206/table/niceng236er22.tab17/?report=objectonly" target="object" title="Table 17" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab17" rid-ob="figobniceng236er22tab17"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab17/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab17/?report=previmg" alt="Table 17. Clinical evidence summary: acupuncture/dry needling compared to usual care or no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab17"><a href="/books/NBK602206/table/niceng236er22.tab17/?report=objectonly" target="object" rid-ob="figobniceng236er22tab17">Table 17</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: acupuncture/dry needling compared to usual care or no treatment. </p></div></div></div><div id="niceng236er22.s1.1.6.8"><h5>1.1.6.8. Electroacupuncture compared to placebo/sham</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab18"><a href="/books/NBK602206/table/niceng236er22.tab18/?report=objectonly" target="object" title="Table 18" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab18" rid-ob="figobniceng236er22tab18"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab18/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab18/?report=previmg" alt="Table 18. Clinical evidence summary: electroacupuncture compared to placebo/sham." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab18"><a href="/books/NBK602206/table/niceng236er22.tab18/?report=objectonly" target="object" rid-ob="figobniceng236er22tab18">Table 18</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: electroacupuncture compared to placebo/sham. </p></div></div></div><div id="niceng236er22.s1.1.6.9"><h5>1.1.6.9. Intra-articular medicine injections - corticosteroids compared to placebo/sham</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab19"><a href="/books/NBK602206/table/niceng236er22.tab19/?report=objectonly" target="object" title="Table 19" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab19" rid-ob="figobniceng236er22tab19"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab19/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab19/?report=previmg" alt="Table 19. Clinical evidence summary: intra-articular medicine injections – corticosteroids compared to placebo/sham." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab19"><a href="/books/NBK602206/table/niceng236er22.tab19/?report=objectonly" target="object" rid-ob="figobniceng236er22tab19">Table 19</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: intra-articular medicine injections – corticosteroids compared to placebo/sham. </p></div></div></div><div id="niceng236er22.s1.1.6.10"><h5>1.1.6.10. Nerve blocks (local anaesthetic) compared to transcutaneous electrical nerve stimulation (TENS) and placebo/sham</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab20"><a href="/books/NBK602206/table/niceng236er22.tab20/?report=objectonly" target="object" title="Table 20" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab20" rid-ob="figobniceng236er22tab20"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab20/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab20/?report=previmg" alt="Table 20. Clinical evidence summary: nerve blocks (local anaesthetic) compared to transcutaneous electrical nerve stimulation (TENS)." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab20"><a href="/books/NBK602206/table/niceng236er22.tab20/?report=objectonly" target="object" rid-ob="figobniceng236er22tab20">Table 20</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: nerve blocks (local anaesthetic) compared to transcutaneous electrical nerve stimulation (TENS). </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab21"><a href="/books/NBK602206/table/niceng236er22.tab21/?report=objectonly" target="object" title="Table 21" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab21" rid-ob="figobniceng236er22tab21"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab21/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab21/?report=previmg" alt="Table 21. Clinical evidence summary: nerve blocks (local anaesthetic) compared to placebo/sham." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab21"><a href="/books/NBK602206/table/niceng236er22.tab21/?report=objectonly" target="object" rid-ob="figobniceng236er22tab21">Table 21</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: nerve blocks (local anaesthetic) compared to placebo/sham. </p></div></div><p>See <a href="#niceng236er22.appf">Appendix F</a> for full GRADE tables.</p></div></div><div id="niceng236er22.s1.1.7"><h4>1.1.7. Economic evidence</h4><div id="niceng236er22.s1.1.7.1"><h5>1.1.7.1. Included studies</h5><p>No health economic studies were included in this review.</p></div><div id="niceng236er22.s1.1.7.2"><h5>1.1.7.2. Excluded studies</h5><p>No relevant health economic studies were excluded due to assessment of limited applicability or methodological limitations.</p><p>See also the health economic study selection flow chart in <a href="#niceng236er22.appg">Appendix G</a>.</p></div></div><div id="niceng236er22.s1.1.8"><h4>1.1.8. Summary of included economic evidence</h4><p>No health economic studies were included.</p></div><div id="niceng236er22.s1.1.9"><h4>1.1.9. Economic model</h4><p>This area was not prioritised for new cost-effectiveness analysis.</p></div><div id="niceng236er22.s1.1.10"><h4>1.1.10. Unit costs</h4><p>The tables below include unit costs relevant to the interventions being considered in this review. <a class="figpopup" href="/books/NBK602206/table/niceng236er22.tab22/?report=objectonly" target="object" rid-figpopup="figniceng236er22tab22" rid-ob="figobniceng236er22tab22">Table 22</a> presents staff costs related to people who may delivering interventions to reduce shoulder pain.</p><div id="niceng236er22.s1.1.10.1"><h5>Electrotherapies (FES, NMES, TENS)</h5><p>The cost of electrotherapies relates primarily to the staff time to administer it and will depend on how long sessions are and how often they are given, and duration of treatment. There are also equipment costs.</p><p>NMES was the most frequently evaluated of out the electrotherapy interventions (7 studies included in clinical review). The interventions varied between studies in terms of frequency and duration, with sessions ranging from 1–6-hours and were delivered between 3–7 days per week for 3–8 weeks. The included evidence for TENS reported sessions lasting 45–60 minutes, 3–7 days per week for 4–8 weeks. TENS can be delivered at home then returned for use by other patients which could lower resource use. The one study (Karaahmet 2019<sup><a class="bibr" href="#niceng236er22.ref21" rid="niceng236er22.ref21">21</a></sup>) that assessed functional electrical stimulation (FES) was structured around 30-minute sessions of FES-cycling, delivered 5 times a week over 4 weeks (20 sessions total).</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab22"><a href="/books/NBK602206/table/niceng236er22.tab22/?report=objectonly" target="object" title="Table 22" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab22" rid-ob="figobniceng236er22tab22"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab22/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab22/?report=previmg" alt="Table 22. Unit costs of health care professionals who may be involved in delivering interventions to reduce shoulder pain." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab22"><a href="/books/NBK602206/table/niceng236er22.tab22/?report=objectonly" target="object" rid-ob="figobniceng236er22tab22">Table 22</a></h4><p class="float-caption no_bottom_margin">Unit costs of health care professionals who may be involved in delivering interventions to reduce shoulder pain. </p></div></div><p><a class="figpopup" href="/books/NBK602206/table/niceng236er22.tab23/?report=objectonly" target="object" rid-figpopup="figniceng236er22tab23" rid-ob="figobniceng236er22tab23">Table 23</a> shows some the equipment costs related to TENS. The cost of a TENS machine varies (approximately £18-£50) depending on the type as a few are recorded in the NHS supply chain catalogue.<sup><a class="bibr" href="#niceng236er22.ref32" rid="niceng236er22.ref32">32</a></sup> Costs for NMES and FES machines were not listed.</p><p>Previous economic evaluations of electrotherapy (TENS, NMES, FES) for treating other types of pain have not included the costs of equipment used by physiotherapists in the analysis as the per-use costs were expected to be small (MacPherson 2017,<sup><a class="bibr" href="#niceng236er22.ref25" rid="niceng236er22.ref25">25</a></sup> Woods 2017<sup><a class="bibr" href="#niceng236er22.ref47" rid="niceng236er22.ref47">47</a></sup>).</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab23"><a href="/books/NBK602206/table/niceng236er22.tab23/?report=objectonly" target="object" title="Table 23" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab23" rid-ob="figobniceng236er22tab23"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab23/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab23/?report=previmg" alt="Table 23. Equipment costs transcutaneous electrical nerve stimulation (TENS)." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab23"><a href="/books/NBK602206/table/niceng236er22.tab23/?report=objectonly" target="object" rid-ob="figobniceng236er22tab23">Table 23</a></h4><p class="float-caption no_bottom_margin">Equipment costs transcutaneous electrical nerve stimulation (TENS). </p></div></div><p>A 2010 NHS Purchasing and Supply Agency report<sup><a class="bibr" href="#niceng236er22.ref38" rid="niceng236er22.ref38">38</a></sup> on FES for drop foot of central neurological origin included an initial assessment appointment costing £140. This analysis also included a clinic model in which the costs of the FES device are incorporated in the ongoing clinical charges. Each ongoing clinical appointment was estimated at £300. FES can also be delivered at home; however, availability varies across current practice.</p></div><div id="niceng236er22.s1.1.10.2"><h5>Acupuncture and electroacupuncture</h5><p>The cost of acupuncture relates primarily to the staff time to administer it and will depend on how long sessions are and how often they are given, and duration of treatment.</p><p>In the clinical review, the frequency and duration for delivering acupuncture and electroacupuncture varied across studies. Acupuncture ranged from being delivered once with a 1-week follow-up to once daily for one month continuously. Sessions typically lasted 30 minutes.</p><p>Equipment costs for acupuncture relate to the needles used. A previous economic model developed for the Chronic Pain NICE guideline (NG193)<sup><a class="bibr" href="#niceng236er22.ref28" rid="niceng236er22.ref28">28</a></sup> used a cost per needle of £0.06. A large acupuncture individual patient meta-analysis in chronic pain reported the number of needles across studies, and the most frequent range was between 10 and 14.<sup><a class="bibr" href="#niceng236er22.ref42" rid="niceng236er22.ref42">42</a></sup></p><p>An outpatient procedure for acupuncture for pain management is £141 (2019/2020 NHS reference costs<sup><a class="bibr" href="#niceng236er22.ref31" rid="niceng236er22.ref31">31</a></sup>). Costs in the community setting may be lower.</p><p>One study included in the clinical review (Sui 2021<sup><a class="bibr" href="#niceng236er22.ref37" rid="niceng236er22.ref37">37</a></sup>) provided acupuncture followed by 30 minutes of electroacupuncture delivered once a day, five days a week for two weeks. Example electroacupuncture equipment costs shown in <a class="figpopup" href="/books/NBK602206/table/niceng236er22.tab24/?report=objectonly" target="object" rid-figpopup="figniceng236er22tab24" rid-ob="figobniceng236er22tab24">Table 24</a> were taken from the analysis conducted as part of the osteoarthritis guideline update<sup><a class="bibr" href="#niceng236er22.ref29" rid="niceng236er22.ref29">29</a></sup>. These devices were the ES-160 (included as it was used in two of the four clinical studies in the osteoarthritis review of electroacupuncture) and AS-super 4, which is a popular alternative in clinical practice. The analysis assumed that both devices have a lifespan of 5 years. Other costs associated with electrotherapy include batteries, needles, disinfectant swabs, and surgeons’ gloves. The last electroacupuncture device included was the HANS-200A instrument, which was used in Sui 2021,<sup><a class="bibr" href="#niceng236er22.ref37" rid="niceng236er22.ref37">37</a></sup> however this would not be as frequently used in an NHS clinical setting.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab24"><a href="/books/NBK602206/table/niceng236er22.tab24/?report=objectonly" target="object" title="Table 24" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab24" rid-ob="figobniceng236er22tab24"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab24/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab24/?report=previmg" alt="Table 24. Example equipment costs for electroacupuncture." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab24"><a href="/books/NBK602206/table/niceng236er22.tab24/?report=objectonly" target="object" rid-ob="figobniceng236er22tab24">Table 24</a></h4><p class="float-caption no_bottom_margin">Example equipment costs for electroacupuncture<sup></sup>. </p></div></div></div><div id="niceng236er22.s1.1.10.3"><h5>Devices</h5><p><a class="figpopup" href="/books/NBK602206/table/niceng236er22.tab25/?report=objectonly" target="object" rid-figpopup="figniceng236er22tab25" rid-ob="figobniceng236er22tab25">Table 25</a> reports the costs associated with the devices reported in the clinical review. Slings and tape are relatively low-cost compared<sup><a class="bibr" href="#niceng236er22.ref43" rid="niceng236er22.ref43">43</a></sup> to the other interventions reported as the equipment costs and staff time involved in the application and correction of the devices are less resource intensive and can be incorporated into standard therapy. Taping was typically kept on for three days before being reapplied, meaning frequent visits may increase staff time compared to the sling. Shoulder braces were more expensive, with one study (Hartwig 2012)<sup><a class="bibr" href="#niceng236er22.ref14" rid="niceng236er22.ref14">14</a></sup> reporting the use of a shoulder brace (Functional orthosis Neuro-Lux (Sporlastic GmbH, Nürtingen, Germany)) which retails online for almost €233 (£212).<sup><a class="bibr" href="#niceng236er22.ref43" rid="niceng236er22.ref43">43</a></sup> Although this specific device was not reported in the NHS supply chain catalogue, it was noted by the committee to be one of the braces used in current practice. These interventions could also take place at home, with people tasked with wearing the devices all day or whenever the upper limb was unsupported.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab25"><a href="/books/NBK602206/table/niceng236er22.tab25/?report=objectonly" target="object" title="Table 25" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab25" rid-ob="figobniceng236er22tab25"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab25/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab25/?report=previmg" alt="Table 25. Example equipment costs of devices." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab25"><a href="/books/NBK602206/table/niceng236er22.tab25/?report=objectonly" target="object" rid-ob="figobniceng236er22tab25">Table 25</a></h4><p class="float-caption no_bottom_margin">Example equipment costs of devices. </p></div></div></div><div id="niceng236er22.s1.1.10.4"><h5>Intra-articular medicine injections and nerve blocks</h5><p>Resource use for intra-articular medicine injections and nerve blocks will relate to the drugs injected and the staff time to deliver the injections.</p><p><a class="figpopup" href="/books/NBK602206/table/niceng236er22.tab26/?report=objectonly" target="object" rid-figpopup="figniceng236er22tab26" rid-ob="figobniceng236er22tab26">Table 26</a> presents unit costs for drugs used in intra-articular injections and nerve blocks. Saline injections were also included in the protocol, but no studies were found in the clinical review related to this and so costs are not shown.</p><p>Participants in all studies included in the clinical review received a single injection and were followed up from between 3 to 12 weeks post-intervention. This reflects current practice, with people receiving typically 1–2 injections. Drug costs per injection estimated based on the drugs and doses used in these studies are summarised in <a class="figpopup" href="/books/NBK602206/table/niceng236er22.tab26/?report=objectonly" target="object" rid-figpopup="figniceng236er22tab26" rid-ob="figobniceng236er22tab26">Table 26</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab26"><a href="/books/NBK602206/table/niceng236er22.tab26/?report=objectonly" target="object" title="Table 26" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab26" rid-ob="figobniceng236er22tab26"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab26/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab26/?report=previmg" alt="Table 26. Unit costs of intra-articular medicine injections and nerve blocks (local anaesthetics)." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab26"><a href="/books/NBK602206/table/niceng236er22.tab26/?report=objectonly" target="object" rid-ob="figobniceng236er22tab26">Table 26</a></h4><p class="float-caption no_bottom_margin">Unit costs of intra-articular medicine injections and nerve blocks (local anaesthetics). </p></div></div><p>Resource use also differed for staff involvement in the injection procedure. <a class="figpopup" href="/books/NBK602206/table/niceng236er22.tab27/?report=objectonly" target="object" rid-figpopup="figniceng236er22tab27" rid-ob="figobniceng236er22tab27">Table 27</a> illustrates outpatient appointment costs associated with having an injection for pain management. All studies reported using a rehabilitation doctor to provide the injection, however, one study (Rah 2012<sup><a class="bibr" href="#niceng236er22.ref36" rid="niceng236er22.ref36">36</a></sup>) reported that two rehabilitation doctors (physiatrists) and a radiologist attended a 2-day training course on the study procedure, physical tests, home exercise program, and ultrasonography for diagnosis and injection procedure. The training costs and ultrasound-guided subacromial injection would incur additional costs compared to the other interventions. Shoulder pain injections can also be provided in primary care settings which would incur lower costs, however this varies depending on the clinician being comfortable with administering the injection.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22tab27"><a href="/books/NBK602206/table/niceng236er22.tab27/?report=objectonly" target="object" title="Table 27" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22tab27" rid-ob="figobniceng236er22tab27"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.tab27/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.tab27/?report=previmg" alt="Table 27. Example procedural costs of intra-articular medicine injections and nerve blocks (local anaesthetics)." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.tab27"><a href="/books/NBK602206/table/niceng236er22.tab27/?report=objectonly" target="object" rid-ob="figobniceng236er22tab27">Table 27</a></h4><p class="float-caption no_bottom_margin">Example procedural costs of intra-articular medicine injections and nerve blocks (local anaesthetics). </p></div></div></div></div><div id="niceng236er22.s1.1.11"><h4>1.1.11. Evidence statements</h4><div id="niceng236er22.s1.1.11.1"><h5>Effectiveness/Qualitative</h5><div id="niceng236er22.s1.1.11.1.1"><h5>Economic</h5><p>No relevant economic evaluations were identified.</p></div></div></div><div id="niceng236er22.s1.1.12"><h4>1.1.12. The committee’s discussion and interpretation of the evidence</h4><div id="niceng236er22.s1.1.12.1"><h5>1.1.12.1. The outcomes that matter most</h5><p>The committee included the following outcomes: person/participant generic health-related quality of life, carer generic health-related quality of life, pain, physical function – upper limb, activities of daily living, stroke-specific Patient-Reported Outcome Measures and withdrawal due to adverse events. All outcomes were considered equally important for decision making and therefore have all been rated as critical.</p><p>Person/participant health-related quality of life outcomes were considered particularly important as a holistic measure of the impact on the person’s quality of living. Pain was considered important as a direct answer to the question. Withdrawal due to adverse events was used to understand the tolerability to the intervention, with the committee acknowledging that different interventions may have different adverse events. Mortality was not considered as it was deemed unlikely to be a result of the treatment and would be included in withdrawal due to adverse events. If mortality was an adverse events then this was highlighted to the committee during their deliberation.</p><p>The committee chose to investigate these outcomes at less than 6 months and more than and equal to 6 months, as they considered that there could be a difference in the short term and long term effects of the interventions.</p><p>The evidence for this question was limited, with some outcomes not being reported for every comparison. No study investigated the effects of interventions on carer generic health-related quality of life. The majority of outcomes were reported at less than 6 months, with only one outcome being reported at more than and equal to 6 months. The most widely reported outcome was pain.</p></div><div id="niceng236er22.s1.1.12.2"><h5>1.1.12.2. The quality of the evidence</h5><p>Twenty eight randomised controlled trial studies were included in the review. These reported a range of different comparisons:</p><p>The following interventions were compared:
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<ul><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation (TENS) compared to neuromuscular electrical stimulation (NMES), nerve blocks (local anaesthetic) and usual care or no treatment</div></li><li class="half_rhythm"><div>Functional electrical stimulation (FES) compared to usual care or no treatment</div></li><li class="half_rhythm"><div>Neuromuscular electrical stimulation (NMES) compared to transcutaneous electrical nerve stimulation (TENS), devices – slings, placebo/sham and usual care or no treatment</div></li><li class="half_rhythm"><div>Devices – tape compared to placebo/sham and usual care or no treatment</div></li><li class="half_rhythm"><div>Devices – slings compared to neuromuscular electrical stimulation (NMES) and usual care or no treatment</div></li><li class="half_rhythm"><div>Devices – braces compared to usual care or no treatment</div></li><li class="half_rhythm"><div>Acupuncture/dry needling compared to placebo/sham and usual care or no treatment</div></li><li class="half_rhythm"><div>Electroacupuncture compared to placebo/sham</div></li><li class="half_rhythm"><div>Intra-articular medicine injections – Corticosteroids compared to placebo/sham</div></li><li class="half_rhythm"><div>Nerve blocks (local anaesthetic) compared to transcutaneous electrical nerve stimulation (TENS) and placebo/sham</div></li></ul></p><p>No relevant clinical studies including the following interventions were identified:
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<ul><li class="half_rhythm"><div>Devices – supports and other devices</div></li><li class="half_rhythm"><div>Intra-articular medicine injections – saline</div></li><li class="half_rhythm"><div>Injections into other sites (for example: bursae) – corticosteroids and saline</div></li></ul></p><p>Studies were generally distributed evenly across the different interventions, with a limited number of studies reporting each comparison. Outcomes were of low or very low quality, with the majority being of very low quality. This was mainly due to risk of bias and imprecision. Risk of bias was a problem in a lot of studies and was mainly due to bias arising from the randomisation process, due to deviations from the intended intervention and due to missing outcome data, though all reasons for downgrading outcomes for risk of bias were present at least once during the analysis.</p><p>A large number of outcomes were downgraded due to imprecision. This was likely due to the studies included being, in general, small studies (with an average number of participants being 30 people) and that there were few studies to meta-analyse to improve the precision in the outcome.</p><p>Where meta-analysis was conducted, studies were generally downgraded for inconsistency due to heterogeneity that could not be resolved by the agreed sensitivity and subgroup analyses. Sensitivity and subgroup analyses often did not resolve the heterogeneity due to either there being an insufficient number of studies included in the results to allow for valid subgroups to be formed, or due to homogeneity in the subgroups present. The majority of studies investigated the effect of people with no previous shoulder pathology. There was a mixture of people in the subacute or chronic period after stroke. However, this did not resolve the heterogeneity when investigated.</p><p>A significant number of studies were excluded for not being reported in the English language. These studies primarily investigated the use of acupuncture. It is unclear whether these studies would be included if they were reported in English. However, there is a possibility of this influencing the results that were found from this review and so may introduce publication bias. This was highlighted to the committee during their deliberation.</p><p>These factors introduced additional uncertainty in the results. The effects on risk of bias did not appear to influence the direction of the effect in the trials. The committee took all of these factors into account when interpreting the evidence.</p><div id="niceng236er22.s1.1.12.2.1"><h5>1.1.12.2.1. Transcutaneous electrical nerve stimulation (TENS)</h5><p>Transcutaneous electrical nerve stimulation (TENS) was compared to neuromuscular electrical stimulation (NMES) and usual care or no treatment.</p><ul><li class="half_rhythm"><div>When compared to neuromuscular electrical stimulation (NMES), 5 outcomes of very low quality were reported. These were downgraded due to risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended intervention, bias due to missing outcome data and bias in measurement of the outcome) and imprecision. The majority of outcomes included only one study, and at most two studies.</div></li><li class="half_rhythm"><div>When compared to nerve blocks (local anaesthetic), 2 outcomes of very low quality were reported. These were downgraded due to risk of bias (due to bias arising from the randomisation process and bias in measurement of the outcome) and imprecision.</div></li><li class="half_rhythm"><div>When compared to usual care or no treatment, 4 outcomes of very low quality were reported. This included the results from 1 trial with 54 participants. Outcomes were downgraded due to risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended intervention and bias due to missing outcome data) and imprecision.</div></li></ul></div><div id="niceng236er22.s1.1.12.2.2"><h5>1.1.12.2.2. Functional electrical stimulation</h5><p>Functional electrical stimulation was compared to usual care or no treatment. This comparison included 4 outcomes of low or very low quality. This included results from 1 trial with 21 participants. Outcomes were generally downgraded due to risk of bias (due to bias arising from the randomisation process and bias in measurement of the outcome) and imprecision.</p></div><div id="niceng236er22.s1.1.12.2.3"><h5>1.1.12.2.3. Neuromuscular electrical nerve stimulation (NMES)</h5><p>Neuromuscular electrical nerve stimulation (NMES) was compared to transcutaneous electrical nerve stimulation (TENS), slings, placebo/sham and usual care or no treatment.</p><ul><li class="half_rhythm"><div>When compared to transcutaneous electrical nerve stimulation (TENS), 5 outcomes of very low quality were reported. These were downgraded due to risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended intervention, bias due to missing outcome data and bias in measurement of the outcome) and imprecision. The majority of outcomes included only one study, and at most two studies.</div></li><li class="half_rhythm"><div>When compared to slings, 2 outcomes of low quality were reported. These were downgraded due to risk of bias (due to bias arising from the randomisation process and bias due to missing outcome data).</div></li><li class="half_rhythm"><div>When compared to placebo/sham, 4 outcomes of very low quality were reported. These were downgraded due to risk of bias (due to bias arising from the randomisation process and bias due to missing outcome data) and imprecision.</div></li><li class="half_rhythm"><div>When compared to usual care or no treatment, 8 outcomes of low to very low quality were reported. These were downgraded due to risk of bias (due to a mixture of bias due to the randomisation process, bias due to deviations from the intended interventions, bias due to missing outcome data and bias in measurement of the outcome), inconsistency (in one outcome) and imprecision.</div></li></ul></div><div id="niceng236er22.s1.1.12.2.4"><h5>1.1.12.2.4. Devices - Tape</h5><p>Tape was compared to placebo/sham and usual care or no treatment.</p><ul><li class="half_rhythm"><div>When compared to placebo/sham, 5 outcomes of low to very low quality were reported. These were downgraded due to risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions and bias due to missing outcome data), inconsistency (in 1 outcome) and imprecision.</div></li><li class="half_rhythm"><div>When compared to usual care or no treatment, 2 outcomes of low and very low quality were reported. These were downgrade due to either risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions, bias due to missing outcome data and bias in measurement of the outcome) or risk of bias (due to deviations from the intended interventions) and imprecision.</div></li></ul></div><div id="niceng236er22.s1.1.12.2.5"><h5>1.1.12.2.5. Devices - Slings</h5><p>Slings were compared to neuromuscular electrical stimulation (NMES) and usual care or no treatment.</p><ul><li class="half_rhythm"><div>When compared to neuromuscular electrical stimulation (NMES), 2 outcomes of low quality were reported. These were downgraded due to risk of bias (due to bias arising from the randomisation process and bias due to missing outcome data).</div></li><li class="half_rhythm"><div>When compared to usual care or no treatment, 3 outcomes of very low quality were reported. These were downgraded due to risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended intervention, bias due to missing outcome data, bias in measurement of the outcome and bias in selection of the reported result), inconsistency (in 1 outcome) and imprecision.</div></li></ul></div><div id="niceng236er22.s1.1.12.2.6"><h5>1.1.12.2.6. Devices - Braces</h5><p>Braces were compared to usual care or no treatment. This comparison included 2 outcomes of low and very low quality. This included the results from 1 trial. The outcomes were downgraded for either risk of bias (due to missing outcome data and bias in the measurement of outcome) or risk of bias (due to missing outcome data) and imprecision.</p></div><div id="niceng236er22.s1.1.12.2.7"><h5>1.1.12.2.7. Acupuncture/dry needling</h5><p>Acupuncture/dry needling was compared to placebo/sham and usual care or no treatment.</p><ul><li class="half_rhythm"><div>When compared to placebo/sham, 3 outcomes of very low quality were reported. These were downgraded due to risk of bias (due to bias arising from the randomisation process and bias due to missing outcome data) and imprecision.</div></li><li class="half_rhythm"><div>When compared to usual care or no treatment, 5 outcomes of low or very low quality were reported. These were downgraded due to risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions, bias due to missing outcome data and bias in measurement of the outcome), inconsistency (in 1 outcome) and imprecision.</div></li></ul></div><div id="niceng236er22.s1.1.12.2.8"><h5>1.1.12.2.8. Electroacupuncture</h5><p>Electroacupuncture was compared to placebo/sham. This comparison included 1 outcome reported in 1 trial that was of very low quality. This was due to risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions and bias in measurement of the outcome) and imprecision.</p></div><div id="niceng236er22.s1.1.12.2.9"><h5>1.1.12.2.9. Intra-articular corticosteroids</h5><p>Intra-articular corticosteroids were compared to placebo/sham. This comparison included 2 outcomes of very low quality. This was due to risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions, bias due to missing outcome data and bias in measurement of the outcome), heterogeneity (in 1 outcome) and imprecision.</p></div><div id="niceng236er22.s1.1.12.2.10"><h5>1.1.12.2.10. Nerve blocks (local anaesthetics)</h5><p>Nerve blocks were compared to transcutaneous electrical nerve stimulation (TENS) and placebo/sham.</p><ul><li class="half_rhythm"><div>When compared to transcutaneous electrical nerve stimulation (TENS), 2 outcomes of very low quality were reported. These were downgraded due to risk of bias (due to bias arising from the randomisation process and bias in measurement of the outcome) and imprecision.</div></li><li class="half_rhythm"><div>When compared to placebo/sham, 2 outcomes of low quality were reported. This was due to inconsistency (in 1 outcome) and imprecision.</div></li></ul></div></div><div id="niceng236er22.s1.1.12.3"><h5>1.1.12.3. Benefits and harms</h5><div id="niceng236er22.s1.1.12.3.1"><h5>1.1.12.3.1. Key uncertainties</h5><p>The committee acknowledged the limited evidence available for all interventions in this review. Studies that were eligible for inclusion were often small and the quality of outcomes was often downgraded for risk of bias and imprecision. Based on this the committee agreed that more evidence investigating the effectiveness of all interventions would be important. Therefore, they agreed research recommendations to investigate this. The lack of certainty in the evidence made it difficult to determine the treatment that was most effective for shoulder pain after stroke. The committee decided that treatments where efficacy have been shown in this review should be considered as treatment options.</p></div><div id="niceng236er22.s1.1.12.3.2"><h5>1.1.12.3.2. Transcutaneous electrical nerve stimulation (TENS)</h5><p>Transcutaneous electrical nerve stimulation (TENS) was compared to neuromuscular electrical stimulation (NMES), nerve blocks (local anaesthetic) and usual care or no treatment. When compared to no treatment, no clinically important difference was seen in pain, physical function – upper limb, activities of daily living and stroke-specific Patient-Reported Outcome Measures at less than 6 months. When compared to neuromuscular electrical stimulation, a clinically important benefit in activities of daily living at less than 6 months was seen with transcutaneous electrical nerve stimulation in 1 study with 72 participants, while no clinically important difference was seen in physical function – upper limb, stroke-specific Patient-Reported Outcome Measures and withdrawal due to adverse events at less than 6 months. However, a clinically important benefit of neuromuscular electrical stimulation over TENS was seen in pain at less than 6 months in 2 studies with 110 participants. When compared to nerve blocks, nerve blocks (rather than TENS) showed clinically important benefits in reducing pain and improving stroke-specific Patient-Reported Outcome Measures at less than 6 months.</p><p>The committee acknowledged the limited evidence for benefit from TENS. The evidence primarily indicated that there was no clinically important benefit from the use of TENS and that other treatments (such as neuromuscular electrical stimulation and nerve blocks) were superior to TENS. Given this, they agreed that they would not recommend TENS for use for the management of shoulder pain after stroke.</p></div><div id="niceng236er22.s1.1.12.3.3"><h5>1.1.12.3.3. Functional electrical stimulation</h5><p>Functional electrical stimulation was compared to usual care or no treatment. A clinically important benefit of functional electrical stimulation was seen with pain at less than 6 months. No clinically important difference was seen in physical function – upper limb, activities of daily living and withdrawal due to adverse events at less than 6 months. These outcomes were all reported in 1 study with 21 participants.</p><p>The committee acknowledged the limited evidence discussing functional electrical stimulation. While this evidence did show a clinically important benefit in reducing pain, the outcomes came from 1 small study and given that other interventions had a more robust evidence base, the committee chose to recommend use of these treatments instead. However, the committee recommended for further research in the use of functional electrical stimulation in the research recommendations for this topic to allow for a more robust evaluation of the technique. In the meantime, the committee noted that functional electrical stimulation could be a treatment that may be effective to help reduce shoulder pain, but that the evidence was not sufficient to make a recommendation at this time.</p></div><div id="niceng236er22.s1.1.12.3.4"><h5>1.1.12.3.4. Neuromuscular electrical nerve stimulation (NMES)</h5><p>Neuromuscular electrical nerve stimulation (NMES) was compared to transcutaneous electrical nerve stimulation (TENS), slings, placebo/sham and usual care or no treatment. When compared to placebo/sham, clinically important benefits were seen in physical function – upper limb and activities of daily living at less than 6 months. However, no clinically important difference was seen in pain and withdrawal due to adverse events at less than 6 months. When compared to usual care or no treatment, clinically important benefits were seen in pain, activities of daily living and withdrawal due to adverse events. An unclear effect was seen in person/participant generic health-related quality of life at less than 6 months where a clinically important benefit was observed in the SF-36 mental component and no clinically important difference in the SF-36 physical component. An unclear effect was also seen for physical function – upper limb, where 1 outcome with 25 participants of low quality indicated a clinically important benefit while 1 outcome with 54 participants but of very low quality indicated no clinically important difference.</p><p>When compared to transcutaneous electrical nerve stimulation, a clinically important benefit in pain at less than 6 months was seen with neuromuscular electrical stimulation in 2 studies with 110 participants, while no clinically important difference was seen in physical function – upper limb, stroke-specific Patient-Reported Outcome Measures and withdrawal due to adverse events at less than 6 months. However, a clinically important benefit of transcutaneous electrical nerve stimulation was seen in activities of daily living at less than 6 months in 1 study with 72 participants. When compared to slings, a clinically important benefit of slings was seen in pain at less than 6 months and more than and equal to 6 months in outcomes from 1 study with 61 participants.</p><p>The committee acknowledged the inconsistency seen between the comparisons to placebo/sham and to usual care or no treatment. The comparison to placebo/sham indicated no clinically important difference of neuromuscular electrical nerve stimulation in reducing pain, while comparison to usual care or no treatment indicated a clinically important benefit. The committee agreed that the outcome showing no clinically important difference included inconsistency where 1 study showed a more beneficial effect and 1 study showed a more harmful effect, while the outcome showing benefit was based on 3 studies including 103 participants, with both outcomes being of very low quality. While they acknowledged the methodological concerns, the committee had greater certainty with the evidence of benefit. Based on the evidence of benefit when compared to usual care or no treatment, the committee agreed that neuromuscular electrical nerve stimulation should be considered for the treatment of post-stroke shoulder pain, and would also have benefits in other aspects of shoulder function, such as activities of daily living and upper limb motor function.</p></div><div id="niceng236er22.s1.1.12.3.5"><h5>1.1.12.3.5. Devices - Tape</h5><p>Tape was compared to placebo/sham and usual care or no treatment. When compared to placebo/sham, clinically important benefits were seen in pain and activities of daily living at less than 6 months. However, no clinically important difference was seen in physical function – upper limb, stroke-specific Patient-Reported Outcome Measures and withdrawal due to adverse events. When compared to usual care or no treatment, a clinically important difference was seen in pain at less than 6 months, while no clinically important difference was seen in withdrawal due to adverse events at less than 6 months.</p><p>The committee agreed that evidence of benefit for pain was seen when tape was compared to placebo/sham and to usual care or no treatment without showing any harms. The committee noted that taping may be useful for people with 1) hypotonic/unstable presentation of shoulder pain, 2) subacromial shoulder pain to optimise joint alignment. They acknowledged that this may not be the most common presentations of shoulder pain. A lay member on the committee discussed their experience, that tape was useful in reducing pain but would need replacing regularly and they would not be able to do that themselves. The practicalities of using tape for treatment needs to be considered by the stroke survivor and those supporting them when considering the treatment. The committee agreed that tape should be considered for the treatment of post-stroke shoulder pain.</p></div><div id="niceng236er22.s1.1.12.3.6"><h5>1.1.12.3.6. Devices - Slings</h5><p>Slings were compared to neuromuscular electrical stimulation (NMES) and usual care or no treatment. When compared to usual care or no treatment, no clinically important difference was seen in pain and physical function – upper limb at less than 6 months. However, a clinically important harm of slings was seen in withdrawal due to adverse events in an outcome including 1 study with 32 participants with the outcome being of very low quality. When compared to neuromuscular electrical stimulation, a clinically important benefit of slings was seen in pain at less than 6 months and more than and equal to 6 months in outcomes from 1 study with 61 participants.</p><p>The committee agreed that there was no evidence of benefit with slings with potential evidence of harm in adverse events. However, they acknowledged that the harm in adverse events was due to 1 withdrawal in a small study, which made the applicability of this evidence limited. The committee reflected that in clinical practice there were people who would benefit from shoulder slings (including people with subluxed shoulders). Shoulder slings may be able to prevent future problems from taking place. However, they noted that sling use may lead to secondary stiffness, that can cause loss of range, pain and further disuse weakness. Taking this into account, the committee agreed that they would not make a recommendation on the use of slings as the evidence had not demonstrated convincingly that slings were effective at reducing shoulder pain after stroke. However, they noted that for some people after stroke a sling may be an effective treatment and did not make a recommendation that they should not be used. They recommended that slings should be considered as a part of further research in this area to investigate whether they could be an effective treatment for certain causes of shoulder pain.</p></div><div id="niceng236er22.s1.1.12.3.7"><h5>1.1.12.3.7. Devices - Braces</h5><p>Braces were compared to usual care or no treatment. A clinically important benefit of braces was seen in pain at less than 6 months. However, a clinically important harm was observed in withdrawal due to adverse events at less than 6 months including 1 study with 41 participants with the outcome being of very low quality.</p><p>The committee acknowledge the inconsistent evidence of benefits in reducing pain but harms in withdrawal due to adverse events. The committee acknowledged that the harm in adverse events was due to 1 withdrawal in a small study, which made the applicability of this evidence limited. The committee reflected on their experience with lay members noting that they did not experience benefits from this, while healthcare professionals acknowledged that there may be some people where braces may be more helpful than others. The committee noted that this may be used for people with dense (severe) upper limb weakness and for people with subluxation. The committee weighed up these factors and agreed that due to the limited evidence compared to other interventions, they would not make a recommendation on the use of braces. However, they noted that braces may be effective for some people with shoulder pain and did not make a recommendation that braces should not be used. They included braces in a research recommendation to investigate whether they could be an effective treatment for certain causes of shoulder pain.</p></div><div id="niceng236er22.s1.1.12.3.8"><h5>1.1.12.3.8. Acupuncture/dry needling</h5><p>Acupuncture/dry needling was compared to placebo/sham and usual care or no treatment. When compared to placebo/sham, a clinically important benefit of acupuncture/dry needling was seen in pain at less than 6 months. No clinically important difference was seen in withdrawal due to adverse events. However, a clinically important benefit of placebo/sham was seen in activities of daily living. When compared to usual care or no treatment, clinically important benefits were seen in person/participant generic health-related quality of life and pain at less than 6 months. However, no clinically important difference was seen in physical function – upper limb and withdrawal due to adverse events at less than 6 months.</p><p>The committee acknowledged the evidence of benefits from acupuncture/dry needling. The committee acknowledged the limited evidence and how this may be further limited by a significant number of studies not being translated in English and so not being able to be checked for their relevance for inclusion in this review, which may have led to additional studies being added for this consideration. The committee agreed that acupuncture may be helpful for people with shoulder pain after stroke. The committee considered this evidence against the considerations of cost effectiveness and resource use.</p><p>Taking this into account, the committee acknowledged that there was insufficient evidence to recommend acupuncture at this time, but noted that the evidence appeared to be positive and recommended that acupuncture should have further research conducted, which included cost-effectiveness analysis, to investigate whether it could be a clinically and cost effective treatment to use for the management of shoulder pain after stroke in an NHS context.</p></div><div id="niceng236er22.s1.1.12.3.9"><h5>1.1.12.3.9. Electroacupuncture</h5><p>Electroacupuncture was compared to placebo/sham. 1 outcome was included for this comparison, pain at less than 6 months, where there was a clinically important benefit of electroacupuncture.</p><p>The committee acknowledged the evidence of benefits from electroacupuncture. The committee acknowledged the limited evidence and how this may be further limited by a significant number of studies not being translated in English and so not being able to be checked for their relevance for inclusion in this review, which may have led to additional studies being added for this consideration. The committee agreed that electroacupuncture may be helpful for people with shoulder pain after stroke. The committee considered this evidence against the considerations of cost effectiveness and resource use.</p><p>Taking this into account, the committee acknowledged that there was insufficient evidence to recommend electroacupuncture at this time, but noted that the evidence appeared to be positive and recommended that acupuncture should have further research conducted, which included cost-effectiveness analysis, to investigate whether it could be a clinically and cost effective treatment to use for the management of shoulder pain after stroke in an NHS context.</p></div><div id="niceng236er22.s1.1.123.10"><h5>1.1.12.3.10. Intra-articular corticosteroids</h5><p>Intra-articular corticosteroids were compared to placebo/sham. 2 outcomes were included for this comparison, pain and activities of daily living at less than 6 months, where there were clinically important benefits of intra-articular corticosteroids.</p><p>The committee acknowledged the evidence of benefits from intra-articular corticosteroids. On examining the studies, the committee noted that the identified studies only included one injection of intra-articular corticosteroids. The committee agreed that in their expert opinion there were benefits from use of intra-articular corticosteroids. The committee noted that these may be provided in primary care by general practitioners with a special interest, or in secondary care where it may be given under ultrasound guidance by radiologists, sports and exercise medicine clinicians or rehabilitation medicine physicians. Therefore, based on the limited evidence and committee’s expert opinion, they agreed that intra-articular corticosteroids should be considered for the treatment of post-stroke shoulder pain.</p></div><div id="niceng236er22.s1.1.12.3.11"><h5>1.1.12.3.11. Nerve blocks (local anaesthetics)</h5><p>Nerve blocks were compared to TENS and placebo/sham. When compared to TENS, clinically important benefits of nerve blocks were seen in reducing pain and improving stroke-specific Patient-Reported Outcome Measures at less than 6 months. When compared to placebo/sham, a clinically important benefit of nerve blocks was seen in pain at less than 6 months. No clinically important difference was seen in withdrawal due to adverse events at less than 6 months.</p><p>The committee acknowledged the benefits from nerve blocks. The nerve blocks included in this review included a combination of local anaesthetic and corticosteroids. The committee acknowledged their experiences that nerve blocks can be useful for some people with shoulder pain after stroke. The committee noted that providing nerve blocks required specialist input to provide them, which could include anaesthetists or another interventional clinician such as a sports and exercise medicine or rehabilitation medicine consultant. Taking into account these factors, the committee agreed that nerve blocks should be considered for the treatment of post-stroke shoulder pain.</p></div></div><div id="niceng236er22.s1.1.12.4"><h5>1.1.12.4. Cost effectiveness and resource use</h5><p>No relevant health economic analyses were identified for this review; therefore, unit costs were presented to aid committee consideration of cost-effectiveness.</p><div id="niceng236er22.s1.1.12.4.1"><h5>1.1.12.4.1. Electrotherapies (FES, NMES, TENS)</h5><p>The cost of electrotherapies relates primarily to the staff time to administer it and will depend on frequency and duration of therapy sessions, as well as the duration of treatment. There are also equipment costs, however, these were not presented to the committee as previous economic evaluations of electrotherapies did not include the costs of equipment as the per-use costs were expected to be small.</p></div><div id="niceng236er22.s1.1.12.4.2"><h5>1.1.12.4.2. Transcutaneous electrical nerve stimulation (TENS)</h5><p>The cost of a TENS machine varies (approximately £18-£50) and can be used at home which could incur less resource use relative to interventions that require staff supervision. However, the clinical evidence summarised in the <a href="#niceng236er22.s1.1.12.2.1">section 1.1.12.2.1</a> indicated that there was no clinically important benefit from the use of transcutaneous electrical nerve stimulation compared to usual care and no treatment. The lack of clinical evidence and additional resource use required compared to usual care led the committee to agree to not recommend transcutaneous electrical nerve stimulation for the management of shoulder pain in post-stroke adults.</p></div><div id="niceng236er22.s1.1.12.4.3"><h5>1.1.12.4.3. Functional electrical stimulation (FES)</h5><p>Previous NHS reports on FES<sup><a class="bibr" href="#niceng236er22.ref38" rid="niceng236er22.ref38">38</a></sup> included an initial assessment appointment costing £140. The analysis also included a clinic model in which the costs of the FES device are incorporated in the ongoing clinical charges. Each ongoing clinical appointment was estimated at £300. The experience of some committee members suggested a less expensive alternative where FES can be delivered at home without staff supervision, although it was acknowledged that the number of FES devices available to take home varies across current practice. The clinical evidence (<a href="#niceng236er22.s1.1.12.2.2">section 1.1.12.2.2</a>) showed that when FES was compared to usual care or no treatment, a clinically important benefit of FES was seen with pain at less than 6 months. However, no clinically important difference was seen in physical function – upper limb, activities of daily living and withdrawal due to adverse events at less than 6 months. Given the limited clinical evidence and lack of cost-effective evidence the committee decided to not recommend FES for the treatment of post-stroke shoulder pain.</p></div><div id="niceng236er22.s1.1.12.4.4"><h5>1.1.12.4.4. Neuromuscular electrical nerve stimulation (NMES)</h5><p>NMES was the most frequently evaluated of out the electrotherapy interventions (7 studies included in clinical review) and was compared to transcutaneous electrical nerve stimulation (TENS), slings, placebo/sham and usual care, or no treatment. It was challenging for the committee to determine resource use for NMES as the frequency and duration reported in the studies varied, with sessions ranging from 1–6-hours and were delivered between 3–7 days per week for 3–8 weeks.</p><p>Despite committee acknowledgement of the inconsistency seen between the comparisons to placebo/sham and to usual care or no treatment, it was agreed that there was more evidence of benefit than harm in the clinical evidence for NMES (see <a href="#niceng236er22.s1.1.12.2.3">section 1.1.12.2.3</a>) and agreed that and would also have benefits in other aspects of shoulder function, such as activities of daily living and upper limb motor function. For these reasons, alongside the lack of published health economic evidence, the committee agreed that NMES should be considered for the treatment of post-stroke shoulder pain.</p></div></div><div id="niceng236er22.s1.1.12.4.5"><h5>1.1.12.4.5. Devices</h5><p>The committee were informed that the following devices could take place at home which could incur lower resource use compared to other interventions in this review, with people tasked with wearing the devices all day or whenever the upper limb was unsupported.</p></div><div id="niceng236er22.s1.1.12.4.6"><h5>1.1.12.4.6. Slings</h5><p>The cost of the sling reported in the clinical studies was relatively low (£6.38) and staff time involved in the application and correction of the sling is less resource intensive compared to other shoulder-pain related interventions and can be incorporated into standard therapy. As previously summarised in <a href="#niceng236er22.s1.1.12.2.5">section 1.1.12.2.5</a> above, 1 clinical study comparing slings to NMES found a clinically important benefit in pain at less than 6 months and more than and equal to 6 months in outcomes. No evidence of benefit was seen when slings were compared to usual care or no treatment, with limited evidence of a clinically important harm of slings for withdrawal due to adverse events. Despite limited clinical evidence, the committee’s experience in clinical practice had demonstrated the benefits of shoulder slings for some individuals (including people with subluxed shoulders), alongside the potential for slings to prevent future problems from taking place. However, without cost-effectiveness evidence and no clinical evidence of benefit when compared to usual care or no treatment, the committee agreed that slings were not recommended for the treatment of post-stroke shoulder pain.</p></div><div id="niceng236er22.s1.1.12.4.7"><h5>1.1.12.4.7. Tape</h5><p>Tape is relatively low cost (£2.14) compared to the other devices in this review. However, both the clinical evidence and a lay member’s experience of this intervention noted that a therapist is required to reapply the tape, resulting in frequent visits which could increase staff time costs. As described in <a href="#niceng236er22.s1.1.12.2.4">section 1.1.12.2.4</a>, studies comparing tape to usual care or no treatment placebo/sham found clinically important benefits in pain at less than 6 months. However, the comparison to placebo/sham indicated no clinically important difference in physical function – upper limb, stroke-specific Patient-Reported Outcome Measures and withdrawal due to adverse events.</p><p>The committee noted that taping would not be a practical treatment for all stroke survivors and that it may be useful for people with less common presentations of shoulder pain. This could possibly lower the impact on resource as less people would be ideal candidates for taping. Based on the limited clinical and economic evidence, the committee agreed that tape should be considered for the treatment of post-stroke shoulder pain, emphasising that stroke survivors and those supporting them should first consider the practicalities of using tape before beginning treatment.</p></div><div id="niceng236er22.s1.1.12.4.8"><h5>1.1.12.4.8. Braces</h5><p>One study reported the use of a shoulder brace which was significantly more costly than the other devices (£212). Although this specific device was not reported in the NHS supply chain catalogue, it was noted by a committee member this was one of the braces used in current practice and that a similar cost or higher (approximately £250) would apply for other shoulder braces typically used. It was also noted that shoulder braces are not customised to order but given the different sizes, some staff time is required for fitting the brace.</p><p>Committee members noted not everyone with post-stroke shoulder pain would be eligible for this treatment, as using a brace is thought to prevent future problems for some people while causing additional harm in others, particularly in instances where the shoulder is already very inflamed. There was limited clinical evidence (<a href="#niceng236er22.s1.1.12.2.6">section 1.1.12.2.6</a>) with the only included study reporting inconsistent evidence of benefits in reducing pain but harms in withdrawal due to adverse events. Given the lack of clinical evidence and economic evidence, alongside additional resource use requirements, the committee agreed to not recommend braces for the treatment of post-stroke shoulder pain.</p></div><div id="niceng236er22.s1.1.12.4.9"><h5>1.1.12.4.9. Acupuncture/dry needling</h5><p>The cost of acupuncture relates primarily to the staff time required to deliver treatment, with an outpatient procedure for acupuncture for pain management costing £141, although costs in the community might be lower. The frequency and duration for delivering acupuncture varied across studies, ranging from a one-off session with a 1-week follow-up to once daily for one month. Sessions typically lasted 30 minutes. Equipment costs for acupuncture are low as it mainly consists of the cost of needles (£0.06 per needle, with 10–14 needles used per session). The committee regarded acupuncture and electroacupuncture as one of the less frequently provided treatments for shoulder pain following stroke, meaning that staff training may be required to deliver these interventions.</p><p>The limited clinical evidence (reported in <a href="#niceng236er22.s1.1.12.2.7">section 1.1.12.2.7</a>) for acupuncture included a clinically important benefit for pain at less than 6 months for acupuncture when compared to both placebo/sham and usual care or no treatment. No clinically important difference was seen in withdrawal due to adverse events for either comparison, however a clinically important benefit was seen for placebo/sham in activities of daily living. The lack of clinical evidence for acupuncture may have been due to several studies that were not assessed because they were not published in English. Given the limited clinical evidence and lack of economic evidence, alongside additional resource use requirements, the committee agreed to not recommend acupuncture for the treatment of post-stroke shoulder pain.</p></div><div id="niceng236er22.s1.1.12.4.10"><h5>1.1.12.4.10. Electroacupuncture</h5><p>Aside from the staff time required to deliver electroacupuncture, example costs of electroacupuncture devices were presented to the committee, which ranged from £240-£534. Other costs associated with electrotherapy include clips, lead cables, batteries, needles, disinfectant swabs, and surgeons’ gloves. Clinical evidence for electroacupuncture was based on a single study that indicated a clinically important benefit for pain at less than 6 months when compared to placebo/sham (see <a href="#niceng236er22.s1.1.12.2.8">section 1.1.12.2.8</a>). As with standard acupuncture, the lack of clinical evidence for electroacupuncture may have been due to several studies that were not assessed because they were not published in English.</p><p>Given the limited clinical evidence and lack of economic evidence, alongside additional resource use requirements, the committee agreed to not recommend electroacupuncture for the treatment of post-stroke shoulder pain.</p></div><div id="niceng236er22.s1.1.12.4.11"><h5>1.1.12.4.11. Intra-articular corticosteroids and Nerve blocks (local anaesthetics)</h5><p>Participants in all clinical studies received a single injection and were followed up from between 3 to 12 weeks post-intervention. The committee agreed that 1–2 injections was typical of current practice.</p><p>The committee were informed that resource use relates to the drugs injected and the staff time to deliver the injections. Resource use between studies differed due to the cost of drugs, as the 4 included studies used different drug combinations and doses. The average drug cost per injection for each of the combinations and doses from the studies were created using drug costs from the BNF. The cost per injection was low £1.99-£11.92, with the most expensive being attributed to betamethasone, which the committee noted would not be used in an NHS clinical setting. The impact on resource use would also be dependent on the staff involved in the injection procedure, outpatient appointment costs associated with having an injection for pain management ranged between £752-£826 (for injection of therapeutic substance) to £529-£910 (for nerve block), with the higher ranges accounting for the use of ultrasonography. Training costs are another factor that could incur additional resource use, as one study reported the use of two rehabilitation doctors (physiatrists) and a radiologist who were required to attend a 2-day training course.</p><p>When nerve blocks were compared to placebo/sham, a clinically important benefit of nerve blocks was seen in pain at less than 6 months (see <a href="#niceng236er22.s1.1.12.2.10">section 1.1.12.2.10</a>). No clinically important difference was seen in withdrawal due to adverse events at less than 6 months. Committee experience of nerve blocks in clinical practice has shown benefits to some people with shoulder pain after stroke. However, the committee also acknowledged the resource use associated with nerve blocks, as specialist input is required to provide them, which could include anaesthetists or another interventional clinician such as a sports and exercise medicine or rehabilitation medicine consultant. In consideration of these factors, the committee decided that nerve blocks should be considered for the treatment of post-stroke shoulder pain.</p><p>The committee noted that the clinical evidence contained only one study for intra-articular corticosteroids, which found clinically important benefits for pain and activities of daily living at less than 6 months when compared to placebo/sham (see <a href="#niceng236er22.s1.1.12.2.9">section 1.1.12.2.9</a>). The committee agreed that in their expert opinion there were benefits from use of intra-articular corticosteroids. Disparity in resource use across current practice was also acknowledged, as intra-articular corticosteroids can be provided in secondary care involving specialist input, or in primary care by general practitioners (which would lower resource use); however, this is dependent on the clinician being comfortable with administering the injection. The limited clinical evidence and the committee’s expert opinion, paired with a lack of economic evidence lead the committee to agree that intra-articular corticosteroids should be considered for the treatment of post-stroke shoulder pain.</p></div><div id="niceng236er22.s1.1.12.5"><h5>1.1.12.5. Other factors the committee took into account</h5><p>The committee acknowledged the potential costs of treatments. Some treatments may be accessed outside of the NHS. Electrotherapy (including transcutaneous electrical nerve stimulation and functional electrical stimulation) and devices may be purchased without healthcare professional input, which can incur costs on stroke survivors. Acupuncture and electroacupuncture may be accessed more commonly by people with an Asian family background, which can lead to inequities in care where people may access this treatment privately instead of through the NHS.</p><p>The committee acknowledged that the treatment of shoulder pain after stroke should be dependent on the cause of the shoulder pain, which is often multifactorial but can include pain from glenohumeral subluxation, spasticity of shoulder muscles, impingement, soft tissue injury, rotator cuff tears, glenohumeral capsulitis, bicipital tendinitis and shoulder hand syndrome<sup><a class="bibr" href="#niceng236er22.ref44" rid="niceng236er22.ref44">44</a></sup>. Therefore, it could be argued that treatment needs to be specific to the person after stroke. The committee acknowledged that the included studies did not investigate all of these causes and so it is difficult to conclude which treatments are more effective for each cause. The committee agreed that pain should be managed by the cause of the pain but noted that research was not currently designed in this manner, so made a research recommendation for research to be conducted to investigate whether assessing the cause of the shoulder pain and then treating accordingly is the best management strategy for post-stroke shoulder pain.</p><p>The committee noted that the majority of the evidence investigated people who did not have pre-existing shoulder conditions but acknowledged that, if present, such conditions would also have a role on the management required.</p><p>Furthermore, the committee agreed that it was often not apparent whether shoulder pain was acute or chronic in the studies they reviewed. The epidemiology of shoulder pain after stroke is unclear, with there being limited information about the proportion of cases that persisted beyond 3 months. The committee acknowledged that chronic pain could have a significant effect and may require different management to acute pain, including psychological therapy. The involvement of psychological services to support people with chronic secondary pain due to stroke-related shoulder pain should be considered if that is thought to be appropriate by the healthcare professionals involved in the person’s care.</p></div></div><div id="niceng236er22.s1.1.13"><h4>1.1.13. Recommendations supported by this evidence review</h4><p>This evidence review supports recommendations 1.14.2 to 1.14.4 and the research recommendations on the management of shoulder pain by cause and diagnostic assessment to inform management of shoulder pain.</p></div></div><div id="niceng236er22.rl.r1"><h3>1.1.14. References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="niceng236er22.ref1">Ada
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[<a href="/pmc/articles/PMC4681912/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4681912</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26696705" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26696705</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>16.</dt><dd><div class="bk_ref" id="niceng236er22.ref16">Huang
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YC, Chang
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KH, Liou
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TH, Cheng
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CW, Lin
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LF, Huang
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SW. Effects of Kinesio taping for stroke patients with hemiplegic shoulder pain: A double-blind, randomized, placebo-controlled study. Journal of Rehabilitation Medicine. 2017; 49(3):208–215
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[<a href="https://pubmed.ncbi.nlm.nih.gov/28233009" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28233009</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>17.</dt><dd><div class="bk_ref" id="niceng236er22.ref17">Huang
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|
YC, Leong
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CP, Wang
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L, Wang
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LY, Yang
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YC, Chuang
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CY
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et al
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Effect of kinesiology taping on hemiplegic shoulder pain and functional outcomes in subacute stroke patients: a randomized controlled study. European journal of physical & rehabilitation medicine. 2016; 52(6):774–781
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[<a href="https://pubmed.ncbi.nlm.nih.gov/27575012" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27575012</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>18.</dt><dd><div class="bk_ref" id="niceng236er22.ref18">iDryNeedle. ES-160 crocodile clips. 2022. Available from: <a href="https://www.idryneedle.com/ito-es-160-replacement-clips.html" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.idryneedle<wbr style="display:inline-block"></wbr>​.com/ito-es-160-replacement-clips.html</a> Last accessed: 01/02/2023.</div></dd></dl><dl class="bkr_refwrap"><dt>19.</dt><dd><div class="bk_ref" id="niceng236er22.ref19">Joint Formulary Committee. British National Formulary (online). 2022. Available from: <a href="https://bnf.nice.org.uk/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://bnf<wbr style="display:inline-block"></wbr>​.nice.org.uk/</a> Last accessed: 01/02/2023.</div></dd></dl><dl class="bkr_refwrap"><dt>20.</dt><dd><div class="bk_ref" id="niceng236er22.ref20">Jones
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K, Burns
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A. Unit costs of health and social care 2021. Canterbury. Personal Social Services Research Unit University of Kent, 2021. Available from: <a href="https://www.pssru.ac.uk/project-pages/unit-costs/unit-costs-of-health-and-social-care-2021/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.pssru.ac<wbr style="display:inline-block"></wbr>​.uk/project-pages/unit-costs<wbr style="display:inline-block"></wbr>​/unit-costs-of-health-and-social-care-2021/</a></div></dd></dl><dl class="bkr_refwrap"><dt>21.</dt><dd><div class="bk_ref" id="niceng236er22.ref21">Karaahmet
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OZ, Gurcay
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E, Unal
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ZK, Cankurtaran
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D, Cakci
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A. Effects of functional electrical stimulation-cycling on shoulder pain and subluxation in patients with acute-subacute stroke: a pilot study. International Journal of Rehabilitation Research. 2019; 42(1):36–40
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E, Gunduz
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B, Erhan
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B, Celik
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C, Elboim-Gabyzon
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M, Naveh
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Y, Kalichman
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L. A Combination of Long-Duration Electrical Stimulation with External Shoulder Support during Routine Daily Activities in Patients with Post-Hemiplegic Shoulder Subluxation: A Randomized Controlled Study. International Journal of Environmental Research and Public Health. 2022; 19(15) [<a href="/pmc/articles/PMC9368353/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9368353</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35955118" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35955118</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>24.</dt><dd><div class="bk_ref" id="niceng236er22.ref24">Lee
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GE, Son
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C, Lee
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J, Lee
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SH, Lee
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HJ, Lee
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et al
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Acupuncture for shoulder pain after stroke: A randomized controlled clinical trial. European Journal of Integrative Medicine. 2016; 8(4):373–383</div></dd></dl><dl class="bkr_refwrap"><dt>25.</dt><dd><div class="bk_ref" id="niceng236er22.ref25">MacPherson
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H, Vickers
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A, Bland
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M, Torgerson
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D, Corbett
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M, Spackman
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E
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et al
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Acupuncture for chronic pain and depression in primary care: a programme of research. Programme Grants for Applied Research. Southampton (UK). 2017. [<a href="https://pubmed.ncbi.nlm.nih.gov/28121095" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28121095</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>26.</dt><dd><div class="bk_ref" id="niceng236er22.ref26">Mendigutia-Gomez
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A, Quintana-Garcia
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MT, Martin-Sevilla
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M, de Lorenzo-Barrientos
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D, Rodriguez-Jimenez
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J, Fernandez-de-Las-Penas
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SB. Effect of therapeutic shoulder sling and proximal control exercises on shoulder subluxation in stroke survivors. Indian Journal of Forensic Medicine and Toxicology. 2020; 14(3):222–227</div></dd></dl><dl class="bkr_refwrap"><dt>28.</dt><dd><div class="bk_ref" id="niceng236er22.ref28">National Institute for Health and Care Excellence. Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain [NG193]. London. 2021. Available from: <a href="https://www.nice.org.uk/guidance/ng193" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org.uk/guidance/ng193</a> [<a href="https://pubmed.ncbi.nlm.nih.gov/33939353" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33939353</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>29.</dt><dd><div class="bk_ref" id="niceng236er22.ref29">National Institute for Health and Care Excellence. Cost-utility analysis: Electroacupuncture for the management of osteoarthritis. 2022. Available from: <a href="https://www.nice.org.uk/guidance/ng226/evidence/electroacupuncture-economic-analysis-pdf-11251847341" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/guidance/ng226/evidence<wbr style="display:inline-block"></wbr>​/electroacupuncture-economic-analysis-pdf-11251847341</a></div></dd></dl><dl class="bkr_refwrap"><dt>30.</dt><dd><div class="bk_ref" id="niceng236er22.ref30">National Institute for Health and Care Excellence. Developing NICE guidelines: the manual [updated January 2022]. London. National Institute for Health and Care Excellence, 2014. Available from: <a href="https://www.nice.org.uk/process/pmg20" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org.uk/process/pmg20</a></div></dd></dl><dl class="bkr_refwrap"><dt>31.</dt><dd><div class="bk_ref" id="niceng236er22.ref31">NHS England and NHS Improvement. 2019/20 National Cost Collection Data Publication. 2022. Available from: <a href="https://www.england.nhs.uk/publication/2019-20-national-cost-collection-data-publication" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.england.nhs<wbr style="display:inline-block"></wbr>​.uk/publication/2019-20-national-cost-collection-data-publication</a> Last accessed: 01/02/2023.</div></dd></dl><dl class="bkr_refwrap"><dt>32.</dt><dd><div class="bk_ref" id="niceng236er22.ref32">NHS Supply Chain. NHS Supply Chain Catalogue. 2022. Available from: <a href="https://my.supplychain.nhs.uk/catalogue" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://my<wbr style="display:inline-block"></wbr>​.supplychain.nhs.uk/catalogue</a> Last accessed: 01/02/2023.</div></dd></dl><dl class="bkr_refwrap"><dt>33.</dt><dd><div class="bk_ref" id="niceng236er22.ref33">Pandian
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JD, Kaur
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P, Arora
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R, Vishwambaran
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DK, Toor
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P, Rocchi
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G, Deserri
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D, Foschi
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P, Mardegan
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C, Pandyan
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UW, Yoon
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SH, Moon
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DJ, Kwack
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KS, Hong
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JY, Lim
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M, Jiang
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N, Yan
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L, Liu
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J, Luo
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B, Zhang
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R, Lovell
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A, Cook
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R. Functional electrical stimulation for dropped foot of central neurological origin: economic report London. 2010. Available from: <a href="http://www.cedar.wales.nhs.uk/sitesplus/documents/1091/CEP10012%20FES%20econ%20report.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.cedar.wales<wbr style="display:inline-block"></wbr>​.nhs.uk/sitesplus/documents<wbr style="display:inline-block"></wbr>​/1091/CEP10012<wbr style="display:inline-block"></wbr>​%20FES%20econ%20report.pdf</a>
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|
</div></dd></dl><dl class="bkr_refwrap"><dt>39.</dt><dd><div class="bk_ref" id="niceng236er22.ref39">Terlemez
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R, Ciftci
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S, Topaloglu
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M, Dogu
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B, Yilmaz
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F, Kuran
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C, Ozturk
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GT, Ugurlu
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FG, Ersoz
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M. Ultrasonographic assessment of neuromuscular electrical stimulation efficacy on glenohumeral subluxation in patients with hemiplegia: a randomized-controlled study. Turkish Journal of Physical Medicine and Rehabilitation. 2017; 63(4):287–292
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A, Lambrecht
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G, Oostra
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KM, Vanderstraeten
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G, Cambier
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D. A randomized controlled trial on the immediate and long-term effects of arm slings on shoulder subluxation in stroke patients. European journal of physical & rehabilitation medicine. 2017; 53(3):400–409
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AJ, Vertosick
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EA, Lewith
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G, MacPherson
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H, Foster
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NE, Sherman
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RD, Gunzler
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ME, Chae
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RD, Knutson
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ME, Chae
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B, Manca
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A, Weatherly
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H, Saramago
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P, Sideris
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DT, Chae
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J, Walker
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ME, Kirsteins
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A, Elovic
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EP, Flanagan
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et al
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J, Ai
|
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Y, Zhan
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L, Pan
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R, Wang
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Y, Dong
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C
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et al
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Effect of abdominal acupuncture combined with routine rehabilitation training on shoulder-hand syndrome after stroke: A randomized controlled trial. Integrative Medicine Research. 2022; 11(2):100805
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[<a href="/pmc/articles/PMC8627967/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8627967</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34877254" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34877254</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>51.</dt><dd><div class="bk_ref" id="niceng236er22.ref51">Zheng
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J, Wu
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Q, Wang
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L, Guo
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T. A clinical study on acupuncture in combination with routine rehabilitation therapy for early pain recovery of post-stroke shoulder-hand syndrome. Experimental and Therapeutic Medicine. 2018; 15(2):2049–2053
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[<a href="/pmc/articles/PMC5776623/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5776623</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29434804" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29434804</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>52.</dt><dd><div class="bk_ref" id="niceng236er22.ref52">Zhou
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M, Li
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F, Lu
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W, Wu
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J, Pei
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S. Efficiency of Neuromuscular Electrical Stimulation and Transcutaneous Nerve Stimulation on Hemiplegic Shoulder Pain: A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation. 2018; 99(9):1730–1739
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[<a href="https://pubmed.ncbi.nlm.nih.gov/29777714" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29777714</span></a>]</div></dd></dl></dl></div></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng236er22.appa"><h3>Appendix A. Review protocols</h3><p id="niceng236er22.appa.et1"><a href="/books/NBK602206/bin/niceng236er22-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Review protocol for the clinical and cost-effectiveness of interventions for shoulder pain after stroke</a><span class="small"> (PDF, 261K)</span></p></div><div id="niceng236er22.appb"><h3>Appendix B. Literature search strategies</h3><div id="niceng236er22.appb.s1"><h4>B.1. Clinical search literature search strategy</h4><p>Searches were constructed using a PICO framework where population (P) terms were combined with Intervention (I) and in some cases Comparison (C) terms. Outcomes (O) are rarely used in search strategies as these concepts may not be indexed or described in the title or abstract and are therefore difficult to retrieve. Search filters were applied to the search where appropriate.</p><p id="niceng236er22.appb.et1"><a href="/books/NBK602206/bin/niceng236er22-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (215K)</span></p></div><div id="niceng236er22.appb.s2"><h4>B.2. Health Economics literature search strategy</h4><p>Health economic evidence was identified by conducting searches using terms for a broad Stroke Rehabilitation population. The following databases were searched: NHS Economic Evaluation Database (NHS EED - this ceased to be updated after 31<sup>st</sup> March 2015), Health Technology Assessment database (HTA - this ceased to be updated from 31<sup>st</sup> March 2018) and The International Network of Agencies for Health Technology Assessment (INAHTA). Searches for recent evidence were run on Medline and Embase from 2014 onwards for health economics, and all years for quality-of-life studies. Additional searches were run in CINAHL and PsycInfo looking for health economic evidence.</p><p id="niceng236er22.appb.et2"><a href="/books/NBK602206/bin/niceng236er22-appb-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (202K)</span></p></div></div><div id="niceng236er22.appc"><h3>Appendix C. Effectiveness evidence study selection</h3><p id="niceng236er22.appc.et1"><a href="/books/NBK602206/bin/niceng236er22-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (246K)</span></p></div><div id="niceng236er22.appd"><h3>Appendix D. Effectiveness evidence</h3><p id="niceng236er22.appd.et1"><a href="/books/NBK602206/bin/niceng236er22-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Adey-Wakeling, 2013</a><span class="small"> (PDF, 192K)</span></p><p id="niceng236er22.appd.et2"><a href="/books/NBK602206/bin/niceng236er22-appd-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Allen, 2010</a><span class="small"> (PDF, 118K)</span></p><p id="niceng236er22.appd.et3"><a href="/books/NBK602206/bin/niceng236er22-appd-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Chae, 2007</a><span class="small"> (PDF, 219K)</span></p><p id="niceng236er22.appd.et4"><a href="/books/NBK602206/bin/niceng236er22-appd-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Chae, 2005</a><span class="small"> (PDF, 216K)</span></p><p id="niceng236er22.appd.et5"><a href="/books/NBK602206/bin/niceng236er22-appd-et5.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Chuang, 2017</a><span class="small"> (PDF, 205K)</span></p><p id="niceng236er22.appd.et6"><a href="/books/NBK602206/bin/niceng236er22-appd-et6.pdf" class="bk_dwnld_icn bk_dwnld_pdf">de Jong, 2013</a><span class="small"> (PDF, 193K)</span></p><p id="niceng236er22.appd.et7"><a href="/books/NBK602206/bin/niceng236er22-appd-et7.pdf" class="bk_dwnld_icn bk_dwnld_pdf">DiLorenzo, 2004</a><span class="small"> (PDF, 195K)</span></p><p id="niceng236er22.appd.et8"><a href="/books/NBK602206/bin/niceng236er22-appd-et8.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Ersoy, 2022</a><span class="small"> (PDF, 193K)</span></p><p id="niceng236er22.appd.et9"><a href="/books/NBK602206/bin/niceng236er22-appd-et9.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Hartwig, 2012</a><span class="small"> (PDF, 193K)</span></p><p id="niceng236er22.appd.et10"><a href="/books/NBK602206/bin/niceng236er22-appd-et10.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Heo, 2015</a><span class="small"> (PDF, 185K)</span></p><p id="niceng236er22.appd.et11"><a href="/books/NBK602206/bin/niceng236er22-appd-et11.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Huang, 2017</a><span class="small"> (PDF, 198K)</span></p><p id="niceng236er22.appd.et12"><a href="/books/NBK602206/bin/niceng236er22-appd-et12.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Huang, 2016</a><span class="small"> (PDF, 200K)</span></p><p id="niceng236er22.appd.et13"><a href="/books/NBK602206/bin/niceng236er22-appd-et13.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Karaahmet, 2019</a><span class="small"> (PDF, 206K)</span></p><p id="niceng236er22.appd.et14"><a href="/books/NBK602206/bin/niceng236er22-appd-et14.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Lakse, 2009</a><span class="small"> (PDF, 189K)</span></p><p id="niceng236er22.appd.et15"><a href="/books/NBK602206/bin/niceng236er22-appd-et15.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Lavi, 2022</a><span class="small"> (PDF, 203K)</span></p><p id="niceng236er22.appd.et16"><a href="/books/NBK602206/bin/niceng236er22-appd-et16.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Lee, 2016</a><span class="small"> (PDF, 201K)</span></p><p id="niceng236er22.appd.et17"><a href="/books/NBK602206/bin/niceng236er22-appd-et17.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Mendigutia-Gomez, 2020</a><span class="small"> (PDF, 197K)</span></p><p id="niceng236er22.appd.et18"><a href="/books/NBK602206/bin/niceng236er22-appd-et18.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Moghe, 2020</a><span class="small"> (PDF, 186K)</span></p><p id="niceng236er22.appd.et19"><a href="/books/NBK602206/bin/niceng236er22-appd-et19.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Pandian, 2013</a><span class="small"> (PDF, 194K)</span></p><p id="niceng236er22.appd.et20"><a href="/books/NBK602206/bin/niceng236er22-appd-et20.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Pillastrini, 2016</a><span class="small"> (PDF, 195K)</span></p><p id="niceng236er22.appd.et21"><a href="/books/NBK602206/bin/niceng236er22-appd-et21.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Rah, 2012</a><span class="small"> (PDF, 195K)</span></p><p id="niceng236er22.appd.et22"><a href="/books/NBK602206/bin/niceng236er22-appd-et22.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Sui, 2021</a><span class="small"> (PDF, 194K)</span></p><p id="niceng236er22.appd.et23"><a href="/books/NBK602206/bin/niceng236er22-appd-et23.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Terlemez, 2020</a><span class="small"> (PDF, 186K)</span></p><p id="niceng236er22.appd.et24"><a href="/books/NBK602206/bin/niceng236er22-appd-et24.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Turkkan, 2017</a><span class="small"> (PDF, 189K)</span></p><p id="niceng236er22.appd.et25"><a href="/books/NBK602206/bin/niceng236er22-appd-et25.pdf" class="bk_dwnld_icn bk_dwnld_pdf">van Bladel, 2017</a><span class="small"> (PDF, 198K)</span></p><p id="niceng236er22.appd.et26"><a href="/books/NBK602206/bin/niceng236er22-appd-et26.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Wilson, 2014</a><span class="small"> (PDF, 221K)</span></p><p id="niceng236er22.appd.et27"><a href="/books/NBK602206/bin/niceng236er22-appd-et27.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Wilson, 2017</a><span class="small"> (PDF, 152K)</span></p><p id="niceng236er22.appd.et28"><a href="/books/NBK602206/bin/niceng236er22-appd-et28.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Yang, 2018</a><span class="small"> (PDF, 184K)</span></p><p id="niceng236er22.appd.et29"><a href="/books/NBK602206/bin/niceng236er22-appd-et29.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Yu, 2004</a><span class="small"> (PDF, 224K)</span></p><p id="niceng236er22.appd.et30"><a href="/books/NBK602206/bin/niceng236er22-appd-et30.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Zhan, 2022</a><span class="small"> (PDF, 203K)</span></p><p id="niceng236er22.appd.et31"><a href="/books/NBK602206/bin/niceng236er22-appd-et31.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Zheng, 2018</a><span class="small"> (PDF, 195K)</span></p><p id="niceng236er22.appd.et32"><a href="/books/NBK602206/bin/niceng236er22-appd-et32.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Zhou, 2018</a><span class="small"> (PDF, 203K)</span></p></div><div id="niceng236er22.appe"><h3>Appendix E. Forest plots</h3><div id="niceng236er22.appe.s1"><h4>E.1. Transcutaneous electrical nerve stimulation (TENS) compared to neuromuscular electrical stimulation (NMES) and usual care or no treatment</h4><div id="niceng236er22.appe.s1.1"><h5>E.1.1. Transcutaneous electrical nerve stimulation (TENS) compared to neuromuscular electrical stimulation (NMES)</h5><p id="niceng236er22.appe.et1"><a href="/books/NBK602206/bin/niceng236er22-appe-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (103K)</span></p></div><div id="niceng236er22.appe.s1.2"><h5>E.1.2. Transcutaneous electrical nerve stimulation (TENS) compared to usual care or no treatment</h5><p id="niceng236er22.appe.et2"><a href="/books/NBK602206/bin/niceng236er22-appe-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (102K)</span></p></div></div><div id="niceng236er22.appe.s2"><h4>E.2. Functional electrical stimulation compared to usual care or no treatment</h4><div id="niceng236er22.appe.s2.1"><h5>E.2.1. Functional electrical stimulation compared to usual care or no treatment</h5><p id="niceng236er22.appe.et3"><a href="/books/NBK602206/bin/niceng236er22-appe-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (100K)</span></p></div></div><div id="niceng236er22.appe.s3"><h4>E.3. Neuromuscular electrical stimulation (NMES) compared to placebo/sham and usual care or no treatment</h4><div id="niceng236er22.appe.s3.1"><h5>E.3.1. Neuromuscular electrical stimulation (NMES) compared to placebo/sham</h5><p id="niceng236er22.appe.et4"><a href="/books/NBK602206/bin/niceng236er22-appe-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (106K)</span></p></div><div id="niceng236er22.appe.s3.2"><h5>E.3.2. Neuromuscular electrical stimulation (NMES) compared to usual care or no treatment</h5><p id="niceng236er22.appe.et5"><a href="/books/NBK602206/bin/niceng236er22-appe-et5.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (112K)</span></p></div></div><div id="niceng236er22.appe.s4"><h4>E.4. Devices - tape compared to placebo/sham and usual care or no treatment</h4><div id="niceng236er22.appe.s4.1"><h5>E.4.1. Devices - tape compared to placebo/sham</h5><p id="niceng236er22.appe.et6"><a href="/books/NBK602206/bin/niceng236er22-appe-et6.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (109K)</span></p></div><div id="niceng236er22.appe.s4.2"><h5>E.4.2. Devices - tape compared to usual care or no treatment</h5><p id="niceng236er22.appe.et7"><a href="/books/NBK602206/bin/niceng236er22-appe-et7.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (103K)</span></p></div></div><div id="niceng236er22.appe.s5"><h4>E.5. Devices - slings compared to neuromuscular electrical stimulation (NMES) and usual care or no treatment</h4><div id="niceng236er22.appe.s5.1"><h5>E.5.1. Devices - slings compared to neuromuscular electrical stimulation (NMES)</h5><p id="niceng236er22.appe.et8"><a href="/books/NBK602206/bin/niceng236er22-appe-et8.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (123K)</span></p></div><div id="niceng236er22.appe.s5.2"><h5>E.5.2. Devices - slings compared to usual care or no treatment</h5><p id="niceng236er22.appe.et9"><a href="/books/NBK602206/bin/niceng236er22-appe-et9.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (124K)</span></p></div></div><div id="niceng236er22.appe.s6"><h4>E.6. Devices - braces compared to usual care or no treatment</h4><div id="niceng236er22.appe.s6.1"><h5>E.6.1. Devices - braces compared to usual care or no treatment</h5><p id="niceng236er22.appe.et10"><a href="/books/NBK602206/bin/niceng236er22-appe-et10.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (96K)</span></p></div></div><div id="niceng236er22.appe.s7"><h4>E.7. Acupuncture/dry needling compared to placebo/sham and usual care or no treatment</h4><div id="niceng236er22.appe.s7.1"><h5>E.7.1. Acupuncture/dry needling compared to placebo/sham</h5><p id="niceng236er22.appe.et11"><a href="/books/NBK602206/bin/niceng236er22-appe-et11.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (102K)</span></p></div><div id="niceng236er22.appe.s7.2"><h5>E.7.2. Acupuncture/dry needling compared to usual care or no treatment</h5><p id="niceng236er22.appe.et12"><a href="/books/NBK602206/bin/niceng236er22-appe-et12.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (109K)</span></p></div></div><div id="niceng236er22.appe.s8"><h4>E.8. Electroacupuncture compared to placebo/sham</h4><div id="niceng236er22.appe.s8.1"><h5>E.8.1. Electroacupuncture compared to placebo/sham</h5><p id="niceng236er22.appe.et13"><a href="/books/NBK602206/bin/niceng236er22-appe-et13.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (97K)</span></p></div></div><div id="niceng236er22.appe.s9"><h4>E.9. Intra-articular medicine injections - corticosteroids compared to placebo/sham</h4><div id="niceng236er22.appe.s9.1"><h5>E.9.1. Intra-articular medicine injections - corticosteroids compared to placebo/sham</h5><p id="niceng236er22.appe.et14"><a href="/books/NBK602206/bin/niceng236er22-appe-et14.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (104K)</span></p></div></div><div id="niceng236er22.appe.s10"><h4>E.10. Nerve blocks (local anaesthetic) compared to transcutaneous electrical nerve stimulation (TENS) and placebo/sham</h4><div id="niceng236er22.appe.s10.1"><h5>E.10.1. Nerve blocks (local anaesthetic) compared to transcutaneous electrical nerve stimulation (TENS)</h5><p id="niceng236er22.appe.et15"><a href="/books/NBK602206/bin/niceng236er22-appe-et15.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (103K)</span></p></div><div id="niceng236er22.appe.s10.2"><h5>E.10.2. Nerve blocks (local anaesthetic) compared to placebo/sham</h5><p id="niceng236er22.appe.et16"><a href="/books/NBK602206/bin/niceng236er22-appe-et16.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (101K)</span></p></div></div></div><div id="niceng236er22.appf"><h3>Appendix F. GRADE tables</h3><div id="niceng236er22.appf.s1"><h4>F.1. Transcutaneous electrical nerve stimulation (TENS) compared to neuromuscular electrical stimulation (NMES) and usual care or no treatment</h4><div id="niceng236er22.appf.s1.1"><h5>F.1.1. Transcutaneous electrical nerve stimulation (TENS) compared to neuromuscular electrical stimulation (NMES)</h5><p id="niceng236er22.appf.et1"><a href="/books/NBK602206/bin/niceng236er22-appf-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (201K)</span></p></div><div id="niceng236er22.appf.s1.2"><h5>F.1.2. Transcutaneous electrical nerve stimulation (TENS) compared to usual care or no treatment</h5><p id="niceng236er22.appf.et2"><a href="/books/NBK602206/bin/niceng236er22-appf-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (197K)</span></p></div></div><div id="niceng236er22.appf.s2"><h4>F.2. Functional electrical stimulation compared to usual care or no treatment</h4><div id="niceng236er22.appf.s2.1"><h5>F.2.1. Functional electrical stimulation compared to usual care or no treatment</h5><p id="niceng236er22.appf.et3"><a href="/books/NBK602206/bin/niceng236er22-appf-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (198K)</span></p></div></div><div id="niceng236er22.s3"><h4>F.3. Neuromuscular electrical stimulation (NMES) compared to placebo/sham and usual care or no treatment</h4><div id="niceng236er22.appf.s3.1"><h5>F.3.1. Neuromuscular electrical stimulation (NMES) compared to placebo/sham</h5><p id="niceng236er22.appf.et4"><a href="/books/NBK602206/bin/niceng236er22-appf-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (197K)</span></p></div><div id="niceng236er22.appf.s3.2"><h5>F.3.2. Neuromuscular electrical stimulation (NMES) compared to usual care or no treatment</h5><p id="niceng236er22.appf.et5"><a href="/books/NBK602206/bin/niceng236er22-appf-et5.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (209K)</span></p></div></div><div id="niceng236er22.appf.s4"><h4>F.4. Devices - tape compared to placebo/sham and usual care or no treatment</h4><div id="niceng236er22.appf.s4.1"><h5>F.4.1. Devices - tape compared to placebo/sham</h5><p id="niceng236er22.appf.et6"><a href="/books/NBK602206/bin/niceng236er22-appf-et6.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (201K)</span></p></div><div id="niceng236er22.appf.s4.2"><h5>F.4.2. Devices - tape compared to usual care or no treatment</h5><p id="niceng236er22.appf.et7"><a href="/books/NBK602206/bin/niceng236er22-appf-et7.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (191K)</span></p></div></div><div id="niceng236er22.appf.s5"><h4>F.5. Devices - slings compared to neuromuscular electrical stimulation (NMES) and usual care or no treatment</h4><div id="niceng236er22.appf.s5.1"><h5>F.5.1. Devices - slings compared to neuromuscular electrical stimulation (NMES)</h5><p id="niceng236er22.appf.et8"><a href="/books/NBK602206/bin/niceng236er22-appf-et8.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (192K)</span></p></div><div id="niceng236er22.appf.s5.2"><h5>F.5.2. Devices - slings compared to usual care or no treatment</h5><p id="niceng236er22.appf.et9"><a href="/books/NBK602206/bin/niceng236er22-appf-et9.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (195K)</span></p></div></div><div id="niceng236er22.appf.s6"><h4>F.6. Devices - braces compared to usual care or no treatment</h4><div id="niceng236er22.appf.s6.1"><h5>F.6.1. Devices - braces compared to usual care or no treatment</h5><p id="niceng236er22.appf.et10"><a href="/books/NBK602206/bin/niceng236er22-appf-et10.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (192K)</span></p></div></div><div id="niceng236er22.appf.s7"><h4>F.7. Acupuncture/dry needling compared to placebo/sham and usual care or no treatment</h4><div id="niceng236er22.appf.s7.1"><h5>F.7.1. Acupuncture/dry needling compared to placebo/sham</h5><p id="niceng236er22.appf.et11"><a href="/books/NBK602206/bin/niceng236er22-appf-et11.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (197K)</span></p></div><div id="niceng236er22.appf.s7.2"><h5>F.7.2. Acupuncture/dry needling compared to usual care or no treatment</h5><p id="niceng236er22.appf.et12"><a href="/books/NBK602206/bin/niceng236er22-appf-et12.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (204K)</span></p></div></div><div id="niceng236er22.appf.s8"><h4>F.8. Electroacupuncture compared to placebo/sham</h4><div id="niceng236er22.appf.s8.1"><h5>F.8.1. Electroacupuncture compared to placebo/sham</h5><p id="niceng236er22.appf.et13"><a href="/books/NBK602206/bin/niceng236er22-appf-et13.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (176K)</span></p></div></div><div id="niceng236er22.appf.s9"><h4>F.9. Intra-articular medicine injections - corticosteroids compared to placebo/sham</h4><div id="niceng236er22.appf.s9.1"><h5>F.9.1. Intra-articular medicine injections - corticosteroids compared to placebo/sham</h5><p id="niceng236er22.appf.et14"><a href="/books/NBK602206/bin/niceng236er22-appf-et14.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (180K)</span></p></div></div><div id="niceng236er22.appf.s10"><h4>F.10. Nerve blocks (local anaesthetic) compared to transcutaneous electrical nerve stimulation (TENS) and placebo/sham</h4><div id="niceng236er22.appf.s10.1"><h5>F.10.1. Nerve blocks (local anaesthetic) compared to transcutaneous electrical nerve stimulation (TENS)</h5><p id="niceng236er22.appf.et15"><a href="/books/NBK602206/bin/niceng236er22-appf-et15.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (179K)</span></p></div><div id="niceng236er22.appf.s10.2"><h5>F.10.2. Nerve blocks (local anaesthetic) compared to placebo/sham</h5><p id="niceng236er22.appf.et16"><a href="/books/NBK602206/bin/niceng236er22-appf-et16.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (179K)</span></p></div></div></div><div id="niceng236er22.appg"><h3>Appendix G. Economic evidence study selection</h3><p id="niceng236er22.appg.et1"><a href="/books/NBK602206/bin/niceng236er22-appg-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (182K)</span></p></div><div id="niceng236er22.apph"><h3>Appendix H. Economic evidence tables</h3><p>No health economic studies were included in this review.</p></div><div id="niceng236er22.appi"><h3>Appendix I. Health economic model</h3><p>New cost-effectiveness analysis was not conducted in this area.</p></div><div id="niceng236er22.appj"><h3>Appendix J. Excluded studies</h3><div id="niceng236er22.appj.s1"><h4>Clinical studies</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22appjtab1"><a href="/books/NBK602206/table/niceng236er22.appj.tab1/?report=objectonly" target="object" title="Table 46" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22appjtab1" rid-ob="figobniceng236er22appjtab1"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.appj.tab1/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.appj.tab1/?report=previmg" alt="Table 46. Studies excluded from the clinical review." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.appj.tab1"><a href="/books/NBK602206/table/niceng236er22.appj.tab1/?report=objectonly" target="object" rid-ob="figobniceng236er22appjtab1">Table 46</a></h4><p class="float-caption no_bottom_margin">Studies excluded from the clinical review. </p></div></div></div><div id="niceng236er22.appj.s2"><h4>Health Economic studies</h4><p>Published health economic studies that met the inclusion criteria (relevant population, comparators, economic study design, published 2006 or later and not from non-OECD country or USA) but that were excluded following appraisal of applicability and methodological quality are listed below. See the health economic protocol for more details.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng236er22appjtab2"><a href="/books/NBK602206/table/niceng236er22.appj.tab2/?report=objectonly" target="object" title="Table 47" class="img_link icnblk_img figpopup" rid-figpopup="figniceng236er22appjtab2" rid-ob="figobniceng236er22appjtab2"><img class="small-thumb" src="/books/NBK602206/table/niceng236er22.appj.tab2/?report=thumb" src-large="/books/NBK602206/table/niceng236er22.appj.tab2/?report=previmg" alt="Table 47. Studies excluded from the health economic review." /></a><div class="icnblk_cntnt"><h4 id="niceng236er22.appj.tab2"><a href="/books/NBK602206/table/niceng236er22.appj.tab2/?report=objectonly" target="object" rid-ob="figobniceng236er22appjtab2">Table 47</a></h4><p class="float-caption no_bottom_margin">Studies excluded from the health economic review. </p></div></div></div></div><div id="niceng236er22.appk"><h3>Appendix K. Research recommendations – full details</h3><div id="niceng236er22.appk.s1"><h4>K.1. Research recommendation</h4><p>What is the clinical and cost-effectiveness of diagnostic assessment to decide the choice of management for shoulder pain after stroke?</p><div id="niceng236er22.appk.s1.1"><h5>K.1.1. Why this is important</h5><p>Shoulder pain is very common and disabling problem after a stroke. It can have a huge impact on a person’s health-related quality of life and ability to participate in rehabilitation. Post-stroke shoulder pain in is complex and multifactorial in aetiology, and different causes of post-stroke shoulder pain may impact the efficacy of various treatment options. A number of causes of post-stroke shoulder pain have been identified including: rotator cufftears, abnormal muscle tone, glenohumeral subluxation, impingement, tendinopathy and shoulder hand syndrome. This review has identified several treatments that may be effective in reducing post stroke shoulder pain including: taping, NMES, intra-articular corticosteroid injection and nerve blocks. However, the evidence base was limited in the amount of evidence and in linking the cause of the shoulder pain to the intervention. Some interventions may be more effective at managing certain types of shoulder pain than others.</p><p>In order to further assess the effectiveness of the interventions identified as clinically effective in the guideline, a research recommendation was made to investigate the effect of using a diagnostic assessment to assess the cause of the shoulder pain and then to use that knowledge to assess the correct treatment to use, compared to usual care. This would be useful as this would help to support the idea that people should have comprehensive assessments of the cause of shoulder pain. The trial would include an internal subgroup analysis as to which treatment was selected to treat which cause of pain to understand whether that treatment was effective for treating that cause of pain.</p></div><div id="niceng236er22.appk.s1.2"><h5>K.1.2. Rationale for research recommendation</h5><p id="niceng236er22.appk.et1"><a href="/books/NBK602206/bin/niceng236er22-appk-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (186K)</span></p></div><div id="niceng236er22.appk.s1.3"><h5>K.1.3. Modified PICO table</h5><p id="niceng236er22.appk.et2"><a href="/books/NBK602206/bin/niceng236er22-appk-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (190K)</span></p></div></div><div id="niceng236er22.appk.s2"><h4>K.2. Research recommendation</h4><p>For people with different causes of shoulder pain after stroke, what is the clinical and cost-effectiveness of interventions in reducing pain?</p><div id="niceng236er22.appk.s2.1"><h5>K.2.1. Why this is important</h5><p>Shoulder pain is a very common and disabling problem after a stroke. It can have a huge impact on a person’s health-related quality of life, activities of daily living and ability to participate in rehabilitation. Post-stroke shoulder pain in is complex and different causes of post-stroke shoulder pain may impact the efficacy of various treatment options. A number of causes of post stroke shoulder pain have been identified, including: rotator cuff tears, abnormal muscle tone, glenohumeral subluxation, impingement, tendinopathy, and shoulder hand syndrome. This review has identified several treatments that may be effective at reducing post-stroke shoulder pain, including: taping, NMES, intra-articular corticosteroid injection and nerve blocks. However, evidence supporting these was limited and there was no cost effectiveness evidence for the interventions. The evidence failed to identity the underlying causes of people’s shoulder pain which may have a large impact on the effectiveness of various treatments. Further research to determine which treatments are effective for different causes of shoulder pain is important to make treatment more targeted and person centred.</p></div><div id="niceng236er22.appk.s2.2"><h5>K.2.2. Rationale for research recommendation</h5><p id="niceng236er22.appk.et3"><a href="/books/NBK602206/bin/niceng236er22-appk-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (62K)</span></p></div><div id="niceng236er22.appk.s2.3"><h5>K.2.3. Modified PICO table</h5><p id="niceng236er22.appk.et4"><a href="/books/NBK602206/bin/niceng236er22-appk-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (187K)</span></p></div></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence reviews underpinning recommendations 1.14.2 to 1.14.4 and recommendations for research in the NICE guideline</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2023.</div><div class="small"><span class="label">Bookshelf ID: NBK602206</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/38530911" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">38530911</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng236er22tab1"><div id="niceng236er22.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">PICO characteristics of review question</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_niceng236er22.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_niceng236er22.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Inclusion:<ul><li class="half_rhythm"><div>Adults (age ≥16 years) who have had a first or recurrent stroke (including people after subarachnoid haemorrhage) with shoulder pain</div></li></ul></p>
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<p>Exclusion:<ul><li class="half_rhythm"><div>Children (age <16 years)</div></li><li class="half_rhythm"><div>People after a transient ischaemic attack</div></li></ul></p>
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</td></tr><tr><th id="hd_b_niceng236er22.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions</th><td headers="hd_b_niceng236er22.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation (TENS)</div></li><li class="half_rhythm"><div>Functional electrical stimulation</div></li><li class="half_rhythm"><div>Neuromuscular electrical stimulation (NMES)</div></li><li class="half_rhythm"><div>Devices<ul class="circle"><li class="half_rhythm"><div>Tape</div></li><li class="half_rhythm"><div>Slings</div></li><li class="half_rhythm"><div>Supports</div></li><li class="half_rhythm"><div>Braces</div></li><li class="half_rhythm"><div>Other devices</div></li></ul></div></li><li class="half_rhythm"><div>Acupuncture/dry needling</div></li><li class="half_rhythm"><div>Electroacupuncture</div></li><li class="half_rhythm"><div>Intra-articular medicine injections<ul class="circle"><li class="half_rhythm"><div>Corticosteroids</div></li><li class="half_rhythm"><div>Saline</div></li></ul></div></li><li class="half_rhythm"><div>Injections into other sites (for example: bursae)<ul class="circle"><li class="half_rhythm"><div>Corticosteroids</div></li><li class="half_rhythm"><div>Saline</div></li></ul></div></li><li class="half_rhythm"><div>Nerve blocks (local anaesthetics)</div></li></ul>
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</td></tr><tr><th id="hd_b_niceng236er22.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparisons</th><td headers="hd_b_niceng236er22.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Each other</div></li><li class="half_rhythm"><div>Placebo/sham</div></li><li class="half_rhythm"><div>Usual care or no treatment</div></li></ul>
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</td></tr><tr><th id="hd_b_niceng236er22.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_niceng236er22.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>All outcomes are considered equally important for decision making and therefore have all been rated as critical:</p>
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<p>At time period:<ul><li class="half_rhythm"><div><6 months</div></li><li class="half_rhythm"><div>≥6 months</div></li><li class="half_rhythm"><div>Person/participant generic health-related quality of life (continuous outcomes will be prioritised)</div></li><li class="half_rhythm"><div>Carer generic health-related quality of life (continuous outcomes will be prioritised)</div></li><li class="half_rhythm"><div>Pain (continuous outcomes will be prioritised)</div></li><li class="half_rhythm"><div>Physical function – upper limb (continuous outcomes will be prioritised)</div></li><li class="half_rhythm"><div>Activities of daily living (continuous outcomes will be prioritised)</div></li><li class="half_rhythm"><div>Stroke-specific Patient-Reported Outcome Measures (continuous outcomes will be prioritised)</div></li><li class="half_rhythm"><div>Withdrawal due to adverse events (dichotomous outcome)</div></li></ul></p>
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</td></tr><tr><th id="hd_b_niceng236er22.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_niceng236er22.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Systematic reviews of RCTs</div></li><li class="half_rhythm"><div>Parallel RCTs</div></li></ul>
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<p>If insufficient RCT evidence is available, non-randomised studies will be considered if they adjust for key confounders (e.g. age, time period after stroke, pre-existing shoulder conditions), including:<ol><li class="half_rhythm"><div>Prospective and retrospective cohort studies</div></li><li class="half_rhythm"><div>Case control studies (if no other evidence identified)</div></li></ol></p>
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</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab2"><div id="niceng236er22.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of studies included in the evidence review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intervention and comparison</th><th id="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><th id="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Adey-Wakeling 2013<sup><a class="bibr" href="#niceng236er22.ref2" rid="niceng236er22.ref2">2</a></sup></p>
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<p>Subsidiary study: Allen 2010<sup><a class="bibr" href="#niceng236er22.ref3" rid="niceng236er22.ref3">3</a></sup></p>
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</td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Nerve blocks (suprascapular nerve block)</b> (n=32)</p>
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<p>Suprascapular nerve block, 1mL of 40mg/mL methylprednisolone and 10mL 0.5% bupivacaine hydrochloride.</p>
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<p><b>Placebo/sham</b> (n=32)</p>
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<p>Injection of 5mL normal saline infiltrated subcutaneously to the same region.</p>
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<p>
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<b>Concomitant therapy:</b>
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</p>
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<p>All people received a 2mL subcutaneous infiltration of 1% lidocaine before injection.</p>
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</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>People after a first or recurrent stroke</b>
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</p>
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<p>Age: Majority 66–79 years.</p>
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<p>N = 64</p>
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<p>Previous shoulder pathology: Not stated/unclear.</p>
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<p>Mean time period after stroke (SD): 12 (9) weeks.</p>
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</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Pain at <6 months</p>
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<p>Withdrawal due to adverse events at <6 months</p>
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</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Background rate of oral drug use: Not reported.</p>
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<p>Setting: Acute stroke and rehabilitation wards in Australia.</p>
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<p>Funding: Supported by a grant from Foundation Dew Park, Repatriation General Hospital.</p>
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</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Chae 2005<sup><a class="bibr" href="#niceng236er22.ref5" rid="niceng236er22.ref5">5</a></sup></p>
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<p>Subsidiary studies:</p>
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<p>Chae 2007<sup><a class="bibr" href="#niceng236er22.ref4" rid="niceng236er22.ref4">4</a></sup></p>
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<p>Yu 2004<sup><a class="bibr" href="#niceng236er22.ref49" rid="niceng236er22.ref49">49</a></sup></p>
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</td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Neuromuscular electrical stimulation (NMES)</b> (n=32)</p>
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<p>Intramuscular electrical stimulation for 6 hours/day for 6 weeks.</p>
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<p><b>Devices – slings (hemisling)</b> (n=29)</p>
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|
<p>Cuff-type hemisling with instructions to use it whenever the upper limb was unsupported.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people continued to receive concomitant treatments, including pharmacologic and nonpharmacologic interventions as per their primary care physicians.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 59 (12.2) years.</p>
|
|
<p>N = 61</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Mean time period after stroke (SD): 129 (164) weeks.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at <6 months and ≥6 months</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Mixed population.</p>
|
|
<p>Setting: Outpatient follow up in the United States of America.</p>
|
|
<p>Funding: Supported in part by grants R44HD34996 and K12HD01097 from the National Institute for Child Health and Human Development, grant M01RR0080 from the National Center for Research Resource, and by NeuroControl Corporation.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Chuang 2017<sup><a class="bibr" href="#niceng236er22.ref6" rid="niceng236er22.ref6">6</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Neuromuscular electrical stimulation (NMES)</b> (n=19)</p>
|
|
<p>EMG-trigger neuromuscular electrical stimulation delivered in 12 sessions over 3 days/week for 4 weeks.</p>
|
|
<p><b>Transcutaneous electrical nerve stimulation (TENS)</b> (n=19)</p>
|
|
<p>TENS delivered for the same time period.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received 20 minutes of bilateral arm training.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 60.8 (11.0) years.</p>
|
|
<p>N = 38</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology</p>
|
|
<p>Mean time period after stroke (SD): 32.68 (53.80) months.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Physical function – upper limb at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Outpatient follow up in Taiwan.</p>
|
|
<p>Funding: Partially supported by the Ministry of Science and Technology (MOST-102-2314-B-182-003, 104-2314-B-182-035-MY3, and 104-2314-B-182-007-MY3) and the Healthy Aging Research Center at Chang Gung University (EMRPD1E1711), and the Chang Gung Memorial Hospital (CMRPD3E0331, CMRPD1G0041, and CMRPD3E113) in Taiwan.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">de Jong 2013<sup><a class="bibr" href="#niceng236er22.ref7" rid="niceng236er22.ref7">7</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Neuromuscular electrical stimulation (NMES)</b> (n=24)</p>
|
|
<p>Motor amplitude NMES for two 45-minute sessions a day, five days a week for eight weeks.</p>
|
|
<p><b>Placebo/sham</b> (n=24)</p>
|
|
<p>Sham arm positioning and transcutaneous electrical nerve stimulation for the same time period.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received arm stretch positioning combined with the interventions. All people received multidisciplinary stroke rehabilitation.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 57.5 (12.2) years.</p>
|
|
<p>N = 48</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Mean time period after stroke (SD): 43.5 (14.4) days.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Physical function – upper limb at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Neurological units of three rehabilitation centers in the Netherlands.</p>
|
|
<p>Funding: Supported by Fonds NutsOhra (SNO-T-0702–72) and Stichting Beatrixoord Noord-Nederland.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">DiLorenzo 2004<sup><a class="bibr" href="#niceng236er22.ref8" rid="niceng236er22.ref8">8</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Acupuncture/dry needling</b> (n=54)</p>
|
|
<p>Dry needling in four sittings every five to seven days.</p>
|
|
<p>Acupuncture/dry needling: Dry needling</p>
|
|
<p><b>Usual care or no treatment</b> (n=47)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Both groups received standard rehabilitation therapy.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 68.60 (7.73) years.</p>
|
|
<p>N = 101</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Mean time period after stroke: 3.54 weeks.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Physical function – upper limb at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Rehabilitation hospital providing services for inpatients and outpatients in Italy</p>
|
|
<p>Funding: No additional information.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ersoy 2022<sup><a class="bibr" href="#niceng236er22.ref9" rid="niceng236er22.ref9">9</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Nerve blocks (local anaesthetic)</b> (n=12)</p>
|
|
<p>Ultrasound guided, 1mL 40mg/mL methylprednisolone with 8mL 0.5% bupivacaine hydrochloride.</p>
|
|
<p><b>Transcutaneous electrical nerve stimulation (TENS)</b> (n=13)</p>
|
|
<p>30 minutes, 5 days a week for 3 weeks. 100Hz, symmetrical waveform, 300 microsecond wave duration, 0–100mA set at the limits of tolerable pain threshold.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people participation in a conventional rehabilitation program of gentle range of motion exercise, Bobath and Proprioceptive Neuromuscular Facilitation exercises.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 65.7 (10.6) years</p>
|
|
<p>N = 25</p>
|
|
<p>Previous shoulder pathology: Not stated/unclear</p>
|
|
<p>Time period after stroke (SD): 10.5 (11.7) units not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Stroke-specific Patient-Reported Outcome Measures at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Outpatients in Turkey.</p>
|
|
<p>Funding: Not funded.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hartwig 2012<sup><a class="bibr" href="#niceng236er22.ref14" rid="niceng236er22.ref14">14</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Devices - braces (Neuro-Lux functional orthosis)</b> (n=20)</p>
|
|
<p>Functional orthosis Neuro-Lux used between 8am and 6pm during normal daily activity.</p>
|
|
<p><b>Usual care or no treatment</b> (n=21)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received conventional care consisting of various passive and active movement exercises of the affected extremity under individual guidance of a therapist. Six training units of 30 minutes each were prescribed every week.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 65 (15) years</p>
|
|
<p>N = 41</p>
|
|
<p>Previous shoulder pathology: Not stated/unclear.</p>
|
|
<p>Time period after stroke (SD): 7.9 (5.3) days</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Inpatient in Germany.</p>
|
|
<p>Funding: Financial support from Sporlastic GmbH, Nurtingen, Germany.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Heo 2015<sup><a class="bibr" href="#niceng236er22.ref15" rid="niceng236er22.ref15">15</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Devices – tape</b> (n=18)</p>
|
|
<p>Inelastic tape and the Jig test and pain test once a week after tape replacement every 3 days.</p>
|
|
<p><b>Usual care or no treatment</b> (n=18)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Bed physical therapy in the intensive care unit.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 58.7 (10.6) years.</p>
|
|
<p>N = 36</p>
|
|
<p>Previous shoulder pathology: Not stated/unclear.</p>
|
|
<p>Time period after stroke: Not stated/unclear.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at <6 months</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Inpatient in the Republic of Korea.</p>
|
|
<p>Funding: No additional information.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Huang 2017<sup><a class="bibr" href="#niceng236er22.ref16" rid="niceng236er22.ref16">16</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Devices – tape</b> (n=11)</p>
|
|
<p>Kinesio tape applied twice per week for 3 weeks.</p>
|
|
<p><b>Placebo/sham</b> (n=10)</p>
|
|
<p>Sham kinesio taping for the same time period.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Both groups underwent identical conventional rehabilitation programmes including physical therapy and occupational therapy sessions, each lasting 60 minutes per day for 5 days per week. Speech therapy was administered according to individual needs.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 57 (13) years.</p>
|
|
<p>N = 21</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Time period after stroke: 71.1 (40.5) days.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Inpatient in Taiwan.</p>
|
|
<p>Funding: Funded by the Taipei Medical University and Shuang Ho Hospital.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Huang 2016<sup><a class="bibr" href="#niceng236er22.ref17" rid="niceng236er22.ref17">17</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Devices – tape</b> (n=22)</p>
|
|
<p>Kinesio taping applied for 3 days followed by 1 day of no taping for 3 weeks.</p>
|
|
<p><b>Placebo/sham</b> (n=27)</p>
|
|
<p>Sham taping by the same methods apart from neutral tension for the same time period.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people underwent inpatient rehabilitation including 1 hour physical therapy and 1 hour occupational therapy/day for 5 days/week.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.4 (10.7) years</p>
|
|
<p>N = 49</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Mean time period after stroke (SD): 28.3 (2.3) days.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Activities of daily living at <6 months</p>
|
|
<p>Physical function – upper limb at <6 months</p>
|
|
<p>Stroke-specific Patient-Reported Outcome Measures at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Inpatient in Taiwan</p>
|
|
<p>Funding: Grants from Chang Gung Memorial Hospital (CMRPG8A0191 and CMRPG8A0192).</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Karaahmet 2019<sup><a class="bibr" href="#niceng236er22.ref21" rid="niceng236er22.ref21">21</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Functional electrical stimulation (FES)</b> (n=12)</p>
|
|
<p>FES-cycling with 30 minute sessions delivered over 20 sessions, 5 times a week over 4 weeks.</p>
|
|
<p><b>Usual care or no treatment</b> (n=9)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Both groups were trained with a standard rehabilitation program, five times a week lasting 30 minutes each, totalling 20 sessions, accompanied by a specialist physiotherapist.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 56.9 (16.7) years.</p>
|
|
<p>N = 21</p>
|
|
<p>Previous shoulder pathology: Not stated/unclear.</p>
|
|
<p>Mean time period after stroke (SD): 41.8 (25.3) days.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Physical function – upper limb at <6 months</p>
|
|
<p>Activities of daily living at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Outpatient follow up in Turkey.</p>
|
|
<p>Funding: No additional information.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lakse 2009<sup><a class="bibr" href="#niceng236er22.ref22" rid="niceng236er22.ref22">22</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Intra-articular medicine injection (corticosteroids)</b> (n=21)</p>
|
|
<p>1mL triamcinolone acetonide with 9mL prilocaine.</p>
|
|
<p><b>Placebo/sham</b> (n=17)</p>
|
|
<p>Local anaesthetic injection only.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received transcutaneous electrical nerve stimulation and a therapeutic exercise program. All people were allowed to consume only 500–1500 mg/day paracetamol as an analgesic if needed. In both groups, people with an increase in muscle tone were given tizanidine 6mg/day.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 64.0 (8.4) years</p>
|
|
<p>N = 38</p>
|
|
<p>Previous shoulder pathology: Not stated/unclear.</p>
|
|
<p>Mean time period after stroke (SD): 6.5 (3.9) months.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at <6 months</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Inpatients in Turkey.</p>
|
|
<p>Funding: Grant P01HD/NS33988 from the National Institute of Child Health and Human Development, the National Institute of Neurological Disorders and Stroke, and the National Center for Rehabilitation Research.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lavi 2022<sup><a class="bibr" href="#niceng236er22.ref23" rid="niceng236er22.ref23">23</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Neuromuscular electrical stimulation (NMES)</b> (n=14)</p>
|
|
<p>NMES for 30 minutes for 1 week, increased up by 10 minutes each week to a maximum of 60 minutes by the 4<sup>th</sup> week. Treatment for 5 days a week for 6 weeks in total.</p>
|
|
<p><b>Placebo/sham</b> (n=14)</p>
|
|
<p>Same device with amplitude turned to zero.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Both groups received a shoulder support and conventional therapy for shoulder strengthening. Both continued daily function and their rehabilitation routine. Both received conventional rehabilitation for an additional 2 weeks before follow up.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 70.4 (13.3) years</p>
|
|
<p>N = 28</p>
|
|
<p>Previous shoulder pathology: Mixed</p>
|
|
<p>Mean time period after stroke (SD): 0.9 (1.4) months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Physical function – upper limb at <6 months</p>
|
|
<p>Activities of daily living at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Outpatient follow-up in Israel.</p>
|
|
<p>Funding: This rsearch received no external funding.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lee 2016<sup><a class="bibr" href="#niceng236er22.ref24" rid="niceng236er22.ref24">24</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Acupuncture/dry needling</b> (n=27)</p>
|
|
<p>Acupuncture 3 times a week for 3 weeks.</p>
|
|
<p>Acupuncture/dry needling: Acupuncture</p>
|
|
<p><b>Placebo/sham</b> (n=26)</p>
|
|
<p>Sham acupuncture received treatment with superficial penetration at different points.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 57.58 (11.36) years</p>
|
|
<p>N = 53</p>
|
|
<p>Previous shoulder pathology: Not stated/unclear.</p>
|
|
<p>Time period after stroke: Majority subacute.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Activities of daily living at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Outpatient follow up in the Republic of Korea.</p>
|
|
<p>Funding: Supported by the Korean National Rehabilitation Center, Ministry of Health & Welfare, Government of the Republic of Korea (13-B-04).</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mendigutia-Gomez 2020<sup><a class="bibr" href="#niceng236er22.ref26" rid="niceng236er22.ref26">26</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Acupuncture/dry needling</b> (n=8)</p>
|
|
<p>Dry needling over active trigger points delivered once and followed up after 1 week.</p>
|
|
<p>Acupuncture/dry needling: Dry needling.</p>
|
|
<p><b>Usual care or no treatment</b> (n=8)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received a single session of a rehabilitation program for 45 minutes.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 48 (7) years</p>
|
|
<p>N = 16</p>
|
|
<p>Previous shoulder pathology: Not stated/unclear.</p>
|
|
<p>Mean time period after stroke (SD): 8.9 (3.8) months.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Hospital Beata Maria Ana in Spain.</p>
|
|
<p>Funding: No financial support.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moghe 2020<sup><a class="bibr" href="#niceng236er22.ref27" rid="niceng236er22.ref27">27</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Devices – slings (therapeutic shoulder sling)</b> (n=25)</p>
|
|
<p>Therapeutic shoulder sling with proximal group exercises for 3 weeks, 5 days per week.</p>
|
|
<p><b>Usual care or no treatment</b> (n=25)</p>
|
|
<p>Conventional therapy only for 3 weeks, 5 days per week.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Conventional management could include education, positioning, exercises, orthotic devices and electrical stimulation.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 45.5 years.</p>
|
|
<p>N = 50</p>
|
|
<p>Previous shoulder pathology: Not stated/unclear.</p>
|
|
<p>Time period after stroke: Not stated/unclear.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at <6 months</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Outpatient follow up in India.</p>
|
|
<p>Funding: Krishna Institute of Medical Sciences.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pandian 2013<sup><a class="bibr" href="#niceng236er22.ref33" rid="niceng236er22.ref33">33</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Devices – taping</b> (n=80)</p>
|
|
<p>Shoulder taping using elastic adhesive tape kept on for 3 days at a time.</p>
|
|
<p><b>Placebo/sham</b> (n=82)</p>
|
|
<p>Sham taping. Tape applied in the same positions without repositioning the joints.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All received conventional therapy including positioning, handling technique and range of motion exercises.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 57.6 (13.3) years.</p>
|
|
<p>N = 162</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Time period after stroke: Acute.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at <6 months Withdrawal due to adverse events at <6 months</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Inpatient in India.</p>
|
|
<p>Funding: Department of Neurology intramural research fund.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pillastrini 2016<sup><a class="bibr" href="#niceng236er22.ref34" rid="niceng236er22.ref34">34</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Devices – tape</b> (n=16)</p>
|
|
<p>Neuromuscular taping technique 15 minutes per session, 4 sessions over 4 weeks.</p>
|
|
<p><b>Usual care or no treatment</b> (n=16)</p>
|
|
<p>Usual care only.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Standard physical therapy program, 45 minutes/session, 4 sessions over 4 weeks.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 66 (10) years</p>
|
|
<p>N = 32</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Mean time period after stroke (SD): 3.0 (2.3) years</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: No response criteria.</p>
|
|
<p>Setting: Outpatient follow up in Italy.</p>
|
|
<p>Funding: This study does not have funding.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rah 2012<sup><a class="bibr" href="#niceng236er22.ref36" rid="niceng236er22.ref36">36</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Intra-articular corticosteroids</b> (n=29)</p>
|
|
<p>Ultrasound-guided subacromial injection with triamcinolone 40mg with 1mL of 1% lidocaine.</p>
|
|
<p><b>Placebo/sham</b> (n=29)</p>
|
|
<p>Intra-articular injection of 5mL of 1% lidocaine.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>People on analgesics, if any, were told to stop administering from 5 days before the injection. All people were given picture leaflets and provided an education on home exercise programs.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 55.8 (11.6) years</p>
|
|
<p>N = 58</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Mean time period after stroke (SD): 21.2 (14.4) months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Activities of daily living at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: No response criteria.</p>
|
|
<p>Setting: Inpatient in Republic of Korea.</p>
|
|
<p>Funding: Supported by Ajou University (grant no. 3-2009-0090).</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sui 2021<sup><a class="bibr" href="#niceng236er22.ref37" rid="niceng236er22.ref37">37</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Electroacupuncture</b> (n=17)</p>
|
|
<p>Acupuncture followed by 30 minutes of electroacupuncture delivered once a day, five days a week for two weeks.</p>
|
|
<p>Acupuncture/dry needling: Acupuncture</p>
|
|
<p><b>Placebo/sham</b> (n=15)</p>
|
|
<p>Sham electroacupuncture therapy. Achieved through different needle insertions.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All received conventional drug and rehabilitation treatment. Conventional drug treatment followed the Chinese Cerebrovascular Disease Prevention and Treatment guidelines. The treatments included good limb positioning, passive shoulder movement, active shoulder strapping, rood therapy, weight training of the affected limb, and electrical stimulation therapy. All people underwent conventional rehabilitation treatments once a day, five days a week for two weeks.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 52.6 (10.8) years</p>
|
|
<p>N = 32</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Time period after stroke: Subacute.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at <6 months</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Outpatient follow up in China.</p>
|
|
<p>Funding: Projects granted from the Traditional Chinese Medicine Bureau of Guangdong Province, the National Natural Science Foundation of China, the Guangdong Basic and Applied Basic Research Foundation, the Shenzhen Science and Technology Program and the Open Project from the CAS Key Laboratory of Human-Machine Inelligence-Synergy Systems.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Terlemez 2020<sup><a class="bibr" href="#niceng236er22.ref39" rid="niceng236er22.ref39">39</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Nerve block (local anaesthetic)</b> (n=20)</p>
|
|
<p>Two groups: one (n=10) received a local anaesthetic injection (5mL of 2% lidocaine) into the suprascapular notch. One (n=10) received a local anaesthetic and corticosteroid injection (5mL of 2% lidocaine and 1mL of betamethasone) into the suprascapular notch.</p>
|
|
<p><b>Placebo/sham</b> (n=10)</p>
|
|
<p>Injection of 5mL of 2% lidocaine into the trapezius muscle.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Age range: 52–75 years</p>
|
|
<p>N = 30</p>
|
|
<p>Previous shoulder pathology: Not stated/unclear.</p>
|
|
<p>Mean time period after stroke: 14.4 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at <6 months</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Inpatient in Turkey.</p>
|
|
<p>Funding: No additional information.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Turkkan 2017<sup><a class="bibr" href="#niceng236er22.ref40" rid="niceng236er22.ref40">40</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Neuromuscular electrical nerve stimulation (NMES)</b> (n=12)</p>
|
|
<p>Neuromuscular electrical stimulation applied for 60 minutes/session in a day, 5 days a week for 4 weeks.</p>
|
|
<p><b>Usual care or no treatment</b> (n=12)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people used a shoulder strap and received similar conventional physiotherapy for glenohumeral subluxation (range of motion, stretching and strengthening exercises).</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 64.1 (15.0) years</p>
|
|
<p>N = 24</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Mean time period after stroke (SD): 3.9 (3.0) months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Activities of daily living at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Outpatient follow up in Turkey.</p>
|
|
<p>Funding: No financial support for the research and/or authorship of the article.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">van Bladel 2017<sup><a class="bibr" href="#niceng236er22.ref41" rid="niceng236er22.ref41">41</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Devices – slings (Actimove or Shoulderlift)</b> (n=21)</p>
|
|
<p>Two slings. One group received an Actimove<sup>®</sup> sling, the other received the Shoulderlift sling.</p>
|
|
<p><b>Usual care or no treatment</b> (n=11)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received an equal standard rehabilitation program aiming at avoiding complications and active exercises adjusted to the level of impairment. Furthermore, people were involved in physiotherapy focusing on balance and gait. All people received occupational therapy and if needed speech therapy and/or cognitive training.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 55 (13) years</p>
|
|
<p>N = 32</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Time period after stroke: 9.39 (4.54) weeks</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Physical function – upper limb at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Hospital inpatients in Belgium.</p>
|
|
<p>Funding: States there are no</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Wilson 2014<sup><a class="bibr" href="#niceng236er22.ref45" rid="niceng236er22.ref45">45</a></sup></p>
|
|
<p>Subsidiary study:</p>
|
|
<p>Wilson 2017<sup><a class="bibr" href="#niceng236er22.ref46" rid="niceng236er22.ref46">46</a></sup></p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Neuromuscular electrical stimulation (NMES)</b> (n=13)</p>
|
|
<p>Percutaneous nerve stimulation applied and used for 6 hours of stimulation per day for 3 weeks.</p>
|
|
<p><b>Usual care or no treatment</b> (n=12)</p>
|
|
<p>Usual care receiving 8 hours of physiotherapy over a 4 week period with daily home exercises.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No physiotherapy or occupational therapy directed at the shoulder or experimental procedures involving the hemiparetic upper limb; no intra-articular or subacromial corticosteroid injections to the affected shoulder; may receive oral spasticity medications, but no neurolytic agents; no addition of analgesic or spasticity medications.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Median age (IQR):</p>
|
|
<p>NMES: 54 (50 to 68) years</p>
|
|
<p>Usual care or no treatment: 55.5 (50 to 62.5) years</p>
|
|
<p>N = 25</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Median time period after stroke (IQR):</p>
|
|
<p>NMES: 2.6 (0.9 to 4) years</p>
|
|
<p>Usual care or no treatment: 2.3 (0.8 to 4.8) years</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Person/participant generic health-related quality of life at <6 months</p>
|
|
<p>Pain at <6 months</p>
|
|
<p>Physical function – upper limb at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Mixed population.</p>
|
|
<p>Setting: Urban, academic rehabilitation center in the United States of America.</p>
|
|
<p>Funding: Supports by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Clinical and Translational Science Collaborative of Cleveland, National Center for Advancing Translational Sciences component of the National Institute of Health.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Yang 2018<sup><a class="bibr" href="#niceng236er22.ref48" rid="niceng236er22.ref48">48</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Devices – tape</b> (n=10)</p>
|
|
<p>Kinesiology taping once a day for 5 days a week for 4 consecutive weeks.</p>
|
|
<p><b>Placebo/sham</b> (n=9)</p>
|
|
<p>Tape applied in the same places but with no tension applied.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Electrical therapy and exercise treatment once a day, 5 days per week for 4 consecutive weeks.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 59.5 (2.9) years</p>
|
|
<p>N = 19</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Mean time period after stroke (SD): 18.7 (1.9) weeks</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at <6 months</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Rehabilitation centre in China.</p>
|
|
<p>Funding: No additional information.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zhan 2022<sup><a class="bibr" href="#niceng236er22.ref50" rid="niceng236er22.ref50">50</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Acupuncture/dry needling</b> (n=25)</p>
|
|
<p>Bo’s abdominal acupuncture combined with routine exercise therapy. Delivered for 2 weeks, each session was 30 minutes, 1 time per day and 5 times per week.</p>
|
|
<p>Acupuncture/dry needling: Acupuncture.</p>
|
|
<p><b>Usual care or no treatment</b> (n=25)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Rehabilitation training for 2 weeks, each session was 30 minutes, 1 time per day and 5 times per week. At the same time, standard doses of NSAID drugs (diclofenac or paracetamol) were used.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 57.4 (8.7) years</p>
|
|
<p>N = 50</p>
|
|
<p>Previous shoulder pathology: Not stated/unclear.</p>
|
|
<p>Mean time period after stroke (SD): 63.9 (36.7) days</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Physical function – upper limb at <6 months</p>
|
|
<p>Activities of daily living at <6 months</p>
|
|
<p>Withdrawal due to adverse events at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Mixed population.</p>
|
|
<p>Setting: Inpatients in China.</p>
|
|
<p>Funding: Funded by Traditional Chinese Medicine Bureau of Guangdong Province, Opening Operation Program of Key Laboratory of Acupuncture and Moxibustion of Traditional Chinese Medicine in Guangdong and General Program of the National Natural Science foundation of China.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zheng 2018<sup><a class="bibr" href="#niceng236er22.ref51" rid="niceng236er22.ref51">51</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Acupuncture/dry needling</b> (n=89)</p>
|
|
<p>Acupuncture once per day for one month continuously and the needle-retaining time was 30 minutes each time.</p>
|
|
<p>Acupuncture/dry needling: Acupuncture.</p>
|
|
<p><b>Usual care or no treatment</b> (n=89)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received usual rehabilitation (including postural therapy, passive movement and active movement) for 1 month (45 minutes once per day).</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 53.8 (3.3) years</p>
|
|
<p>N = 178</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Mean time period after stroke (SD): 41.7 (7.7) days</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Person/participant generic health-related quality of life at <6 months</p>
|
|
<p>Pain at <6 months</p>
|
|
<p>Physical function – upper limb at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Outpatient follow up in China.</p>
|
|
<p>Funding: No additional information.</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zhou 2018<sup><a class="bibr" href="#niceng236er22.ref52" rid="niceng236er22.ref52">52</a></sup></td><td headers="hd_h_niceng236er22.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Neuromuscular electrical stimulation (NMES)</b> (n=36)</p>
|
|
<p>Neuromuscular electrical stimulation applied over 20 sessions of 1 hour stimulation conducted daily for 4 weeks.</p>
|
|
<p><b>Transcutaneous electrical nerve stimulation (TENS)</b> (n=36)</p>
|
|
<p>Transcutaneous electrical nerve stimulation applied for 20 sessions of 1 hour stimulation conducted daily for 4 weeks.</p>
|
|
<p><b>Usual care or no treatment</b> (n=18)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>People in all groups underwent a standardized rehabilitation program, which was delivered by occupational therapists and physical therapists.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>People after a first or recurrent stroke</b>
|
|
</p>
|
|
<p>Mean age (SD): 59.9 (10.4) years.</p>
|
|
<p>N = 90</p>
|
|
<p>Previous shoulder pathology: No previous shoulder pathology.</p>
|
|
<p>Time period after stroke: 91.0 (98.5) days.</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at <6 months</p>
|
|
<p>Physical function – upper limb at <6 months</p>
|
|
<p>Activities of daily living at <6 months</p>
|
|
<p>Stroke-specific Patient-Reported Outcome Measures at <6 months</p>
|
|
</td><td headers="hd_h_niceng236er22.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Background rate of oral drug use: Not reported.</p>
|
|
<p>Setting: Outpatient follow up in China.</p>
|
|
<p>Funding: Funding from the Research Fund of the Baoshan district of science and technology.</p>
|
|
</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab3"><div id="niceng236er22.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Summary matrix of the protocol interventions compared to placebo/sham</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_niceng236er22.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Outcome</th><th id="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Time period</th><th id="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Neuromuscular electrical stimulation (NMES)</th><th id="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Devices – tape</th><th id="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Acupuncture/dry needling</th><th id="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Electroacupuncture</th><th id="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intra-articular medicine injections - corticosteroids</th><th id="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Nerve blocks (local anaesthetic)</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Person/participant generic health-related quality of life</td><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Carer generic health-related quality of life</td><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Pain</td><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=14)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>4 studies (n=220)</p>
|
|
<p>Low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=53)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=32)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>2 studies (n=96)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>2 studies (n=84)</p>
|
|
<p>Low quality</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Physical function – upper limb</td><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=39)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=44)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Activities of daily living</td><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=44)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=53)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=58)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Stroke-specific Patient-Reported Outcome Measures</td><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=44)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events</td><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=48)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>3 studies (n=232)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=53)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=64)</p>
|
|
<p>Low quality</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab3_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab4"><div id="niceng236er22.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Summary matrix of the protocol interventions compared to usual care or no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab4_lrgtbl__"><table><thead><tr><th id="hd_h_niceng236er22.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Outcome</th><th id="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Time period</th><th id="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Transcutaneous electrical nerve stimulation (TENS)</th><th id="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Functional electrical stimulation (FES)</th><th id="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Neuromuscular electrical stimulation (NMES)</th><th id="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Devices - tape</th><th id="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Devices - slings</th><th id="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Devices - braces</th><th id="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Acupuncture/dry needling</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Person/participant generic health-related quality of life</td><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 outcomes</p>
|
|
<p>1 study (n=25)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=178)</p>
|
|
<p>Low quality</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Carer generic health-related quality of life</td><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Pain</td><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=54)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=21)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>3 studies (n=103)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>2 studies (n=67)</p>
|
|
<p>Low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>2 studies (n=78)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=41)</p>
|
|
<p>Low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>4 studies (n=344)</p>
|
|
<p>Very low quality</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Physical function – upper limb</td><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=54)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=21)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 outcomes</p>
|
|
<p>1 study (n=79)</p>
|
|
<p>Low-very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=28)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 outcomes</p>
|
|
<p>3 studies (n=328)</p>
|
|
<p>Very low quality</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Activities of daily living</td><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=54)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=21)</p>
|
|
<p>Low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>2 studies (n=78)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Stroke-specific Patient-Reported Outcome Measures</td><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=54)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=54)</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events</td><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=21)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=25)</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=32)</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=32)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=41)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>2 studies (n=66)</p>
|
|
<p>Very low quality</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab4_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab5"><div id="niceng236er22.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">Summary matrix of the protocol interventions compared to each other</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_niceng236er22.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Outcome</th><th id="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Time period</th><th id="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Transcutaneous electrical nerve stimulation (TENS) compared to neuromuscular electrical stimulation (NMES)</th><th id="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Devices – slings compared to neuromuscular electrical stimulation (NMES)</th><th id="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Nerve blocks (local anaesthetic) compared to transcutaneous electrical nerve stimulation (TENS)</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Person/participant generic health-related quality of life</td><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Carer generic health-related quality of life</td><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Pain</td><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>2 studies (n=110)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=61)</p>
|
|
<p>Low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=24)</p>
|
|
<p>Very low quality</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=61)</p>
|
|
<p>Low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Physical function – upper limb</td><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>2 studies (n=110)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Activities of daily living</td><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 outcome</p>
|
|
<p>1 study (n=72)</p>
|
|
<p>Very low quality</p>
|
|
</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Stroke-specific Patient-Reported Outcome Measures</td><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>1 outcome</p>
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<p>1 study (n=72)</p>
|
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<p>Very low quality</p>
|
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</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>1 outcome</p>
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<p>1 study (n=24)</p>
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<p>Very low quality</p>
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</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events</td><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>1 outcome</p>
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<p>1 study (n=38)</p>
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<p>Very low quality</p>
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</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng236er22.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">≥6 months</td><td headers="hd_h_niceng236er22.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng236er22.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab6"><div id="niceng236er22.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">Clinical evidence summary: transcutaneous electrical nerve stimulation (TENS) compared to neuromuscular electrical stimulation (NMES)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab6_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab6_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab6_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab6_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab6_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab6_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab6_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab6_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab6_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab6_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab6_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab6_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab6_1_1_1_5" id="hd_h_niceng236er22.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with neuromuscular electrical stimulation (NMES)</th><th headers="hd_h_niceng236er22.tab6_1_1_1_5" id="hd_h_niceng236er22.tab6_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Transcutaneous electrical nerve stimulation (TENS)</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (Numeric rating scale, 0–10, lower values are better, change score and final value) at <6 months</td><td headers="hd_h_niceng236er22.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">110 (2 RCTs) follow-up: mean 8 weeks</td><td headers="hd_h_niceng236er22.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
|
|
</td><td headers="hd_h_niceng236er22.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab6_1_1_1_5 hd_h_niceng236er22.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was 1.44</td><td headers="hd_h_niceng236er22.tab6_1_1_1_5 hd_h_niceng236er22.tab6_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>1.28 higher</b> (0.4 higher to 2.15 higher)</td><td headers="hd_h_niceng236er22.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.86 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function - upper limb (Fugl Meyer Assessment Upper Limb, 0–66, higher values are better, change score and final value) at <6 months</td><td headers="hd_h_niceng236er22.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">110 (2 RCTs) follow-up: mean 8 weeks</td><td headers="hd_h_niceng236er22.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
|
|
</td><td headers="hd_h_niceng236er22.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab6_1_1_1_5 hd_h_niceng236er22.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function - upper limb at <6 months was 25.5</td><td headers="hd_h_niceng236er22.tab6_1_1_1_5 hd_h_niceng236er22.tab6_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>0.62 higher</b> (9 lower to 10.25 higher)</td><td headers="hd_h_niceng236er22.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 6.6 (Fugl-Meyer upper extremity = Difference by 10% of the total scale)</td></tr><tr><td headers="hd_h_niceng236er22.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Activities of daily living (Barthel index, 0–100, higher values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72 (1 RCT) follow-up: 8 weeks</td><td headers="hd_h_niceng236er22.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
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<p>Very low<sub><sup>b</sup><sup>,</sup><sup>c</sup></sub></p>
|
|
</td><td headers="hd_h_niceng236er22.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab6_1_1_1_5 hd_h_niceng236er22.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean activities of daily living at <6 months was 11.67</td><td headers="hd_h_niceng236er22.tab6_1_1_1_5 hd_h_niceng236er22.tab6_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>3.15 higher</b> (35.78 lower to 42.08 higher)</td><td headers="hd_h_niceng236er22.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = Barthel Index 1.85 (established MID)</td></tr><tr><td headers="hd_h_niceng236er22.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stroke-specific Patient-Reported Outcome Measures (stroke specific quality of life, 49–245, higher values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72 (1 RCT) follow-up: 8 weeks</td><td headers="hd_h_niceng236er22.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>⨁◯◯◯</p>
|
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<p>Very low<sub><sup>b</sup><sup>,</sup><sup>c</sup></sub></p>
|
|
</td><td headers="hd_h_niceng236er22.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab6_1_1_1_5 hd_h_niceng236er22.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean stroke-specific Patient-Reported Outcome Measures at <6 months was 17.81</td><td headers="hd_h_niceng236er22.tab6_1_1_1_5 hd_h_niceng236er22.tab6_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>5.13 lower</b> (61.7 lower to 51.44 higher)</td><td headers="hd_h_niceng236er22.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 12.3 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events at <6 months</td><td headers="hd_h_niceng236er22.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38 (1 RCT) follow-up: 8 weeks</td><td headers="hd_h_niceng236er22.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>d</sup><sup>,</sup><sup>e</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RD 0.0 (−0.1 to 0.1)</td><td headers="hd_h_niceng236er22.tab6_1_1_1_5 hd_h_niceng236er22.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng236er22.tab6_1_1_1_5 hd_h_niceng236er22.tab6_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>0 fewer per 1,000</b> (100 fewer to 100 more)<sub><sup>f</sup></sub></td><td headers="hd_h_niceng236er22.tab6_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75–150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab6_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended intervention, bias due to missing outcome data and bias in measurement of the outcome)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab6_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng236er22.tab6_3"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended intervention and bias due to missing outcome data)</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng236er22.tab6_4"><p class="no_margin">Downgraded by 1 increment as the majority of the evidence was of high risk of bias (due to bias arising from the randomisation process)</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng236er22.tab6_5"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng236er22.tab6_6"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab7"><div id="niceng236er22.tab7" class="table"><h3><span class="label">Table 7</span><span class="title">Clinical evidence summary: transcutaneous electrical nerve stimulation (TENS) compared to usual care or no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab7_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab7_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab7_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab7_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab7_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab7_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab7_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab7_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab7_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab7_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab7_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab7_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab7_1_1_1_5" id="hd_h_niceng236er22.tab7_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with usual care or no treatment</th><th headers="hd_h_niceng236er22.tab7_1_1_1_5" id="hd_h_niceng236er22.tab7_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Transcutaneous electrical nerve stimulation (TENS)</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (Numeric rating scale, 0–10, lower values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54 (1 RCT) follow-up: 8 weeks</td><td headers="hd_h_niceng236er22.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
|
|
</td><td headers="hd_h_niceng236er22.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab7_1_1_1_5 hd_h_niceng236er22.tab7_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was −1.23</td><td headers="hd_h_niceng236er22.tab7_1_1_1_5 hd_h_niceng236er22.tab7_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>0.34 lower</b> (3.35 lower to 2.67 higher)</td><td headers="hd_h_niceng236er22.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.57 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function - upper limb (Fugl Meyer Assessment Upper Limb, 0–66, higher values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54 (1 RCT) follow-up: 8 weeks</td><td headers="hd_h_niceng236er22.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
|
|
</td><td headers="hd_h_niceng236er22.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab7_1_1_1_5 hd_h_niceng236er22.tab7_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function - upper limb at <6 months was 5.31</td><td headers="hd_h_niceng236er22.tab7_1_1_1_5 hd_h_niceng236er22.tab7_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>0.15 higher</b> (27.48 lower to 27.78 higher)</td><td headers="hd_h_niceng236er22.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 6.6 (Fugl-Meyer upper extremity = Difference by 10% of the total scale)</td></tr><tr><td headers="hd_h_niceng236er22.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Activities of daily living (Barthel index, 0–100, higher values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54 (1 RCT) follow-up: 8 weeks</td><td headers="hd_h_niceng236er22.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab7_1_1_1_5 hd_h_niceng236er22.tab7_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean activities of daily living at <6 months was 13.08</td><td headers="hd_h_niceng236er22.tab7_1_1_1_5 hd_h_niceng236er22.tab7_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>1.74 higher</b> (39.53 lower to 43.01 higher)</td><td headers="hd_h_niceng236er22.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = Barthel Index 1.85 (established MID)</td></tr><tr><td headers="hd_h_niceng236er22.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stroke-specific Patient-Reported Outcome Measures (stroke specific quality of life, 49–245, higher values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54 (1 RCT) follow-up: 8 weeks</td><td headers="hd_h_niceng236er22.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab7_1_1_1_5 hd_h_niceng236er22.tab7_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean stroke-specific Patient-Reported Outcome Measures at <6 months was 10.77</td><td headers="hd_h_niceng236er22.tab7_1_1_1_5 hd_h_niceng236er22.tab7_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>1.91 higher</b> (43.34 lower to 47.16 higher)</td><td headers="hd_h_niceng236er22.tab7_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 15.7 (0.5 × median baseline SD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab7__1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended intervention and bias due to missing outcome data)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab7__2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab8"><div id="niceng236er22.tab8" class="table"><h3><span class="label">Table 8</span><span class="title">Clinical evidence summary: functional electrical stimulation (FES) compared to usual care or no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab8_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab8_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab8_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab8_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab8_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab8_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab8_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab8_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab8_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab8_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab8_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab8_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab8_1_1_1_5" id="hd_h_niceng236er22.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with usual care or no treatment</th><th headers="hd_h_niceng236er22.tab8_1_1_1_5" id="hd_h_niceng236er22.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Functional electrical stimulation (FES)</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (numeric rating scale, 0–10, lower values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21 (1 RCT) follow-up: 4 weeks</td><td headers="hd_h_niceng236er22.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab8_1_1_1_5 hd_h_niceng236er22.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was 0.7</td><td headers="hd_h_niceng236er22.tab8_1_1_1_5 hd_h_niceng236er22.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>2.1 lower</b> (3.57 lower to 0.63 lower)</td><td headers="hd_h_niceng236er22.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 1.4 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function - upper limb (Fugl Meyer Assessment, 0–66, higher values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21 (1 RCT) follow-up: 4 weeks</td><td headers="hd_h_niceng236er22.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab8_1_1_1_5 hd_h_niceng236er22.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function - upper limb at <6 months was 12.3</td><td headers="hd_h_niceng236er22.tab8_1_1_1_5 hd_h_niceng236er22.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>2.8 lower</b> (16.19 lower to 10.59 higher)</td><td headers="hd_h_niceng236er22.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 6.6 (Fugl-Meyer upper extremity = Difference by 10% of the total scale)</td></tr><tr><td headers="hd_h_niceng236er22.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Activities of daily living (Functional Independence Measure, 18–126, higher values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21 (1 RCT) follow-up: 4 weeks</td><td headers="hd_h_niceng236er22.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>Low<sub><sup>a</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab8_1_1_1_5 hd_h_niceng236er22.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean activities of daily living at <6 months was −3.5</td><td headers="hd_h_niceng236er22.tab8_1_1_1_5 hd_h_niceng236er22.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>2.5 higher</b> (5.82 lower to 0.82 higher)</td><td headers="hd_h_niceng236er22.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 22 (Functional independence measure established MID)</td></tr><tr><td headers="hd_h_niceng236er22.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events at <6 months</td><td headers="hd_h_niceng236er22.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21 (1 RCT) follow-up: 4 weeks</td><td headers="hd_h_niceng236er22.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>c</sup><sup>,</sup><sup>d</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RD 0.00 (−0.17 to 0.17)</td><td headers="hd_h_niceng236er22.tab8_1_1_1_5 hd_h_niceng236er22.tab8_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng236er22.tab8_1_1_1_5 hd_h_niceng236er22.tab8_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>0 fewer per 1,000</b> (170 fewer to 170 more) <sub><sup>e</sup></sub></td><td headers="hd_h_niceng236er22.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75–150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab8_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias due to the randomisation process and bias in measurement of the outcome)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab8_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng236er22.tab8_3"><p class="no_margin">Downgraded by 1 increment as the majority of the evidence was of high risk of bias (due to bias due to the randomisation process)</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng236er22.tab8_4"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng236er22.tab8_5"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab9"><div id="niceng236er22.tab9" class="table"><h3><span class="label">Table 9</span><span class="title">Clinical evidence summary: neuromuscular electrical stimulation (NMES) compared to placebo/sham</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab9/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab9_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab9_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab9_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab9_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab9_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab9_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab9_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab9_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab9_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab9_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab9_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab9_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab9_1_1_1_5" id="hd_h_niceng236er22.tab9_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with placebo/sham</th><th headers="hd_h_niceng236er22.tab9_1_1_1_5" id="hd_h_niceng236er22.tab9_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Neuromuscular electrical stimulation (NMES)</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (numeric rating scale, 0–10, lower values are better, change score and final value) at <6 months</td><td headers="hd_h_niceng236er22.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32 (2 RCTs) follow-up: mean 14 weeks</td><td headers="hd_h_niceng236er22.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab9_1_1_1_5 hd_h_niceng236er22.tab9_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was 2.7</td><td headers="hd_h_niceng236er22.tab9_1_1_1_5 hd_h_niceng236er22.tab9_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>1.39 higher</b> (0.86 lower to 3.64 higher)</td><td headers="hd_h_niceng236er22.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 1.6 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function - upper limb (Fugl Meyer Upper Extremity, 0–66, higher values are better, change score and final value) at <6 months</td><td headers="hd_h_niceng236er22.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39 (2 RCTs) follow-up: mean 14 weeks</td><td headers="hd_h_niceng236er22.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup>,c</sub></p>
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</td><td headers="hd_h_niceng236er22.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab9_1_1_1_5 hd_h_niceng236er22.tab9_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function - upper limb at <6 months was 14.6</td><td headers="hd_h_niceng236er22.tab9_1_1_1_5 hd_h_niceng236er22.tab9_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>7.19 higher</b> (9.59 lower to 23.97 higher)</td><td headers="hd_h_niceng236er22.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 6.6 (10% of Fugl Meyer scale = established MID)</td></tr><tr><td headers="hd_h_niceng236er22.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Activities of daily living (functional independence living, 18–126, higher values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 (1 RCT) follow-up: 8 weeks</td><td headers="hd_h_niceng236er22.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab9_1_1_1_5 hd_h_niceng236er22.tab9_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean activities of daily living at <6 months was 14.9</td><td headers="hd_h_niceng236er22.tab9_1_1_1_5 hd_h_niceng236er22.tab9_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>16.98 higher</b> (2.92 higher to 31.04 higher)</td><td headers="hd_h_niceng236er22.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 9.5 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events at <6 months</td><td headers="hd_h_niceng236er22.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">76 (1 RCT) follow-up: mean 14 weeks</td><td headers="hd_h_niceng236er22.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup>,d,e</sub></p>
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</td><td headers="hd_h_niceng236er22.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RD 0.03 (−0.12 to 0.17)</td><td headers="hd_h_niceng236er22.tab9_1_1_1_5 hd_h_niceng236er22.tab9_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">105 per 1,000</td><td headers="hd_h_niceng236er22.tab9_1_1_1_5 hd_h_niceng236er22.tab9_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>30 more per 1,000</b> (120 fewer to 170 more) <sub>d</sub></td><td headers="hd_h_niceng236er22.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Precision calculated through Optimal Information Size (OIS) due to zero events in some studies. OIS determined power for the sample size = 0.07 (0.8–0.9 = serious, <0.8 = very serious).</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab9_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process and bias due to missing outcome data)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab9_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab10"><div id="niceng236er22.tab10" class="table"><h3><span class="label">Table 10</span><span class="title">Clinical evidence summary: neuromuscular electrical stimulation (NMES) compared to usual care or no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab10/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab10_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab10_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab10_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab10_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab10_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab10_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab10_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab10_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab10_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab10_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab10_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab10_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab10_1_1_1_5" id="hd_h_niceng236er22.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with usual care or no treatment</th><th headers="hd_h_niceng236er22.tab10_1_1_1_5" id="hd_h_niceng236er22.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Neuromuscular electrical stimulation (NMES)</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Person/participant generic health-related quality of life (SF-36 v2 physical component summary, 0–100, higher values are better, final value) at <6 months</td><td headers="hd_h_niceng236er22.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25 (1 RCT) follow-up: 16 weeks</td><td headers="hd_h_niceng236er22.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean person/participant generic health-related quality of life at <6 months was 33.8</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>0.3 higher</b> (8.99 lower to 9.59 higher)</td><td headers="hd_h_niceng236er22.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (SF-36 established MID)</td></tr><tr><td headers="hd_h_niceng236er22.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Person/participant generic health-related quality of life (SF-36 v2 mental component summary, 0–100, higher values are better, final value) at <6 months</td><td headers="hd_h_niceng236er22.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25 (1 RCT) follow-up: 16 weeks</td><td headers="hd_h_niceng236er22.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean person/participant generic health-related quality of life at <6 months was 52.3</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>6.3 higher</b> (6.48 lower to 19.08 higher)</td><td headers="hd_h_niceng236er22.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (SF-36 established MID)</td></tr><tr><td headers="hd_h_niceng236er22.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (visual analogue scale, numeric rating scale, worst pain 7 days, 0–100, lower values are better, change score and final values) at <6 months</td><td headers="hd_h_niceng236er22.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">103 (3 RCTs) follow-up: mean 9 weeks</td><td headers="hd_h_niceng236er22.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>b</sup><sup>,</sup><sup>c</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was 31.1</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>17.96 lower</b> (30.12 lower to 5.8 lower)</td><td headers="hd_h_niceng236er22.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 12.4 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function - upper limb (Fugl Meyer Assessment, 0–66, higher values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54 (1 RCT) follow-up: 8 weeks</td><td headers="hd_h_niceng236er22.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>b</sup><sup>,</sup><sup>d</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function - upper limb at <6 months was 5.31</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>0.45 lower</b> (24.38 lower to 23.48 higher)</td><td headers="hd_h_niceng236er22.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 6.6 (Fugl-Meyer upper extremity = Difference by 10% of the total scale)</td></tr><tr><td headers="hd_h_niceng236er22.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function - upper limb (Fugl Meyer Assessment, 0–100, higher values are better, final value) at <6 months</td><td headers="hd_h_niceng236er22.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25 (1 RCT) follow-up: 16 weeks</td><td headers="hd_h_niceng236er22.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>Low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function - upper limb at <6 months was 41.5</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>35.4 higher</b> (6.91 lower to 77.71 higher)</td><td headers="hd_h_niceng236er22.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 10 (Fugl-Meyer upper extremity = Difference by 10% of the total scale)</td></tr><tr><td headers="hd_h_niceng236er22.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Activities of daily living (Barthel index, shoulder disability questionnaire, 0–100, higher values are better, change score and final value) at <6 months</td><td headers="hd_h_niceng236er22.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">78 (2 RCTs) follow-up: mean 6 weeks</td><td headers="hd_h_niceng236er22.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>b</sup><sup>,</sup><sup>c</sup><sup>,</sup><sup>e</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean activities of daily living at <6 months was 37.6</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>14.9 higher</b> (17.35 lower to 47.15 higher)</td><td headers="hd_h_niceng236er22.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 12.7 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stroke-specific Patient-Reported Outcome Measures (Stroke specific quality of life, 49–245, higher values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54 (1 RCT) follow-up: 8 weeks</td><td headers="hd_h_niceng236er22.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>b</sup><sup>,</sup><sup>d</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean stroke-specific Patient-Reported Outcome Measures at <6 months was 10.77</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>7.04 higher</b> (41.59 lower to 55.67 higher)</td><td headers="hd_h_niceng236er22.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 12.5 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events at <6 months</td><td headers="hd_h_niceng236er22.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25 (1 RCT) follow-up: 16 weeks</td><td headers="hd_h_niceng236er22.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>Low<sub><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.46 (0.05 to 4.46)</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">167 per 1,000</td><td headers="hd_h_niceng236er22.tab10_1_1_1_5 hd_h_niceng236er22.tab10_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>90 fewer per 1,000</b> (158 fewer to 577 more)</td><td headers="hd_h_niceng236er22.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID (precision) = RR 0.80 – 1.25.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab10_1"><p class="no_margin">Downgraded by 1 increment as the majority of the evidence was of high risk of bias (due to bias arising from the randomisation process)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab10_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng236er22.tab10_3"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions, bias due to missing outcome data and bias in measurement of the outcome)</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng236er22.tab10_4"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions and bias due to missing outcome data)</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng236er22.tab10_5"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab11"><div id="niceng236er22.tab11" class="table"><h3><span class="label">Table 11</span><span class="title">Clinical evidence summary: devices – tape compared to placebo/sham</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab11/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab11_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab11_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab11_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab11_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab11_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab11_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab11_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab11_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab11_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab11_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab11_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab11_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab11_1_1_1_5" id="hd_h_niceng236er22.tab11_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with placebo/sham</th><th headers="hd_h_niceng236er22.tab11_1_1_1_5" id="hd_h_niceng236er22.tab11_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Devices - tape</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (visual analogue scale, numeric rating scale, 0–100, lower values are better, change scores and final values) at <6 months</td><td headers="hd_h_niceng236er22.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">220 (4 RCTs) follow-up: mean 4 weeks</td><td headers="hd_h_niceng236er22.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>Low<sub><sup>a</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab11_1_1_1_5 hd_h_niceng236er22.tab11_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab11_1_1_1_5 hd_h_niceng236er22.tab11_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>14.11 lower</b> (18.32 lower to 9.91 lower)</td><td headers="hd_h_niceng236er22.tab11_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 9.1 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function - upper limb (Fugl Meyer Assessment, 0–66, higher values are better, final value) at <6 months</td><td headers="hd_h_niceng236er22.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44 (1 RCT) follow-up: 3 weeks</td><td headers="hd_h_niceng236er22.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab11_1_1_1_5 hd_h_niceng236er22.tab11_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function - upper limb at <6 months was 16.4</td><td headers="hd_h_niceng236er22.tab11_1_1_1_5 hd_h_niceng236er22.tab11_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>0</b> (11.14 lower to 11.14 higher)</td><td headers="hd_h_niceng236er22.tab11_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 6.6 (Fugl-Meyer upper extremity = Difference by 10% of the total scale)</td></tr><tr><td headers="hd_h_niceng236er22.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Activities of daily living (Barthel index, 0–100, higher values are better, final value) at <6 months</td><td headers="hd_h_niceng236er22.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44 (1 RCT) follow-up: 3 weeks</td><td headers="hd_h_niceng236er22.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab11_1_1_1_5 hd_h_niceng236er22.tab11_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean activities of daily living at <6 months was 58.3</td><td headers="hd_h_niceng236er22.tab11_1_1_1_5 hd_h_niceng236er22.tab11_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>5.5 higher</b> (7.24 lower to 18.24 higher)</td><td headers="hd_h_niceng236er22.tab11_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = Barthel Index 1.85 (established MID)</td></tr><tr><td headers="hd_h_niceng236er22.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stroke-specific Patient-Reported Outcome Measures (Stroke specific quality of life, 49–245, higher values are better, final value) at <6 months</td><td headers="hd_h_niceng236er22.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44 (1 RCT) follow-up: 3 weeks</td><td headers="hd_h_niceng236er22.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab11_1_1_1_5 hd_h_niceng236er22.tab11_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean stroke-specific Patient-Reported Outcome Measures at <6 months was 152.7</td><td headers="hd_h_niceng236er22.tab11_1_1_1_5 hd_h_niceng236er22.tab11_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>7.5 higher</b> (6.97 lower to 21.97 higher)</td><td headers="hd_h_niceng236er22.tab11_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 9.9 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events at <6 months</td><td headers="hd_h_niceng236er22.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">232 (3 RCTs) follow-up: mean 3 weeks</td><td headers="hd_h_niceng236er22.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>c</sup><sup>,</sup><sup>d</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RD −0.03 (−0.16 to 0.09)</td><td headers="hd_h_niceng236er22.tab11_1_1_1_5 hd_h_niceng236er22.tab11_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">88 per 1,000</td><td headers="hd_h_niceng236er22.tab11_1_1_1_5 hd_h_niceng236er22.tab11_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>30 more per 1,000</b> (160 fewer to 90 more)<sub><sup>e</sup></sub></td><td headers="hd_h_niceng236er22.tab11_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Precision calculated through Optimal Information Size (OIS) due to zero events in some studies. OIS determined power for the sample size = 0.07 (0.8–0.9 = serious, <0.8 = very serious).</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab11_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions, and bias due to missing outcome data)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab11_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng236er22.tab11_3"><p class="no_margin">Downgraded for heterogeneity due to conflicting number of events in different studies (zero events in one or more studies)</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng236er22.tab11_4"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng236er22.tab11_5"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab12"><div id="niceng236er22.tab12" class="table"><h3><span class="label">Table 12</span><span class="title">Clinical evidence summary: devices – tape compared to usual care or no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab12/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab12_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab12_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab12_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab12_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab12_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab12_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab12_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab12_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab12_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab12_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab12_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab12_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab12_1_1_1_5" id="hd_h_niceng236er22.tab12_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with usual care or no treatment</th><th headers="hd_h_niceng236er22.tab12_1_1_1_5" id="hd_h_niceng236er22.tab12_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Devices - tape</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab12_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (visual analogue scale, 0–10, lower values are better, change score and final value) at <6 months</td><td headers="hd_h_niceng236er22.tab12_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67 (2 RCTs) follow-up: mean 8 weeks</td><td headers="hd_h_niceng236er22.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>Low<sub><sup>a</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab12_1_1_1_5 hd_h_niceng236er22.tab12_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was 4.65</td><td headers="hd_h_niceng236er22.tab12_1_1_1_5 hd_h_niceng236er22.tab12_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>1.8 lower</b> (2.46 lower to 1.14 lower)</td><td headers="hd_h_niceng236er22.tab12_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.8 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab12_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events at <6 months</td><td headers="hd_h_niceng236er22.tab12_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32 (1 RCT) follow-up: 8 weeks</td><td headers="hd_h_niceng236er22.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>b</sup><sup>,</sup><sup>c</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RD 0.00 (−0.11 to 0.11)</td><td headers="hd_h_niceng236er22.tab12_1_1_1_5 hd_h_niceng236er22.tab12_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng236er22.tab12_1_1_1_5 hd_h_niceng236er22.tab12_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>0 fewer per 1,000</b> (110 fewer to 110 more)</td><td headers="hd_h_niceng236er22.tab12_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75–150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab12_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions, bias due to missing outcome data and bias in measurement of the outcome)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab12_2"><p class="no_margin">Downgraded by 1 increment as the majority of the evidence was of high risk of bias (due to bias due to deviations from the intended interventions)</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng236er22.tab12_3"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab13"><div id="niceng236er22.tab13" class="table"><h3><span class="label">Table 13</span><span class="title">Clinical evidence summary: devices – slings compared to neuromuscular electrical stimulation (NMES)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab13/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab13_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab13_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab13_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab13_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab13_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab13_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab13_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab13_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab13_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab13_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab13_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab13_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab13_1_1_1_5" id="hd_h_niceng236er22.tab13_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with neuromuscular electrical stimulation (NMES)</th><th headers="hd_h_niceng236er22.tab13_1_1_1_5" id="hd_h_niceng236er22.tab13_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Devices - slings</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (brief pain inventory question 12/numeric rating scale, 0–10, lower values are better, change scores) at <6 months</td><td headers="hd_h_niceng236er22.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61 (1 RCT) follow-up: 18 weeks</td><td headers="hd_h_niceng236er22.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>Low<sub><sup>a</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab13_1_1_1_5 hd_h_niceng236er22.tab13_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was −4.44</td><td headers="hd_h_niceng236er22.tab13_1_1_1_5 hd_h_niceng236er22.tab13_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>3.76 higher</b> (2.32 higher to 5.2 higher)</td><td headers="hd_h_niceng236er22.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 1.1 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (brief pain inventory question 12/numeric rating scale, 0–10, lower values are better, change scores) at ≥6 months</td><td headers="hd_h_niceng236er22.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61 (1 RCT) follow-up: 12 months</td><td headers="hd_h_niceng236er22.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>Low<sub><sup>a</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab13_1_1_1_5 hd_h_niceng236er22.tab13_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at ≥6 months was −5</td><td headers="hd_h_niceng236er22.tab13_1_1_1_5 hd_h_niceng236er22.tab13_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>2.69 higher</b> (1.27 higher to 4.11 higher)</td><td headers="hd_h_niceng236er22.tab13_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 1.1 (0.5 × median baseline SD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab13_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process and bias due to missing outcome data)</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab14"><div id="niceng236er22.tab14" class="table"><h3><span class="label">Table 14</span><span class="title">Clinical evidence summary: devices – slings compared to usual care or no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab14/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab14_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab14_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab14_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab14_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab14_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab14_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab14_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab14_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab14_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab14_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab14_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab14_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab14_1_1_1_5" id="hd_h_niceng236er22.tab14_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with usual care or no treatment</th><th headers="hd_h_niceng236er22.tab14_1_1_1_5" id="hd_h_niceng236er22.tab14_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Devices - slings</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (visual analogue scale, 0–10, lower values are better, final values) at <6 months</td><td headers="hd_h_niceng236er22.tab14_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">78 (2 RCTs)</td><td headers="hd_h_niceng236er22.tab14_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab14_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab14_1_1_1_5 hd_h_niceng236er22.tab14_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was 4.14</td><td headers="hd_h_niceng236er22.tab14_1_1_1_5 hd_h_niceng236er22.tab14_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>0.31 lower</b> (2.2 lower to 1.59 higher)</td><td headers="hd_h_niceng236er22.tab14_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 1.2 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function - upper limb (Fugl Meyer Assessment, 0–66, higher values are better, final values) at <6 months</td><td headers="hd_h_niceng236er22.tab14_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28 (1 RCT) follow-up: 6 weeks</td><td headers="hd_h_niceng236er22.tab14_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>c</sup><sup>,</sup><sup>d</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab14_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab14_1_1_1_5 hd_h_niceng236er22.tab14_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function - upper limb at <6 months was 12.78</td><td headers="hd_h_niceng236er22.tab14_1_1_1_5 hd_h_niceng236er22.tab14_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>2.34 lower</b> (11.26 lower to 6.58 higher)</td><td headers="hd_h_niceng236er22.tab14_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 6.6 (Fugl-Meyer upper extremity = Difference by 10% of the total scale)</td></tr><tr><td headers="hd_h_niceng236er22.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events at <6 months</td><td headers="hd_h_niceng236er22.tab14_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32 (1 RCT) follow-up: 6 weeks</td><td headers="hd_h_niceng236er22.tab14_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>c</sup><sup>,</sup><sup>e</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab14_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Peto OR 4.59 (0.07 to 284.41)</td><td headers="hd_h_niceng236er22.tab14_1_1_1_5 hd_h_niceng236er22.tab14_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng236er22.tab14_1_1_1_5 hd_h_niceng236er22.tab14_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>50 more per 1,000</b> (110 fewer to 20 more)<sub><sup>f</sup></sub></td><td headers="hd_h_niceng236er22.tab14_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID (precision) = Peto OR 0.80 – 1.25.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab14_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions, bias due to missing outcome data, bias in measurement of the outcome and bias in selection of the reported result)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab14_2"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng236er22.tab14_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng236er22.tab14_4"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions and bias in measurement of the outcome)</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng236er22.tab14_5"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process and bias due to deviations from the intended interventions)</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng236er22.tab14_6"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab15"><div id="niceng236er22.tab15" class="table"><h3><span class="label">Table 15</span><span class="title">Clinical evidence summary: devices – braces compared to usual care or no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab15/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab15_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab15_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab15_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab15_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab15_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab15_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab15_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab15_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab15_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab15_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab15_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab15_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab15_1_1_1_5" id="hd_h_niceng236er22.tab15_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with usual care or no treatment</th><th headers="hd_h_niceng236er22.tab15_1_1_1_5" id="hd_h_niceng236er22.tab15_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Devices - braces</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab15_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (Shoulder Hand Syndrome score pain subscale, 0–5, lower values are better, final value) at <6 months</td><td headers="hd_h_niceng236er22.tab15_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41 (1 RCT) follow-up: 4 weeks</td><td headers="hd_h_niceng236er22.tab15_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>Low<sub><sup>a</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab15_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab15_1_1_1_5 hd_h_niceng236er22.tab15_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was 1.8</td><td headers="hd_h_niceng236er22.tab15_1_1_1_5 hd_h_niceng236er22.tab15_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>1.4 lower</b> (1.9 lower to 0.9 lower)</td><td headers="hd_h_niceng236er22.tab15_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.53 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab15_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events at <6 months</td><td headers="hd_h_niceng236er22.tab15_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41 (1 RCT) follow-up: 4 weeks</td><td headers="hd_h_niceng236er22.tab15_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>b</sup><sup>,</sup><sup>c</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab15_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">OR 7.77 (0.15 to 391.93)</td><td headers="hd_h_niceng236er22.tab15_1_1_1_5 hd_h_niceng236er22.tab15_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng236er22.tab15_1_1_1_5 hd_h_niceng236er22.tab15_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>50 more per 1,000</b> (80 fewer to 180 more)<sub><sup>d</sup></sub></td><td headers="hd_h_niceng236er22.tab15_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID (precision) = Peto OR 0.80 – 1.25.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab15_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias due to missing outcome data and bias in measurement of the outcome)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab15_2"><p class="no_margin">Downgraded by 1 increment as the majority of the evidence was of high risk of bias (due to bias due to missing outcome data)</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng236er22.tab15_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng236er22.tab15_4"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab16"><div id="niceng236er22.tab16" class="table"><h3><span class="label">Table 16</span><span class="title">Clinical evidence summary: acupuncture/dry needling compared to placebo/sham</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab16/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab16_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab16_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab16_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab16_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab16_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab16_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab16_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab16_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab16_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab16_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab16_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab16_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab16_1_1_1_5" id="hd_h_niceng236er22.tab16_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with placebo/sham</th><th headers="hd_h_niceng236er22.tab16_1_1_1_5" id="hd_h_niceng236er22.tab16_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Acupuncture/dry needling</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab16_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (visual analogue scale, 0–10, lower values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab16_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53 (1 RCT) follow-up: 4 weeks</td><td headers="hd_h_niceng236er22.tab16_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab16_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab16_1_1_1_5 hd_h_niceng236er22.tab16_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was −1.65</td><td headers="hd_h_niceng236er22.tab16_1_1_1_5 hd_h_niceng236er22.tab16_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>1.35 lower</b> (2.92 lower to 0.22 higher)</td><td headers="hd_h_niceng236er22.tab16_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.97 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab16_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Activities of daily living (Korean modified Barthel index, 0–100, higher values are better, final value) at <6 months</td><td headers="hd_h_niceng236er22.tab16_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53 (1 RCT) follow-up: 4 weeks</td><td headers="hd_h_niceng236er22.tab16_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab16_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab16_1_1_1_5 hd_h_niceng236er22.tab16_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean activities of daily living at <6 months was 71.31</td><td headers="hd_h_niceng236er22.tab16_1_1_1_5 hd_h_niceng236er22.tab16_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>7.75 lower</b> (17.56 lower to 2.06 higher)</td><td headers="hd_h_niceng236er22.tab16_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = Barthel Index 1.85 (established MID)</td></tr><tr><td headers="hd_h_niceng236er22.tab16_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events at <6 months</td><td headers="hd_h_niceng236er22.tab16_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53 (1 RCT) follow-up: 4 weeks</td><td headers="hd_h_niceng236er22.tab16_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>c</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab16_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RD 0.00 (−0.07 to 0.07)</td><td headers="hd_h_niceng236er22.tab16_1_1_1_5 hd_h_niceng236er22.tab16_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng236er22.tab16_1_1_1_5 hd_h_niceng236er22.tab16_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>0 fewer per 1,000</b> (70 fewer to 70 more)<sub><sup>d</sup></sub></td><td headers="hd_h_niceng236er22.tab16_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75–150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab16_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process and bias due to missing outcome data)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab16_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng236er22.tab16_3"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng236er22.tab16_4"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab17"><div id="niceng236er22.tab17" class="table"><h3><span class="label">Table 17</span><span class="title">Clinical evidence summary: acupuncture/dry needling compared to usual care or no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab17/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab17_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab17_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab17_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab17_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab17_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab17_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab17_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab17_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab17_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab17_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab17_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab17_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab17_1_1_1_5" id="hd_h_niceng236er22.tab17_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with usual care or no treatment</th><th headers="hd_h_niceng236er22.tab17_1_1_1_5" id="hd_h_niceng236er22.tab17_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Acupuncture/dry needling</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Person/participant generic health-related quality of life (quality of life scale, unclear scale range, higher values are better, final values) at <6 months</td><td headers="hd_h_niceng236er22.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">178 (1 RCT) follow-up: 4 weeks</td><td headers="hd_h_niceng236er22.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>Low<sub><sup>a</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab17_1_1_1_5 hd_h_niceng236er22.tab17_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean person/participant generic health-related quality of life at <6 months was 76.68</td><td headers="hd_h_niceng236er22.tab17_1_1_1_5 hd_h_niceng236er22.tab17_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>23.83 higher</b> (19.96 higher to 27.7 higher)</td><td headers="hd_h_niceng236er22.tab17_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 13.9 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (visual analogue scale, numeric rating scale, 0–10, lower values are better, change scores and final value) at <6 months</td><td headers="hd_h_niceng236er22.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">344 (4 RCTs) follow-up: mean 3 weeks</td><td headers="hd_h_niceng236er22.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab17_1_1_1_5 hd_h_niceng236er22.tab17_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was 2.72</td><td headers="hd_h_niceng236er22.tab17_1_1_1_5 hd_h_niceng236er22.tab17_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>1.78 lower</b> (3.48 lower to 0.08 lower)</td><td headers="hd_h_niceng236er22.tab17_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.68 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function - upper limb (Fugl Meyer Assessment, 0–66, higher values are better, change scores) at <6 months</td><td headers="hd_h_niceng236er22.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">227 (2 RCTs) follow-up: mean 3 weeks</td><td headers="hd_h_niceng236er22.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>c</sup><sup>,</sup><sup>d</sup><sup>,</sup><sup>e</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab17_1_1_1_5 hd_h_niceng236er22.tab17_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function - upper limb at <6 months was 7.58</td><td headers="hd_h_niceng236er22.tab17_1_1_1_5 hd_h_niceng236er22.tab17_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>2.9 higher</b> (2.91 lower to 8.71 higher)</td><td headers="hd_h_niceng236er22.tab17_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 6.6 (Fugl-Meyer upper extremity = Difference by 10% of the total scale)</td></tr><tr><td headers="hd_h_niceng236er22.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function - upper limb (Rivermead Motricity Index Effectiveness, 0–100, higher values are better, final value) at <6 months</td><td headers="hd_h_niceng236er22.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">101 (1 RCT) follow-up: 3 weeks</td><td headers="hd_h_niceng236er22.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>c</sup><sup>,</sup><sup>f</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab17_1_1_1_5 hd_h_niceng236er22.tab17_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function - upper limb at <6 months was 47.54</td><td headers="hd_h_niceng236er22.tab17_1_1_1_5 hd_h_niceng236er22.tab17_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>2.47 higher</b> (3.96 lower to 8.9 higher)</td><td headers="hd_h_niceng236er22.tab17_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 7.69 (0.5 × median control group SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events at <6 months</td><td headers="hd_h_niceng236er22.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66 (2 RCTs) follow-up: mean 2 weeks</td><td headers="hd_h_niceng236er22.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>b</sup><sup>,</sup><sup>g</sup><sup>,</sup><sup>h</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RD −0.03 (−0.13 to 0.07)</td><td headers="hd_h_niceng236er22.tab17_1_1_1_5 hd_h_niceng236er22.tab17_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30 per 1,000</td><td headers="hd_h_niceng236er22.tab17_1_1_1_5 hd_h_niceng236er22.tab17_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>31 fewer per 1,000</b> (34 fewer to 28 fewer).</td><td headers="hd_h_niceng236er22.tab17_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Precision calculated through Optimal Information Size (OIS) due to zero events in some studies. OIS determined power for the sample size = 0.29 (0.8–0.9 = serious, <0.8 = very serious).</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab17_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions, bias due to missing outcome data and bias in measurement of the outcome)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab17_2"><p class="no_margin">Downgraded for heterogeneity due to conflicting number of events in different studies (zero events in one or more studies)</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng236er22.tab17_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng236er22.tab17_4"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to missing outcome data and bias in measurement of the outcome)</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng236er22.tab17_5"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng236er22.tab17_6"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process and bias in measurement of the outcome)</p></div></dd></dl><dl class="bkr_refwrap"><dt>g</dt><dd><div id="niceng236er22.tab17_7"><p class="no_margin">Downgraded by 1 increment as the majority of the evidence was of high risk of bias (due to bias arising from the randomisation process)</p></div></dd></dl><dl class="bkr_refwrap"><dt>h</dt><dd><div id="niceng236er22.tab17_8"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl><dl class="bkr_refwrap"><dt>i</dt><dd><div id="niceng236er22.tab17_9"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab18"><div id="niceng236er22.tab18" class="table"><h3><span class="label">Table 18</span><span class="title">Clinical evidence summary: electroacupuncture compared to placebo/sham</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab18/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab18_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab18_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab18_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab18_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab18_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab18_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab18_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab18_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab18_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab18_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab18_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab18_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab18_1_1_1_5" id="hd_h_niceng236er22.tab18_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with placebo/sham</th><th headers="hd_h_niceng236er22.tab18_1_1_1_5" id="hd_h_niceng236er22.tab18_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Electroacupuncture</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (visual analogue scale, 0–10, lower values are better, final values) at <6 months</td><td headers="hd_h_niceng236er22.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32 (1 RCT) follow-up: 2 weeks</td><td headers="hd_h_niceng236er22.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab18_1_1_1_5 hd_h_niceng236er22.tab18_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was 2.93</td><td headers="hd_h_niceng236er22.tab18_1_1_1_5 hd_h_niceng236er22.tab18_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>0.93 lower</b> (1.72 lower to 0.14 lower)</td><td headers="hd_h_niceng236er22.tab18_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.64 (0.5 × median baseline SD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab18_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions and bias in measurement of the outcome)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab18_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab19"><div id="niceng236er22.tab19" class="table"><h3><span class="label">Table 19</span><span class="title">Clinical evidence summary: intra-articular medicine injections – corticosteroids compared to placebo/sham</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab19/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab19_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab19_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab19_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab19_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab19_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab19_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab19_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab19_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab19_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab19_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab19_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab19_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab19_1_1_1_5" id="hd_h_niceng236er22.tab19_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with placebo/sham</th><th headers="hd_h_niceng236er22.tab19_1_1_1_5" id="hd_h_niceng236er22.tab19_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Intra-articular medicine injections - corticosteroids</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab19_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (visual analogue scale, 0–10, lower values are better, change score and final value) at <6 months</td><td headers="hd_h_niceng236er22.tab19_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">96 (2 RCTs) follow-up: mean 6 weeks</td><td headers="hd_h_niceng236er22.tab19_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab19_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab19_1_1_1_5 hd_h_niceng236er22.tab19_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was 2.86</td><td headers="hd_h_niceng236er22.tab19_1_1_1_5 hd_h_niceng236er22.tab19_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>1.26 lower</b> (2.34 lower to 0.17 lower)</td><td headers="hd_h_niceng236er22.tab19_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.78 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab19_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Activities of daily living (Barthel index, 0–100, higher values are better, final value) at <6 months</td><td headers="hd_h_niceng236er22.tab19_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58 (1 RCT) follow-up: mean 8 weeks</td><td headers="hd_h_niceng236er22.tab19_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>c</sup><sup>,</sup><sup>d</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab19_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab19_1_1_1_5 hd_h_niceng236er22.tab19_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean activities of daily living at <6 months was 72.7</td><td headers="hd_h_niceng236er22.tab19_1_1_1_5 hd_h_niceng236er22.tab19_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>4.8 higher</b> (6.42 lower to 16.02 higher)</td><td headers="hd_h_niceng236er22.tab19_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = Barthel Index 1.85 (established MID)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab19_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process, bias due to deviations from the intended interventions, bias due to missing outcome data and bias in measurement of the outcome)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab19_2"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng236er22.tab19_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng236er22.tab19_4"><p class="no_margin">Downgraded by 1 increment as the majority of the evidence was of high risk of bias (due to bias arising from the randomisation process)</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab20"><div id="niceng236er22.tab20" class="table"><h3><span class="label">Table 20</span><span class="title">Clinical evidence summary: nerve blocks (local anaesthetic) compared to transcutaneous electrical nerve stimulation (TENS)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab20/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab20_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab20_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab20_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab20_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab20_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab20_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab20_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab20_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab20_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab20_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab20_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab20_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab20_1_1_1_5" id="hd_h_niceng236er22.tab20_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with Transcutaneous electrical nerve stimulation (TENS)</th><th headers="hd_h_niceng236er22.tab20_1_1_1_5" id="hd_h_niceng236er22.tab20_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Nerve blocks (local anaesthetic)</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab20_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0–100, lower values are better, change score) at <6 months</td><td headers="hd_h_niceng236er22.tab20_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24 (1 RCT) follow-up: 3 weeks</td><td headers="hd_h_niceng236er22.tab20_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab20_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab20_1_1_1_5 hd_h_niceng236er22.tab20_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was −30</td><td headers="hd_h_niceng236er22.tab20_1_1_1_5 hd_h_niceng236er22.tab20_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>25.8 lower</b> (50.2 lower to 1.4 lower)</td><td headers="hd_h_niceng236er22.tab20_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 12.9 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab20_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stroke-specific Patient-Reported Outcome Measures (SS-QOL, 0–100, higher values are better, change scores) at <6 months</td><td headers="hd_h_niceng236er22.tab20_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24 (1 RCT) follow-up: 3 weeks</td><td headers="hd_h_niceng236er22.tab20_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>Very low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab20_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab20_1_1_1_5 hd_h_niceng236er22.tab20_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean stroke-specific Patient-Reported Outcome Measures at <6 months was 2.1</td><td headers="hd_h_niceng236er22.tab20_1_1_1_5 hd_h_niceng236er22.tab20_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>3.2 higher</b> (0.11 higher to 6.29 higher)</td><td headers="hd_h_niceng236er22.tab20_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3.2 (0.5 × median baseline SD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab20_1"><p class="no_margin">Downgraded by 2 increments as the majority of the evidence was of very high risk of bias (due to bias arising from the randomisation process and bias in measurement of the outcome)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab20_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab21"><div id="niceng236er22.tab21" class="table"><h3><span class="label">Table 21</span><span class="title">Clinical evidence summary: nerve blocks (local anaesthetic) compared to placebo/sham</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab21/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab21_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab21_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab21_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng236er22.tab21_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab21_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng236er22.tab21_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab21_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng236er22.tab21_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab21_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng236er22.tab21_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng236er22.tab21_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng236er22.tab21_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng236er22.tab21_1_1_1_5" id="hd_h_niceng236er22.tab21_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with placebo/sham</th><th headers="hd_h_niceng236er22.tab21_1_1_1_5" id="hd_h_niceng236er22.tab21_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Nerve blocks (local anaesthetic)</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab21_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (visual analogue scale, 0–100, lower values are better, final values) at <6 months</td><td headers="hd_h_niceng236er22.tab21_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">84 (2 RCTs) follow-up: mean 8 weeks</td><td headers="hd_h_niceng236er22.tab21_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>Low<sub><sup>a</sup><sup>,</sup><sup>b</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab21_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng236er22.tab21_1_1_1_5 hd_h_niceng236er22.tab21_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain at <6 months was 50.6</td><td headers="hd_h_niceng236er22.tab21_1_1_1_5 hd_h_niceng236er22.tab21_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MD <b>17.25 lower</b> (28.87 lower to 5.63 lower)</td><td headers="hd_h_niceng236er22.tab21_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 10.1 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng236er22.tab21_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Withdrawal due to adverse events at <6 months</td><td headers="hd_h_niceng236er22.tab21_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64 (1 RCT) follow-up: 12 weeks</td><td headers="hd_h_niceng236er22.tab21_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>Low<sub><sup>c</sup></sub></p>
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</td><td headers="hd_h_niceng236er22.tab21_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RD 0.00 (−0.06 to 0.06)</td><td headers="hd_h_niceng236er22.tab21_1_1_1_5 hd_h_niceng236er22.tab21_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng236er22.tab21_1_1_1_5 hd_h_niceng236er22.tab21_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>0 fewer per 1,000</b> (60 fewer to 60 more)<sub><sup>d</sup></sub></td><td headers="hd_h_niceng236er22.tab21_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75–150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng236er22.tab21_1"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng236er22.tab21_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng236er22.tab21_3"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng236er22.tab21_4"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab22"><div id="niceng236er22.tab22" class="table"><h3><span class="label">Table 22</span><span class="title">Unit costs of health care professionals who may be involved in delivering interventions to reduce shoulder pain</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab22/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab22_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Resource</th><th id="hd_h_niceng236er22.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost per working hour (hospital / community)<sup>(a)</sup></th><th id="hd_h_niceng236er22.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Source</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Band 6 PT/OT/SLT</td><td headers="hd_h_niceng236er22.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£53 / £55</td><td headers="hd_h_niceng236er22.tab22_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">PSSRU 2021<sup><a class="bibr" href="#niceng236er22.ref20" rid="niceng236er22.ref20">20</a></sup></td></tr><tr><td headers="hd_h_niceng236er22.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Band 7 PT/OT/SLT</td><td headers="hd_h_niceng236er22.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£64 / £67</td></tr><tr><td headers="hd_h_niceng236er22.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Band 6 nurse</td><td headers="hd_h_niceng236er22.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£54 / £58</td></tr><tr><td headers="hd_h_niceng236er22.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Band 7 nurse</td><td headers="hd_h_niceng236er22.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£64 / £69</td></tr><tr><td headers="hd_h_niceng236er22.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Specialty Registrar (48-hour work week, hospital only)</td><td headers="hd_h_niceng236er22.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">£69</td><td headers="hd_h_niceng236er22.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Abbreviations: OT= occupational therapist; PT= physiotherapist; PSSRU= Personal Social Services Research Unit; SLT= speech and language therapist.</p></div></dd></dl><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="niceng236er22.tab22_1"><p class="no_margin">Note: Costs per working hour include salary, salary oncosts, overheads (management and other non-care staff costs including administration and estates staff), capital overheads and qualification costs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab23"><div id="niceng236er22.tab23" class="table"><h3><span class="label">Table 23</span><span class="title">Equipment costs transcutaneous electrical nerve stimulation (TENS)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab23/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab23_lrgtbl__"><table><thead><tr><th id="hd_h_niceng236er22.tab23_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Resource</th><th id="hd_h_niceng236er22.tab23_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost</th><th id="hd_h_niceng236er22.tab23_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Source</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab23_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Direct TENS machine full kit including 4 electrodes/Dual channel TENS machine/TENS machine TPN 200 Plus</td><td headers="hd_h_niceng236er22.tab23_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£44.99/£31.10/£17.40</td><td headers="hd_h_niceng236er22.tab23_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Supply Chain Catalogue 2021<sup><a class="bibr" href="#niceng236er22.ref32" rid="niceng236er22.ref32">32</a></sup></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab24"><div id="niceng236er22.tab24" class="table"><h3><span class="label">Table 24</span><span class="title">Example equipment costs for electroacupuncture<sup>(a)</sup></span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab24/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab24_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab24_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Device details</th><th id="hd_h_niceng236er22.tab24_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Device cost</th><th id="hd_h_niceng236er22.tab24_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost of crocodile clips</th><th id="hd_h_niceng236er22.tab24_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost of lead cables</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab24_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">ES-160</td><td headers="hd_h_niceng236er22.tab24_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£395<sup><a class="bibr" href="#niceng236er22.ref13" rid="niceng236er22.ref13">13</a></sup></td><td headers="hd_h_niceng236er22.tab24_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£43.24<sup><a class="bibr" href="#niceng236er22.ref18" rid="niceng236er22.ref18">18</a>
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(b)</sup></td><td headers="hd_h_niceng236er22.tab24_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£59.50<sup><a class="bibr" href="#niceng236er22.ref12" rid="niceng236er22.ref12">12</a>
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(b)</sup></td></tr><tr><td headers="hd_h_niceng236er22.tab24_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">AS-super 4</td><td headers="hd_h_niceng236er22.tab24_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£240<sup><a class="bibr" href="#niceng236er22.ref11" rid="niceng236er22.ref11">11</a></sup></td><td headers="hd_h_niceng236er22.tab24_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£23<sup><a class="bibr" href="#niceng236er22.ref10" rid="niceng236er22.ref10">10</a>
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(c)</sup></td><td headers="hd_h_niceng236er22.tab24_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="niceng236er22.tab24_1"><p class="no_margin">Taken from online sources, excluding VAT.</p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="niceng236er22.tab24_2"><p class="no_margin">Cost of 10 units based on the assumption that 10 needles are utilised per session.</p></div></dd></dl><dl class="bkr_refwrap"><dt>(c)</dt><dd><div id="niceng236er22.tab24_3"><p class="no_margin">Clips and cables sold together.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab25"><div id="niceng236er22.tab25" class="table"><h3><span class="label">Table 25</span><span class="title">Example equipment costs of devices</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab25/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab25_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab25_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Item</th><th id="hd_h_niceng236er22.tab25_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Unit cost</th><th id="hd_h_niceng236er22.tab25_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Source</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab25_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Kinesiology sports tape 5.0cm × 5m<sup>(a)</sup></td><td headers="hd_h_niceng236er22.tab25_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">£2.14</td><td headers="hd_h_niceng236er22.tab25_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:bottom;">NHS Supply Chain Catalogue 2021<sup><a class="bibr" href="#niceng236er22.ref32" rid="niceng236er22.ref32">32</a></sup></td></tr><tr><td headers="hd_h_niceng236er22.tab25_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Actimove Sling Adjustable 3.6cm × 10.8m<sup>(b)</sup></td><td headers="hd_h_niceng236er22.tab25_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">£6.38</td></tr><tr><td headers="hd_h_niceng236er22.tab25_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Functional orthosis NeuroLux (Sporlastic GmbH, Nürtingen, Germany)<sup>(c)</sup></td><td headers="hd_h_niceng236er22.tab25_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">£212</td><td headers="hd_h_niceng236er22.tab25_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Vitego, 2022<sup><a class="bibr" href="#niceng236er22.ref43" rid="niceng236er22.ref43">43</a></sup>
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<sup>(d)</sup></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="niceng236er22.tab25_1"><p class="no_margin">Assumed to be similar to kinesiology tape described in Huang 2016<sup><a class="bibr" href="#niceng236er22.ref17" rid="niceng236er22.ref17">17</a></sup> and Huang 2017<sup><a class="bibr" href="#niceng236er22.ref16" rid="niceng236er22.ref16">16</a></sup></p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="niceng236er22.tab25_2"><p class="no_margin">Actimove sling was reported in van Bladel 2017<sup><a class="bibr" href="#niceng236er22.ref41" rid="niceng236er22.ref41">41</a></sup></p></div></dd></dl><dl class="bkr_refwrap"><dt>(c)</dt><dd><div id="niceng236er22.tab25_3"><p class="no_margin">Example of shoulder brace cost, reported (Hartwig 2012)<sup><a class="bibr" href="#niceng236er22.ref14" rid="niceng236er22.ref14">14</a></sup></p></div></dd></dl><dl class="bkr_refwrap"><dt>(d)</dt><dd><div id="niceng236er22.tab25_4"><p class="no_margin">Taken from online sources, excluding VAT.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab26"><div id="niceng236er22.tab26" class="table"><h3><span class="label">Table 26</span><span class="title">Unit costs of intra-articular medicine injections and nerve blocks (local anaesthetics)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab26/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab26_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Drug</th><th id="hd_h_niceng236er22.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Units/pack</th><th id="hd_h_niceng236er22.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost/pack<sup>(a)</sup></th><th id="hd_h_niceng236er22.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost per injection</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Corticosteroids</td><td headers="hd_h_niceng236er22.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng236er22.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng236er22.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng236er22.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Triamcinolone acetonide 40 mg per 1 ml<sup>(b)</sup></td><td headers="hd_h_niceng236er22.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_niceng236er22.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£7.45</td><td headers="hd_h_niceng236er22.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1.49</td></tr><tr><td headers="hd_h_niceng236er22.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Triamcinolone acetonide 10 mg per 1 ml<sup>(c)</sup></td><td headers="hd_h_niceng236er22.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng236er22.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£3.63</td><td headers="hd_h_niceng236er22.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£3.63</td></tr><tr><td headers="hd_h_niceng236er22.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methylprednisolone (as Methylprednisolone sodium succinate) 40 mg<sup>(d)</sup></td><td headers="hd_h_niceng236er22.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_niceng236er22.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1.58</td><td headers="hd_h_niceng236er22.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1.58</td></tr><tr><td headers="hd_h_niceng236er22.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Betamethasone (as Betamethasone sodium phosphate) 4 mg per 1 ml<sup>(e)</sup></td><td headers="hd_h_niceng236er22.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_niceng236er22.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£57.98</td><td headers="hd_h_niceng236er22.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£11.60</td></tr><tr><td headers="hd_h_niceng236er22.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nerve blocks</td><td headers="hd_h_niceng236er22.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng236er22.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng236er22.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng236er22.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bupivacaine hydrochloride 5 mg per 1 ml<sup>(d)</sup></td><td headers="hd_h_niceng236er22.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_niceng236er22.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£7.56</td><td headers="hd_h_niceng236er22.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.76</td></tr><tr><td headers="hd_h_niceng236er22.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Prilocaine hydrochloride 10 mg per 1 ml<sup>(c)</sup></td><td headers="hd_h_niceng236er22.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5</td><td headers="hd_h_niceng236er22.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5.06</td><td headers="hd_h_niceng236er22.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1.01</td></tr><tr><td headers="hd_h_niceng236er22.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lidocaine hydrochloride 10 mg per 1 ml<sup>(b)</sup></td><td headers="hd_h_niceng236er22.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_niceng236er22.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5</td><td headers="hd_h_niceng236er22.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.50</td></tr><tr><td headers="hd_h_niceng236er22.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lidocaine hydrochloride 20 mg per 1 ml<sup>(e)</sup></td><td headers="hd_h_niceng236er22.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10</td><td headers="hd_h_niceng236er22.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£3.20</td><td headers="hd_h_niceng236er22.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0.32</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="niceng236er22.tab26_1"><p class="no_margin">Costs are based on the NHS Drug Tariff price from the BNF,<sup><a class="bibr" href="#niceng236er22.ref19" rid="niceng236er22.ref19">19</a></sup> accessed 25/05/22</p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="niceng236er22.tab26_2"><p class="no_margin">Reported in Rah 2012<sup><a class="bibr" href="#niceng236er22.ref36" rid="niceng236er22.ref36">36</a></sup>. Participants received ultrasound-guided subacromial injection with triamcinolone 40mg with 1mL of 1% lidocaine. BNF drug cost is based on Kenalog Intra-articular / Intramuscular 40mg/1ml suspension for injection vials (Bristol-Myers Squibb Pharmaceuticals Ltd) and Lidocaine 100mg/10ml (1%) solution for injection ampoules Advanz Pharma</p></div></dd></dl><dl class="bkr_refwrap"><dt>(c)</dt><dd><div id="niceng236er22.tab26_3"><p class="no_margin">Lakse 2009<sup><a class="bibr" href="#niceng236er22.ref22" rid="niceng236er22.ref22">22</a></sup>; Participants received 1mL triamcinolone acetonide with 9mL prilocaine. BNF drug costs are based on Adcortyl Intra-articular / Intradermal 50mg/5ml suspension for injection vials Bristol-Myers Squibb Pharmaceuticals Ltd and Citanest 1% solution for injection 50ml vials Aspen Pharma Trading Ltd.</p></div></dd></dl><dl class="bkr_refwrap"><dt>(d)</dt><dd><div id="niceng236er22.tab26_4"><p class="no_margin">Reported in Adey-Wakeling 2013<sup><a class="bibr" href="#niceng236er22.ref2" rid="niceng236er22.ref2">2</a></sup>; participants received suprascapular nerve block, 1mL of 40mg/mL methylprednisolone and 10mL 0.5% bupivacaine hydrochloride. BNF drug costs are based on Solu-Medrone 40mg powder and solvent for solution for injection vials (Pfizer Ltd) and Bupivacaine 50mg/10ml (0.5%) solution for injection ampoules (Advanz Pharma).</p></div></dd></dl><dl class="bkr_refwrap"><dt>(e)</dt><dd><div id="niceng236er22.tab26_5"><p class="no_margin">Reported in Terlemez 2020<sup><a class="bibr" href="#niceng236er22.ref39" rid="niceng236er22.ref39">39</a></sup>; Participants received 5mL of 2% lidocaine and 1mL of betamethasone. BNF drug costs are based on Lidocaine 100mg/5ml (2%) solution for injection ampoules (A A H Pharmaceuticals Ltd) and Betamethasone 4mg/1ml solution for injection ampoules Alliance Healthcare (Distribution) Ltd</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22tab27"><div id="niceng236er22.tab27" class="table"><h3><span class="label">Table 27</span><span class="title">Example procedural costs of intra-articular medicine injections and nerve blocks (local anaesthetics)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.tab27/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.tab27_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng236er22.tab27_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">OPROC<sup>(a)</sup></th><th id="hd_h_niceng236er22.tab27_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost</th><th id="hd_h_niceng236er22.tab27_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Source</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.tab27_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nerve Block or Destruction of Nerve, Under Image Control, for Pain Management</td><td headers="hd_h_niceng236er22.tab27_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£910</td><td headers="hd_h_niceng236er22.tab27_1_1_1_3" rowspan="4" colspan="1" style="text-align:left;vertical-align:top;">2019/2020 NHS reference costs<sup><a class="bibr" href="#niceng236er22.ref31" rid="niceng236er22.ref31">31</a></sup></td></tr><tr><td headers="hd_h_niceng236er22.tab27_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nerve Block or Destruction of Nerve, for Pain Management</td><td headers="hd_h_niceng236er22.tab27_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£529</td></tr><tr><td headers="hd_h_niceng236er22.tab27_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Injection of Therapeutic Substance into Joint Under Image Control for Pain Management</td><td headers="hd_h_niceng236er22.tab27_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£826</td></tr><tr><td headers="hd_h_niceng236er22.tab27_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Injection of Therapeutic Substance into Joint for Pain Management</td><td headers="hd_h_niceng236er22.tab27_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£752</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="niceng236er22.tab27_1"><p class="no_margin">Out-patient clinic - patient procedure.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng236er22appjtab1"><div id="niceng236er22.appj.tab1" class="table"><h3><span class="label">Table 46</span><span class="title">Studies excluded from the clinical review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.appj.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.appj.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Code [Reason]</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
(2013) Suprascapular nerve block for shoulder pain in the first year after stroke: a randomised controlled trial. Arthritis and rheumatism
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65(suppl10): 464
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|
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23970790" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23970790</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Duplicate reference</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bladel
|
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A, V. A. N., Cambier
|
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D., Lefeber
|
|
N. et al (2020) The use of shoulder orthoses poststroke: effects on balance and gait. A systematic review. European journal of physical & rehabilitation medicine. 56(6): 695–705
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/32539311" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32539311</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ada
|
|
L.; Foongchomcheay
|
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A.; Canning
|
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C. (2005) Supportive devices for preventing and treating subluxation of the shoulder after stroke. Cochrane Database of Systematic Reviews: cd003863
|
|
[<a href="/pmc/articles/PMC6984447/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6984447</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/15674917" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15674917</span></a>]
|
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</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>- Systematic review used as source of primary studies</p>
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|
<p>
|
|
<i>Cochrane review that specifically included studies for people with subluxation of the shoulder after stroke, rather than all people with shoulder pain. Included only supportive devices and did not look at all of the outcomes of interest specified by the committee. Used as a source of primary studies.</i>
|
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</p>
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</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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Ada
|
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L., Foongchomcheay
|
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A., Langhammer
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B.
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et al (2017) Lap-tray and triangular sling are no more effective than a hemi-sling in preventing shoulder subluxation in those at risk early after stroke: a randomized trial. European journal of physical & rehabilitation medicine. 53(1): 41–48
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/27327391" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27327391</span></a>]
|
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</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>- Population not relevant to this review protocol</p>
|
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<p>
|
|
<i>The study looks at preventing shoulder pain rather than managing shoulder pain that already exists</i>
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|
</p>
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</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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Ada
|
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L; Foongchomcheay
|
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A; Canning
|
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Cg (2005) Supportive devices for preventing and treating subluxation of the shoulder after stroke. Cochrane Database of Systematic Reviews [<a href="/pmc/articles/PMC6984447/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6984447</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/15674917" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15674917</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Duplicate reference</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Adey-Wakeling
|
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Z.; Crotty
|
|
M.; Shanahan
|
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E. M. (2013) Suprascapular nerve block reduces shoulder pain post stroke: a randomised controlled trial. International journal of stroke
|
|
8suppl1: 20–21 [<a href="https://pubmed.ncbi.nlm.nih.gov/23970790" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23970790</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Duplicate reference</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Alanbay
|
|
E., Aras
|
|
B., Kesikburun
|
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S.
|
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et al (2020) Effectiveness of Suprascapular Nerve Pulsed Radiofrequency Treatment for Hemiplegic Shoulder Pain: A Randomized-Controlled Trial. Pain Physician
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23(3): 245–252
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/32517390" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32517390</span></a>]
|
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</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>Suprascapular nerve pulsed radiofrequency treatment</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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Ancliffe
|
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J (1992) Strapping the shoulder in patients following a cerebrovascular accident (CVA): A pilot study. The Australian journal of physiotherapy
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38(1): 37–40
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25025515" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25025515</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Non-randomised study that does not appear to adjust for confounders in a univariate or multivariate analysis or with matched groups</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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Appel
|
|
C.; Mayston
|
|
M.; Perry
|
|
L. (2011) Feasibility study of a randomized controlled trial protocol to examine clinical effectiveness of shoulder strapping in acute stroke patients. Clinical Rehabilitation
|
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25(9): 833–43
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21551176" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21551176</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Arya
|
|
K. N.; Pandian
|
|
S.; Puri
|
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V. (2018) Rehabilitation methods for reducing shoulder subluxation in post-stroke hemiparesis: a systematic review. Topics in Stroke Rehabilitation
|
|
25(1): 68–81
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29017429" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29017429</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Does not specifically discuss shoulder pain</i>
|
|
</p>
|
|
<p>- Review article but not a systematic review</p>
|
|
<p>
|
|
<i>Narrative review that included single arm studies</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Badaru
|
|
U. M. (2020) Comparative Efficacy of Soft Tissue Massage and Transcutaneous Electric Nerve Stimulation in the Management of Hemiplegic Shoulder Pain. Nigerian journal of physiological sciences: official publication of the
|
|
Physiological Society of Nigeria
|
|
35(2): 143–146 [<a href="https://pubmed.ncbi.nlm.nih.gov/34009203" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34009203</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>Soft tissue massage (not stated to be included in the protocol)</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Baker
|
|
LL and Parker
|
|
K (1986) Neuromuscular electrical stimulation of the muscles surrounding the shoulder. Physical therapy
|
|
66(12): 1930–1937
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/3491372" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3491372</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- No relevant outcomes</p>
|
|
<p>
|
|
<i>Shoulder subluxation amount only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bao
|
|
YH, Wang
|
|
YW, Chu
|
|
JM, Zhu
|
|
GX, Wang CM
|
|
HH (2012) Effects of electro-acupuncture combined with rehabilitation on improving upper extremity function for patients with post-stroke shoulder pain. Chin J Tradit Med Sci Tech: 59–60
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bao
|
|
YH, Wang
|
|
YW, Chu
|
|
JM, Zhu
|
|
GX, Wang CM
|
|
HH (2011) Effects of electro-acupuncture combined with rehabilitation for patients with post-stroke shoulder pain. Chin Arch Tradit Chin Med: 2536–9
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bao
|
|
X.; Shao
|
|
Y. J.; Liu
|
|
H. Y. (2018) The effect of intraarticular injection of botulinum toxin type A, triamcinolone or saline plus rehabilitation exercise shoulder pain on patients with poststroke. Annals of physical and rehabilitation medicine
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Boonsong
|
|
P.; Jaroenarpornwatana
|
|
A.; Boonhong
|
|
J. (2009) Preliminary study of suprascapular nerve block (SSNB) in hemiplegic shoulder pain. Journal of the Medical Association of Thailand
|
|
92(12): 1669–74
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20043571" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20043571</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>The control arm received ultrasound therapy</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bu
|
|
L, Xu
|
|
HQ, Tan WJ
|
|
DR (2013) Effects of electro-acupuncture combined with scapular control training on shoulder pain and upper limbs function in hemiplegia patients. Glob Tradit Chin Med: 246–7
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in Enalish</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chatterjee
|
|
S, Hayner
|
|
KA, Arumugam
|
|
N
|
|
et al (2016) The California Tri-pull Taping Method in the Treatment of Shoulder Subluxation After Stroke: A Randomized Clinical Trial. North American journal of medical sciences
|
|
8(4): 175–182
|
|
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Reported beta coefficients only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chau
|
|
J. P. C., Lo
|
|
S. H. S., Yu
|
|
X.
|
|
et al (2018) Effects of Acupuncture on the Recovery Outcomes of Stroke Survivors with Shoulder Pain: A Systematic Review. Frontiers in neurology [electronic resource]. 9: 30
|
|
[<a href="/pmc/articles/PMC5797784/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5797784</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29445354" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29445354</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chen
|
|
HX, He MF
|
|
XR (2011) Clinical observation on the combination of abdominal acupuncture and rehabilitation in treating omalgia after stroke. J Nanjing Univ Tradit Chin Med: 333–5
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chen
|
|
J (2016) Effects of acupuncture combined with exercise for patients with poststroke shoulder pain. Womens Health Res: 79–81
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chen
|
|
Y, Huang TS
|
|
LK (2015) Clinical research of using acupuncture and rehabilitation training in the treatment of post-stroke shoulder-hand syndrome stage I. Sichuan Tradit Chin Med: 150–2
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chen
|
|
C. H., Chen
|
|
T. W., Weng
|
|
M. C.
|
|
et al (2000) The effect of electroacupuncture on shoulder subluxation for stroke patients. Kaohsiung Journal of Medical Sciences
|
|
16(10): 525–32
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/11272799" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11272799</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Full text paper not available</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Church
|
|
C., Price
|
|
C., Pandyan
|
|
A. D.
|
|
et al (2006) Randomized controlled trial to evaluate the effect of surface neuromuscular electrical stimulation to the shoulder after acute stroke. Stroke
|
|
37(12): 2995–3001
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/17053181" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17053181</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Reported outcomes as medians and interquartile ranges</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cuesta-Gomez
|
|
A., Carratala-Tejada
|
|
M., Molina-Rueda
|
|
F.
|
|
et al (2019) Functional electrical stimulation improves reaching movement in the shoulder and elbow muscles of stroke patients: A three-dimensional motion analysis. Restorative Neurology & Neuroscience
|
|
37(3): 231–238
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/31177249" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31177249</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- No relevant outcomes</p>
|
|
<p>
|
|
<i>Kinematic data only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dacre
|
|
J. E.; Beeney
|
|
N.; Scott
|
|
D. L. (1989) Injections and physiotherapy for the painful stiff shoulder. Annals of the Rheumatic Diseases
|
|
48(4): 322–5
|
|
[<a href="/pmc/articles/PMC1003749/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1003749</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/2712613" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2712613</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Commentary only</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dall'Agnol
|
|
M. S. and Cechetti
|
|
F. (2018) Kinesio Taping Associated with Acupuncture in the Treatment of the Paretic Upper Limb After Stroke. Jams Journal of Acupuncture & Meridian Studies
|
|
11(2): 67–73
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29436374" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29436374</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Reported median and interquartile range only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
de Oliveira Cacho
|
|
R., Cacho
|
|
E. W. A., Ortolan
|
|
R. L.
|
|
et al (2015) Trunk restraint therapy: the continuous use of the harness could promote feedback dependence in poststroke patients: a randomized trial. Medicine
|
|
94(12): e641
|
|
[<a href="/pmc/articles/PMC4554010/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4554010</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25816031" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25816031</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>No statement about shoulder pain</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
de Sire
|
|
A., Moggio
|
|
L., Demeco
|
|
A.
|
|
et al (2021) Efficacy of rehabilitative techniques in reducing hemiplegic shoulder pain in stroke: Systematic review and meta-analysis. Annals of Physical & Rehabilitation Medicine
|
|
65(5): 101602
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/34757009" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34757009</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Deng
|
|
P., Zhao
|
|
Z., Zhang
|
|
S.
|
|
et al (2021) Effect of kinesio taping on hemiplegic shoulder pain: A systematic review and meta-analysis of randomized controlled trials. Clinical Rehabilitation
|
|
35(3): 317–331
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33063559" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33063559</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dorsch
|
|
S.; Ada
|
|
L.; Canning
|
|
C. G. (2014) EMG-triggered electrical stimulation is a feasible intervention to apply to multiple arm muscles in people early after stroke, but does not improve strength and activity more than usual therapy: a randomized feasibility trial. Clinical Rehabilitation
|
|
28(5): 482–90
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24198342" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24198342</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>No statement about shoulder pain</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dyer
|
|
S.; Mordaunt
|
|
D. A.; Adey-Wakeling
|
|
Z. (2020) Interventions for Post-Stroke Shoulder Pain: An Overview of Systematic Reviews. International journal of general medicine
|
|
13: 1411–1426
|
|
[<a href="/pmc/articles/PMC7732168/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7732168</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33324087" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33324087</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Review of reviews</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ekim
|
|
A.; Armağan
|
|
O.; Oner
|
|
C. (2008) Efficiency of TENS treatment in hemiplegic shoulder pain: a placebo controlled study. Agri: Agri (Algoloji) Dernegi'nin Yayin organidir [Journal of the Turkish Society of Algology]
|
|
20(1): 41–46 [<a href="https://pubmed.ncbi.nlm.nih.gov/18338278" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18338278</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ellis
|
|
M. D.; Sukal-Moulton
|
|
T.; Dewald
|
|
J. P. (2009) Progressive shoulder abduction loading is a crucial element of arm rehabilitation in chronic stroke. Neurorehabilitation & Neural Repair
|
|
23(8): 862–9
|
|
[<a href="/pmc/articles/PMC2833097/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2833097</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19454622" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19454622</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Excluded if they had an acute or chronic painful condition of the upper limb</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Faghri
|
|
P. D. and Rodgers
|
|
M. M. (1997) The effects of functional neuromuscular stimulation-augmented physical therapy program in the functional recovery of hemiplegic arm in stroke patients. Clinical Kinesiology
|
|
51(1): 9–15
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Outcomes reported in graphical form only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Faghri
|
|
P. D., Rodgers
|
|
M. M., Glaser
|
|
R. M.
|
|
et al (1994) The effects of functional electrical stimulation on shoulder subluxation, arm function recovery, and shoulder pain in hemiplegic stroke patients. Archives of Physical Medicine & Rehabilitation
|
|
75(1): 73–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/8291967" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8291967</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Outcomes reported in graphical form</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fil
|
|
A., Armutlu
|
|
K., Atay
|
|
A. O.
|
|
et al (2011) The effect of electrical stimulation in combination with Bobath techniques in the prevention of shoulder subluxation in acute stroke patients. Clinical Rehabilitation
|
|
25(1): 51–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20702513" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20702513</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Does not include presence of shoulder pain as an inclusion criteria</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fu M
|
|
KS (2015) Efficacy Observation on Functional Electrical Stimulation for Shoulder Pain after Stroke. Chinese Manipul Rehabil: 11–4
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Glize
|
|
Bertrand, Cook
|
|
Amandine, Benard
|
|
Antoine
|
|
et al (2022) Early multidisciplinary prevention program of post-stroke shoulder pain: A randomized clinical trial. Clinical rehabilitation
|
|
36(8): 1042–1051
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/35505589" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35505589</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Prevention of shoulder pain rather than people with shoulder pain</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Grampurohit
|
|
N.; Pradhan
|
|
S.; Kartin
|
|
D. (2015) Efficacy of adhesive taping as an adjunt to physical rehabilitation to influence outcomes post-stroke: a systematic review. Topics in Stroke Rehabilitation
|
|
22(1): 72–82
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25776123" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25776123</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Griffin
|
|
A. and Bernhardt
|
|
J. (2006) Strapping the hemiplegic shoulder prevents development of pain during rehabilitation: a randomized controlled trial. Clinical Rehabilitation
|
|
20(4): 287–95
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/16719027" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16719027</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Includes people at risk of developing pain rather than people who have pain (excludes people who had more than minimal shoulder pain)</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gu
|
|
P. and Ran
|
|
J. J. (2016) Electrical Stimulation for Hemiplegic Shoulder Function: A Systematic Review and Meta-Analysis of 15 Randomized Controlled Trials. Archives of Physical Medicine and Rehabilitation
|
|
97(9): 1588–1594
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/27178095" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27178095</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gustafsson
|
|
L. and McKenna
|
|
K. (2006) A programme of static positional stretches does not reduce hemiplegic shoulder pain or maintain shoulder range of motion--a randomized controlled trial. Clinical Rehabilitation
|
|
20(4): 277–86
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/16719026" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16719026</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Only includes people who do not have shoulder pain at baseline</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hanger
|
|
H. C., Whitewood
|
|
P., Brown
|
|
G.
|
|
et al (2000) A randomized controlled trial of strapping to prevent post-stroke shoulder pain. Clinical Rehabilitation
|
|
14(4): 370–80
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/10945421" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10945421</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Study aims to prevent shoulder pain rather than managing existing shoulder pain</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hara
|
|
Y., Ogawa
|
|
S., Tsujiuchi
|
|
K.
|
|
et al (2008) A home-based rehabilitation program for the hemiplegic upper extremity by power-assisted functional electrical stimulation. Disability & Rehabilitation
|
|
30(4): 296–304
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/17852312" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17852312</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Shoulder pain is not stated to be needed as a component for inclusion</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hartwig
|
|
M.; Gelbrich
|
|
G.; Griewing
|
|
B. (2012) Functional orthosis in shoulder joint subluxation after ischaemic brain stroke to avoid posthemiplegic shoulder-hand syndrome: a randomized controlled trial. Clinical rehabilitation
|
|
26(9): 807–816
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22308558" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22308558</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Duplicate reference</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
He SS
|
|
GS (2016) Evaluation of abdominal acupuncture and rehabilitation treatment for shoulder-hand syndrome (period 1) after stroke. Clin Acupunct Moxi: 11–3
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hesse
|
|
S., Werner
|
|
C., Pohl
|
|
M.
|
|
et al (2008) Mechanical arm trainer for the treatment of the severely affected arm after a stroke: a single-blinded randomized trial in two centers. American Journal of Physical Medicine & Rehabilitation
|
|
87(10): 779–88
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18806506" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18806506</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>Mechanical arm trainer</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hochsprung
|
|
A., Dominguez-Matito
|
|
A., Lopez-Hervas
|
|
A.
|
|
et al (2017) Short- and medium-term effect of kinesio taping or electrical stimulation in hemiplegic shoulder pain prevention: A randomized controlled pilot trial. Neurorehabilitation
|
|
41(4): 801–810
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29254115" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29254115</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Study is looking at preventing shoulder pain and all people have no pain at baseline</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hong
|
|
LR, Chen
|
|
B, Yu
|
|
SM, Huang
|
|
XS, Wang JP
|
|
XY (2011) Efficacy of acupuncture plus rehabilitation training in treating shoulder-hand syndrome after hemiparalysis. Med J Chin Peoples Armed Police Forces
|
|
22: 658–60
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hou
|
|
Yajing, Zhang
|
|
Tong, Liu
|
|
Wei
|
|
et al (2022) The Effectiveness of Ultrasound-Guided Subacromial-Subdeltoid Bursa Combined With Long Head of the Biceps Tendon Sheath Corticosteroid Injection for Hemiplegic Shoulder Pain: A Randomized Controlled Trial. Frontiers in neurology
|
|
13: 899037
|
|
[<a href="/pmc/articles/PMC9237414/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9237414</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35775042" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35775042</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Comparator in study does not match that specified in this review protocol</p>
|
|
<p>
|
|
<i>Compares injection into the bursa and sheath to injection into the bursa alone which is not specified as a comparison in the protocol</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Huang
|
|
Z. Q., Pei
|
|
J., Wang
|
|
W. M.
|
|
et al (2015) Clinical observation of acupuncture plus medicine and function training for post-stroke shoulder-hand syndrome. Shanghai journal of acupuncture and moxibustion [shang hai zhen jiu za zhi]
|
|
34(6): 511–512
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hurd
|
|
MM; Farrell
|
|
KH; Waylonis
|
|
GW (1974) Shoulder sling for hemiplegia: friend or foe?. Archives of physical medicine and rehabilitation
|
|
55(11): 519–522
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/4441266" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4441266</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Pain reported as the number of people with severe pain rather than as a continuous outcome scale - categorical data only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hwang
|
|
K. H., Lee
|
|
J. H., Sim
|
|
Y. J.
|
|
et al (2010) Strapping on Subluxation of the Hemiplegic Shoulder: effects of Elasticity Difference Strapped. Journal of korean academy of rehabilitation medicine
|
|
34(3): 304–309
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jeong
|
|
Y. G., Jeong
|
|
Y. J., Kim
|
|
H. S.
|
|
et al (2020) Predictors of the effect of an arm sling on gait efficiency in stroke patients with shoulder subluxation: a pre-post design clinical trial. Physiotherapy Theory & Practice: 1–8 [<a href="https://pubmed.ncbi.nlm.nih.gov/32741231" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32741231</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Cross over trial, <1 week follow up period</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jia
|
|
CJ, Ni
|
|
GX, Tan H
|
|
ZX (2012) Effects of acupuncture combined with rehabilitation for stroke survivors with stage I shoulder hand syndrome. Changchun Univ Tradit Chin Med: 711–2
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jin
|
|
Y. S.; Yuan
|
|
B.; Zhang
|
|
G. Z. (2015) The clinical research on shoulder acupuncture combined with upper limb function training to improve upper limb motor functions in patients with hemiplegia after stroke. Henan traditional chinese medicine [henan zhong yi]
|
|
35(1): 142–144
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jonsdottir
|
|
J., Thorsen
|
|
R., Aprile
|
|
I.
|
|
et al (2017) Arm rehabilitation in post stroke subjects: A randomized controlled trial on the efficacy of myoelectrically driven FES applied in a task-oriented approach. PLoS ONE [Electronic Resource]
|
|
12(12): e0188642
|
|
[<a href="/pmc/articles/PMC5714329/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5714329</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29200424" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29200424</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Median visual analogue scale for pain was 0 at baseline</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jung
|
|
K. M. and Choi
|
|
J. D. (2019) The Effects of Active Shoulder Exercise with a Sling Suspension System on Shoulder Subluxation, Proprioception, and Upper Extremity Function in Patients with Acute Stroke. Medical Science Monitor
|
|
25: 4849–4855
|
|
[<a href="/pmc/articles/PMC6618341/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6618341</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31256191" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31256191</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>No statement that people had to have shoulder pain</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jung
|
|
K., Jung
|
|
J., In
|
|
T.
|
|
et al (2017) The influence of Task-Related Training combined with Transcutaneous Electrical Nerve Stimulation on paretic upper limb muscle activation in patients with chronic stroke. Neurorehabilitation
|
|
40(3): 315–323
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28339404" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28339404</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Does not include pain in the inclusion criteria with no statement about pain throughout the study</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kim
|
|
EB and Kim
|
|
YD (2015) Effects of kinesiology taping on the upper-extremity function and activities of daily living in patients with hemiplegia. Journal of physical therapy science
|
|
27(5): 1455–1457
|
|
[<a href="/pmc/articles/PMC4483417/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4483417</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26157239" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26157239</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Does not specifically include people with shoulder pain (taping involves the lower back as well as the shoulder)</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kim
|
|
Min Gyun, Lee
|
|
Seung Ah, Park
|
|
Eo Jin
|
|
et al (2022) Elastic Dynamic Sling on Subluxation of Hemiplegic Shoulder in Patients with Subacute Stroke: A Multicenter Randomized Controlled Trial. International journal of environmental research and public health
|
|
19(16) [<a href="/pmc/articles/PMC9408021/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9408021</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36011613" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36011613</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Minimal pain at baseline with pain not present as an inclusion criteria</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kim
|
|
T. H. and Chang
|
|
M. C. (2021) Comparison of the effectiveness of pulsed radiofrequency of the suprascapular nerve and intra-articular corticosteroid injection for hemiplegic shoulder pain management. Journal of Integrative Neuroscience
|
|
20(3): 687–693
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/34645102" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34645102</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>Pulsed radiofrequency ablation</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kobayashi
|
|
H, Onishi
|
|
H, Ihashi
|
|
K
|
|
et al (1999) Reduction in subluxation and improved muscle function of the hemiplegic shoulder joint after therapeutic electrical stimulation. Journal of Electromyography and Kinesiology
|
|
9(5): 327–36.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/10527214" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10527214</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Not all participants had shoulder pain</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Koog
|
|
Y. H., Jin
|
|
S. S., Yoon
|
|
K.
|
|
et al (2010) Interventions for hemiplegic shoulder pain: systematic review of randomised controlled trials. Disability & Rehabilitation
|
|
32(4): 282–91
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20055567" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20055567</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Koyuncu
|
|
E., Nakipoglu-Yuzer
|
|
G. F., Dogan
|
|
A.
|
|
et al (2010) The effectiveness of functional electrical stimulation for the treatment of shoulder subluxation and shoulder pain in hemiplegic patients: A randomized controlled trial. Disability & Rehabilitation
|
|
32(7): 560–6
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20136474" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20136474</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Reported median and interquartile range values only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Krempen
|
|
J. F., Silver
|
|
R. A., Hadley
|
|
J.
|
|
et al (1977) The use of the Varney Brace for subluxating shoulders in stroke and upper motor neuron injuries. Clinical orthopaedics and related research
|
|
122: 204–206 [<a href="https://pubmed.ncbi.nlm.nih.gov/837609" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 837609</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Single arm non-randomised study</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Leandri
|
|
M, Parodi
|
|
CI, Corrieri
|
|
N
|
|
et al (1990) Comparison of TENS treatments in hemiplegic shoulder pain. Scandinavian journal of rehabilitation medicine
|
|
22(2): 69–71
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/2363027" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2363027</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- No relevant outcomes</p>
|
|
<p>
|
|
<i>Reports kinematic outcomes only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lee
|
|
J. A., Park
|
|
S. W., Hwang
|
|
P. W.
|
|
et al (2012) Acupuncture for shoulder pain after stroke: a systematic review. Journal of Alternative & Complementary Medicine
|
|
18(9): 818–23
|
|
[<a href="/pmc/articles/PMC3429280/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3429280</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22924414" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22924414</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lee
|
|
J. H., Baker
|
|
L. L., Johnson
|
|
R. E.
|
|
et al (2017) Effectiveness of neuromuscular electrical stimulation for management of shoulder subluxation post-stroke: a systematic review with meta-analysis. Clinical Rehabilitation
|
|
31(11): 1431–1444
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28343442" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28343442</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lee
|
|
S. H. and Lim
|
|
S. M. (2016) Acupuncture for Poststroke Shoulder Pain: A Systematic Review and Meta-Analysis. Evidence-Based Complementary & Alternative Medicine: eCAM
|
|
2016: 3549878
|
|
[<a href="/pmc/articles/PMC4983325/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4983325</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27547224" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27547224</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lerma Castano
|
|
P. R., Rodriguez Laiseca
|
|
Y. A., Montealegre Suarez
|
|
D. P.
|
|
et al (2020) Effects of kinesiotaping combined with the motor relearning method on upper limb motor function in adults with hemiparesis after stroke. Journal of Bodywork & Movement Therapies
|
|
24(4): 546–553
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33218559" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33218559</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Data in graphical form only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Li
|
|
B. (2015) Treating 57 cases of stroke shoulder-hand syndrome by acupuncture. Clin J Chin Med: 40–1
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Li
|
|
N., Tian
|
|
F., Wang
|
|
C.
|
|
et al (2012) Therapeutic effect of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients: a clinical two-center randomized controlled trial. Journal of Traditional Chinese Medicine
|
|
32(3): 343–349
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23297553" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23297553</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>Intervention includes manipulation (manual therapy) combined with electroacupuncture which was not included in the protocol</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lin
|
|
HX, Ye
|
|
GQ, Liao
|
|
HX, Lin FY
|
|
LB (2014) Acupuncture combined with rehabilitation training in the treatment of shoulder-hand syndrome after stroke. World Chin Med: 84, 85–8
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lin
|
|
L. F., Lin
|
|
Y. J., Lin
|
|
Z. H.
|
|
et al (2018) Feasibility and efficacy of wearable devices for upper limb rehabilitation in patients with chronic stroke: a randomized controlled pilot study. European journal of physical & rehabilitation medicine. 54(3): 388–396
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28627862" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28627862</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>Wearable devices to help monitor exercise that do not fit to the definition of devices used in the review</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Linn
|
|
S. L.; Granat
|
|
M. H.; Lees
|
|
K. R. (1999) Prevention of shoulder subluxation after stroke with electrical stimulation. Stroke
|
|
30(5): 963–8
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/10229728" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10229728</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Aiming at preventing shoulder subluxation and pain rather than treating existing pain</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Liu
|
|
J., Feng
|
|
W., Zhou
|
|
J.
|
|
et al (2020) Effects of sling exercise therapy on balance, mobility, activities of daily living, quality of life and shoulder pain in stroke patients: a randomized controlled trial. European Journal of Integrative Medicine
|
|
35 (no pagination)
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>Sling exercise therapy rather than a sling device</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Liu
|
|
S. and Shi
|
|
Z. Y. (2013) Observation on the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke. World Journal of Acupuncture - Moxibustion
|
|
23(1): 21–26
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- No relevant outcomes</p>
|
|
<p>
|
|
<i>Reported outcomes including results of blood tests only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Liu
|
|
S., Zhang
|
|
C. S., Cai
|
|
Y.
|
|
et al (2019) Acupuncture for Post-stroke Shoulder-Hand Syndrome: A Systematic Review and Meta-Analysis. Frontiers in neurology [electronic resource]. 10: 433
|
|
[<a href="/pmc/articles/PMC6498454/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6498454</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31105643" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31105643</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lu
|
|
J., Zhang
|
|
L. X., Liu
|
|
K. J.
|
|
et al (2010) Clinical observation on electroacupuncture
|
|
combined with rehabilitation techniques for treatment of shoulder subluxation after stroke. Zhongguo zhen jiu [Chinese acupuncture & moxibustion]
|
|
30(1): 31–34 [<a href="https://pubmed.ncbi.nlm.nih.gov/20353111" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20353111</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Manigandan
|
|
J. B., Ganesh
|
|
G. S., Pattnaik
|
|
M.
|
|
et al (2014) Effect of electrical stimulation to long head of biceps in reducing gleno humeral subluxation after stroke. Neurorehabilitation
|
|
34(2): 245–52
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24419017" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24419017</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Comparator in study does not match that specified in this review protocol</p>
|
|
<p>
|
|
<i>Comparing electrical stimulation applied to different muscles associated with the shoulder</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mao
|
|
Y, Xue
|
|
L, Xue J
|
|
EA (2016) Efficacy of low frequency electric stimulation plus acupuncture for hemiplegia and shoulder pain. Med J Qilu
|
|
31: 592–3
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
McCabe
|
|
J., Monkiewicz
|
|
M., Holcomb
|
|
J.
|
|
et al (2015) Comparison of robotics, functional electrical stimulation, and motor learning methods for treatment of persistent upper extremity dysfunction after stroke: a randomized controlled trial. Archives of Physical Medicine & Rehabilitation
|
|
96(6): 981–90
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25461822" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25461822</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Does not state that people have to experience pain to be included in the study</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Meng
|
|
F. Y. and Wen
|
|
J. (2014) Effect of warm acupuncture stimulation of Waiguan (TE 5) on post-stroke shoulder-hand syndrome. Zhen CI yan jiu = acupuncture research
|
|
39(3): 228–31, 251
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25069201" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25069201</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nadler
|
|
M. and Pauls
|
|
M. (2017) Shoulder orthoses for the prevention and reduction of hemiplegic shoulder pain and subluxation: systematic review. Clinical Rehabilitation
|
|
31(4): 444–453
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/27184582" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27184582</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nakipoglu-Yuzer
|
|
G. F.; Koyuncu
|
|
E.; Ozgirgin
|
|
N. (2010) Effectiveness of functional electrical stimulation on upper extremity rehabilitation outcomes in patients with hemiplegia due to cerebrovascular accident. Turkiye fiziksel tip ve rehabilitasyon dergisi
|
|
56(4): 177–181
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Niaki
|
|
A. S., Momenzadeh
|
|
S., Mohammadinasab
|
|
H.
|
|
et al (2011) Evaluating the effects of local injections of bupivacaine and triamcinolone acetate on shoulder joint pain and restricted range of motion following cerebrovascular accidents. Tehran University Medical Journal
|
|
69(6): 381–387
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Page
|
|
T. and Lockwood
|
|
C. (2003) Prevention and management of shoulder pain in the hemiplegic patient. JBI Library of Systematic Reviewis
|
|
1(4): 1–28 [<a href="https://pubmed.ncbi.nlm.nih.gov/27820409" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27820409</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Pan
|
|
R„ Zhou
|
|
M., Cai
|
|
H. et al (2018) A randomized controlled trial of a modified wheelchair arm-support to reduce shoulder pain in stroke patients. Clinical Rehabilitation
|
|
32(1): 37–47
|
|
[<a href="/pmc/articles/PMC5751850/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5751850</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28629270" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28629270</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Reports median and interquartile range values for outcomes only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Peng
|
|
L., Zhang
|
|
C., Zhou
|
|
L.
|
|
et al (2018) Traditional manual acupuncture combined with rehabilitation therapy for shoulder hand syndrome after stroke within the Chinese healthcare system: a systematic review and meta-analysis. Clinical Rehabilitation
|
|
32(4): 429439
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28901172" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28901172</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Price
|
|
C. I. and Pandvan
|
|
A. D. (2000) Electrical stimulation for preventing and treating poststroke shoulder pain. Cochrane Database of Systematic Reviews: cd001698
|
|
[<a href="/pmc/articles/PMC8406756/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8406756</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/11034725" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11034725</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Systematic review used as source of primary studies</p>
|
|
<p>
|
|
<i>Cochrane review including only electrical stimulation. Includes some studies that do not explicitly state that people have shoulder pain. Does not include all of the outcomes specified by the committee that needed to be included. References checked.</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Price
|
|
Cim and Pandvan
|
|
Ad (2000) Electrical stimulation for preventing and treating poststroke shoulder pain. Cochrane Database of Systematic Reviews [<a href="/pmc/articles/PMC8406756/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8406756</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/11034725" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11034725</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Duplicate reference</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Qiu
|
|
H., Li
|
|
J., Zhou
|
|
T.
|
|
et al (2019) Electrical Stimulation in the Treatment of Hemiplegic Shoulder Pain: A Meta-Analysis of Randomized Controlled Trials. American Journal of Physical Medicine & Rehabilitation
|
|
98(4): 280–286
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30300232" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30300232</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ratmanskv
|
|
M: Defrin
|
|
R: Soroker
|
|
N (2012) A randomized controlled study of segmental neuromvotherapy for post-stroke hemiplegic shoulder pain. Journal of rehabilitation medicine
|
|
44(10): 830–836
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22949162" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22949162</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>Combination of nerve block, local anaesthetic injection, TENS and manual therapy</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ravichandran
|
|
H.. Janakirarnan
|
|
B.. Sun da ram
|
|
S. et al (2019) Systematic Review on Effectiveness of shoulder taping in Hemiplegia. Journal of Stroke & Cerebrovascular Diseases
|
|
28(6): 1463–1473
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30956057" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30956057</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shang
|
|
Y. J., Ma
|
|
C. C., Cai
|
|
Y. Y.
|
|
et al (2008) Clinical study on acupuncture combined with rehabilitation therapy for treatment of poststroke shoulder-hand syndrome. Zhongguo zhen jiu [Chinese acupuncture & moxibustion]
|
|
28(5): 331–333
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18652322" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18652322</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shi DK
|
|
TX (2011) Carpus-ankle acupuncture combined with physical therapy for patients with post-stroke shoulder pain: a randomized controlled trial. J Chengdu Univ Tradit Chin Med: 33–5
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shimodozono
|
|
M., Noma
|
|
T., Matsumoto
|
|
S.
|
|
et al (2014) Repetitive facilitative exercise under continuous electrical stimulation for severe arm impairment after sub-acute stroke: a randomized controlled pilot study. Brain Injury
|
|
28(2): 203–10
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24304090" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24304090</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Does not explicitly mention shoulder pain in the inclusion criteria</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shin
|
|
S., Yang
|
|
S. P., Yu
|
|
A.
|
|
et al (2019) Effectiveness and safety of electroacupuncture for poststroke patients with shoulder pain: study protocol for a double-center, randomized, patient- and assessor-blinded, sham-controlled, parallel, clinical trial. BMC Complementary & Alternative Medicine
|
|
19(1): 58
|
|
[<a href="/pmc/articles/PMC6416864/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6416864</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30866914" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30866914</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Protocol only</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Snels
|
|
I. A., Beckerman
|
|
H., Twisk
|
|
J. W.
|
|
et al (2000) Effect of triamcinolone acetonide injections on hemiplegic shoulder pain: A randomized clinical trial. Stroke
|
|
31(10): 2396–401
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/11022070" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11022070</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Reports median values and interquartile ranges only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sonde
|
|
L., Gip
|
|
C., Fernaeus
|
|
S. E.
|
|
et al (1998) Stimulation with low frequency (1.7 Hz) transcutaneous electric nerve stimulation (low-tens) increases motor function of the post-stroke paretic arm. Scandinavian Journal of Rehabilitation Medicine
|
|
30(2): 95–9
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/9606771" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9606771</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Reported F and P values only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sun
|
|
YZ, Wang YJ
|
|
WW (2012) Effect of acupuncture plus rehabilitation training on shoulder-hand syndrome due to ischemic stroke. J Acupunct Tuina Sci: 109–13
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sun
|
|
ZY, Han
|
|
SK, Cao
|
|
WJ, Liu
|
|
JH, Zuo LQ
|
|
LG (2013) Effects of Buqi Huatan Tongluo recipe combined with interior-exterior meridians acupuncture on spasticity relief for patients with shoulder hand syndrome after stroke. Shaanxi J Tradit Chin Med: 1004–6
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Tang
|
|
D, Wu WP
|
|
SX (2016) A randomized controlled trial on the effects of meridians-based acupuncture combined with function training for shoulder hand syndrome after stroke. Clin Acupunct Moxi: 26–9
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Tong
|
|
S., Su
|
|
L., Lü
|
|
H. B.
|
|
et al (2013) Observation on the efficacy of acupuncture at key acupoints combined with rehabilitation therapy for spasmodic hemiplegia after cerebral infarction. Zhongguo zhen jiu [Chinese acupuncture & moxibustion]
|
|
33(5): 399–402
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23885610" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23885610</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Vafadar
|
|
A. K.; Cote
|
|
J. N.; Archambault
|
|
P. S. (2015) Effectiveness of functional electrical stimulation in improving clinical outcomes in the upper arm following stroke: a systematic review and meta-analysis. BioMed Research International
|
|
2015: 729768
|
|
[<a href="/pmc/articles/PMC4317587/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4317587</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25685805" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25685805</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Vasconcellos da Silva
|
|
W., de Medeiros Cirne
|
|
G. N., Meneses da Silva Filho, E. et al (2018) Functional electrical stimulation reduces pain and shoulder subluxation in chronic post-stroke patients?. Manual therapy, posturology & rehabilitation journal
|
|
16: 1–5
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Case study</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wan
|
|
W. R., Wang
|
|
T. L., Cheng
|
|
S. L.
|
|
et al (2013) Post-stroke shoulder-hand syndrome treated with acupuncture and rehabilitation: a randomized controlled trial. Zhongguo zhen jiu [Chinese acupuncture & moxibustion]
|
|
33(11): 970–974
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24494280" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24494280</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wang
|
|
RY; Chan
|
|
RC; Tsai
|
|
MW (2000) Functional electrical stimulation on chronic and acute hemiplegic shoulder subluxation. American journal of physical medicine & rehabilitation
|
|
79(4): 385
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/10892625" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10892625</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Crossover trial</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wang
|
|
Z., Lin
|
|
Z., Zhang
|
|
Y.
|
|
et al (2020) Motor entry point acupuncture for shoulder abduction dysfunction after stroke: A randomized controlled feasibility trial. European Journal of Integrative Medicine
|
|
35 (no pagination)
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Comparator in study does not match that specified in this review protocol</p>
|
|
<p>
|
|
<i>Comparing acupuncture performed at different sites</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wang
|
|
Z, Lin
|
|
Z, Zhang
|
|
Y
|
|
et al (2020) Motor entry point acupuncture for shoulder abduction dysfunction after stroke: A randomized controlled trial. European Journal of Integrative Medicine
|
|
35
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Comparator in study does not match that specified in this review protocol</p>
|
|
<p>
|
|
<i>Compares two types of acupuncture</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wayne
|
|
P. M., Krebs
|
|
D. E., Macklin
|
|
E. A.
|
|
et al (2005) Acupuncture for upper-extremity rehabilitation in chronic stroke: a randomized sham-controlled study. Archives of Physical Medicine & Rehabilitation
|
|
86(12): 2248–55
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/16344019" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16344019</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Shoulder pain is not included as an inclusion criteria</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wei
|
|
W. X. J., Fong
|
|
K. N. K., Chung
|
|
R. C. K.
|
|
et al (2019) "Remind-to-Move" for Promoting Upper Extremity Recovery Using Wearable Devices in Subacute Stroke: A Multi-Center Randomized Controlled Study. IEEE Transactions on Neural Systems & Rehabilitation Engineering
|
|
27(1): 51–59
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30475722" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30475722</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>Device that cueing movement/is related to movement and is not the type of device discussed in the protocol</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Whitehair
|
|
V. C., Chae
|
|
J., Hisel
|
|
T.
|
|
et al (2019) The effect of electrical stimulation on impairment of the painful post-stroke shoulder. Topics in Stroke Rehabilitation
|
|
26(7): 544–547
|
|
[<a href="/pmc/articles/PMC6764870/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6764870</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31298627" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31298627</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Non-randomised study that does not appear to adjust for confounders in a univariate or multivariate analysis or with matched groups</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wilson
|
|
R. D., Page
|
|
S. J., Delahanty
|
|
M.
|
|
et al (2016) Upper-Limb Recovery After Stroke: A Randomized Controlled Trial Comparing EMG-Triggered, Cyclic, and Sensory Electrical Stimulation. Neurorehabilitation & Neural Repair
|
|
30(10): 978–987
|
|
[<a href="/pmc/articles/PMC5048487/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5048487</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27225977" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27225977</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not relevant to this review protocol</p>
|
|
<p>
|
|
<i>Does not specifically focus on shoulder pain with very limited information about pain</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wu
|
|
DJ, Wu ZJ
|
|
LW (2017) Effects of acupuncture combined with rehabilitation for patients with shoulder hand syndrome after stroke. Pract Tradit Chin Med: 169–70
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wu
|
|
JY, Ye
|
|
BY, Xue
|
|
XH, Huang
|
|
SE, Lin ZC
|
|
HJ (2015) Observations on the efficacy of wrist-ankle acupuncture plus continuous exercise therapy for poststroke shoulder pain. Shang J Acupunct Moxi: 409–11
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wu
|
|
MB, Liao
|
|
RX, Yang
|
|
HH, Li
|
|
N, Ling
|
|
HL, Liu XH
|
|
EA (2016) Observation on the clinical effects of the internal and external combined with sequential therapy for treating shoulder-hand syndrome. China Med Pharm: 13–7
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Xu
|
|
F, Li HL
|
|
ZZ (2015) A randomized controlled trial on the effectiveness of acupuncture combined with rehabilitation for post-stroke shoulder hand syndrome. Chin J Trauma Disabil Med: 141–2
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yamamoto
|
|
S.; Tanaka
|
|
S.; Motojima
|
|
N. (2018) Comparison of ankle-foot orthoses with plantar flexion stop and plantar flexion resistance in the gait of stroke patients: A randomized controlled trial. Prosthetics & Orthotics International
|
|
42(5): 544–553
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29865941" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29865941</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>Device for the ankle and foot rather than shoulder</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yang
|
|
D, Xie
|
|
M, Zhang
|
|
CE, Ye BY
|
|
SG (2009) Effects of electro-acupuncture combined with rehabilitation for patients with shoulder hand syndrome. Liaoning J Tradit Chin Med: 1770–1
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yang
|
|
C. Y., Joo
|
|
M. C., Kil
|
|
E. Y.
|
|
et al (2006) Electromyographically Triggered Electrical Stimulation on Shoulder Subluxation in Hemiplegic Stroke Patients. Journal of the korean geriatrics society
|
|
10(1): 36–42
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yang
|
|
C., Xu
|
|
H., Wang
|
|
R.
|
|
et al (2020) The management of hemiplegic shoulder pain in stroke subjects undergoing pulsed radiofrequency treatment of the suprascapular and axillary nerves: a pilot study. Annals of Palliative Medicine
|
|
9(5): 3357–3365
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/32954762" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32954762</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>Pulsed radiofrequency treatment of the suprascapular and axillary nerves</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yasar
|
|
E., Vural
|
|
D., Safaz
|
|
I.
|
|
et al (2011) Which treatment approach is better for hemiplegic shoulder pain in stroke patients: intra-articular steroid or suprascapular nerve block? A randomized controlled trial. Clinical Rehabilitation
|
|
25(1): 60–8
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20943716" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20943716</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Reported as F and p values rather than values for each intervention at each time period.</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yin
|
|
J. C., Zhou
|
|
G. P., Zhou
|
|
G. H.
|
|
et al (2015) Therapeutic observation of acupuncture at the interiorly-exteriorly related meridians plus rehabilitation training for post-stroke shoulder-hand syndrome. Shanghai journal of acupuncture and moxibustion [shang hai zhen jiu za zhi]
|
|
34(1): 7–9
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zhan
|
|
Jie, Wei
|
|
Xiaojing, Tao
|
|
Chenyang
|
|
et al (2022) Effectiveness of acupuncture combined with rehabilitation training vs. rehabilitation training alone for post-stroke shoulder pain: A systematic review and meta-analysis of randomized controlled trials. Frontiers in medicine
|
|
9: 947285
|
|
[<a href="/pmc/articles/PMC9578557/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9578557</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36267617" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36267617</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zhang XR
|
|
LW (2015) The effects of acupuncture combined with rehabilitation for stage I shoulder hand syndrome patients. China Med Eng: 200
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zhang
|
|
ZX, Zhang
|
|
Y, Yu TY
|
|
GH (2012) The effects of acupuncture on Jiantong point combined with exercise for post-stroke shoulder pain patients. Shandong Med J: 82–3
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
ZHAO Li-sheng
|
|
WJ (2017) Effect of Kinesio Taping on Subluxation of Shoulder in Hemiplegic Patients after Stroke. 10(23): 1200–1202
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Data not reported in an extractable format or a format that can be analysed</p>
|
|
<p>
|
|
<i>Graphical form only</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zhao
|
|
H., Nie
|
|
W., Sun
|
|
Y.
|
|
et al (2015) Warm Needling Therapy and Acupuncture at Meridian-Sinew Sites Based on the Meridian-Sinew Theory: Hemiplegic Shoulder Pain. Evidence-Based Complementary & Alternative Medicine: eCAM
|
|
2015: 694973
|
|
[<a href="/pmc/articles/PMC4606215/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4606215</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26495023" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26495023</span></a>]
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study does not contain an intervention relevant to this review protocol</p>
|
|
<p>
|
|
<i>Includes the use of moxibustion with acupuncture which is not included in the protocol</i>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zhong
|
|
CQ, Ni
|
|
DL, Lin WJ
|
|
CF (2016) Effects of acupuncture combined with rehabilitation for patients with hand shoulder syndrome after stroke. Hainan Med: 1687–8
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr><tr><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zhou XY
|
|
CW (2016) Effects of intradermal needle retention combined with acupuncture for patients with post-stroke shoulder pain. Med Forum
|
|
</td><td headers="hd_h_niceng236er22.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Study not reported in English</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng236er22appjtab2"><div id="niceng236er22.appj.tab2" class="table"><h3><span class="label">Table 47</span><span class="title">Studies excluded from the health economic review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK602206/table/niceng236er22.appj.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng236er22.appj.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_niceng236er22.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reference</th><th id="hd_h_niceng236er22.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng236er22.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_niceng236er22.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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