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J Acupunct Res > Volume 38(1); 2021 > Article |
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VAS, visual analogue scale; NRS, numeric rating scale; CMS, Constant-Murley score; SPADI, Shoulder Pain and Disability Index; DASH, Disabilities of the Arm, Shoulder and Hand; UCLA, University of California-Los Angeles; ASES, American Shoulder and Elbow Surgeons; SF-36, Short-Form 36; EQ-5D, EuroQoL-5D.
English databases |
Chinese databases |
Korean databases |
Trial registries |
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CENTRAL, Cochrane Central Register of Controlled Trials; CINAHL, Cumulative Index to Nursing and Allied Health Literature; AMED, Allied and Complementary Medicine; PEDro, Physiotherapy Evidence Database; CAJ, China Academic Journal Full-text Database; KISS, Korean studies Information Service System; NDSL, National Digital Science Library; RISS, Research Information Sharing Service; KMBASE, Korean Medical Database; OASIS, Oriental Medicine Advanced Searching Integrated System; ISRCTN, International Standard Randomized Controlled Trials Number; ICTRP, International Clinical Trials Registry Platform.
Study ID (Authory [ref]) |
1) Sample size 2) Diagnosis 3) Country |
1) Interventions and controls 2) Session / duration / frequency of acupuncture treatment 3) Session / duration / frequency of other treatments |
1) Primary outcomes 2) Total follow-up periods |
---|---|---|---|
Arias-Buria 2017 [48] |
1) 50 (25/25) 2) Subacromial pain syndrome (clinical) 3) Spain |
1) TrP-DN plus exercise (n = 25) versus exercise alone (n = 25) 2) 2 sessions/ 5 weeks/ at the second and fourth sessions among a total of 5 sessions (once a week) 3) Exercise: 5 sessions/ 5 weeks/ once a week (+twice daily for 5 weeks on an individual basis) |
1) Function 2) Up to 12 months post-treatment |
Chai 2019 [25] |
1) 60 (30/30) 2) Supraspinatus tendinitis (clinical) 3) China |
1) MA plus topical NSAID (n = 30) versus ESWT plus topical NSAID (n = 30) 2) 14 sessions/ 2 weeks/ 7 times a week 3-1) ESWT: 4 sessions/ 2 weeks/ twice a week 3-2) Topical NSAID: applied for 12h, from 30 min after the end of MA or ESWT. |
1) Pain, shoulder abduction ROM, proportion of improved participants 2) 1 week post-treatment |
Chen 2018 [36] |
1) 178 (89/89) 2) Shoulder impingement syndrome (clinical and imaging) 3) China |
1) Acupotomy (n = 89) versus injection therapy (n = 89) 2) 3 sessions/ 3 weeks/ once a week 3) Injection therapy: same as those of acupuncture treatment |
1) Function, proportion of improved participants 2) Up to 12 weeks post-treatment |
Chen 2019 [41] |
1) 40 (20/20) 2) RC injury (clinical and imaging) 3) China |
1) EA (n = 20) versus exercise (n = 20) 2) 30 sessions/ 6 weeks/ 5 times a week 3) Exercise: twice daily for 6 weeks on an individual basis |
1) Pain, function, shoulder ROM 2) Post-treatment |
Fan 2016 [37] |
1) 30 (10/10/10) 2) RC injury (clinical) 3) China |
1) EA plus electrotherapy and exercise (n = 10) versus EA plus MW and exercise (n = 10) versus electrotherapy, MW and exercise (n = 10) 2) 28 sessions/ 31 days/ once daily, 1 day rest between 7 days of treatment 3-1) Electrotherapy: same as those of acupuncture treatment 3-2) MW: same as those of acupuncture treatment 3-3) Exercise: after each session of the assigned treatment |
1) Sub-elements of Constant Murley score: pain, ADL, ROM, strength; proportion of improved participants 2) Mid-/post-treatment |
Ge 2013 [42] |
1) 120 (60/60) 2) Shoulder impingement syndrome (clinical) 3) China |
1) Acupotomy plus manual therapy (n = 60) versus injection therapy plus manual therapy (n = 60) 2) 3–5 sessions/ 3–5 weeks/ once a week 3-1) Injection therapy: 5 sessions/ 5–10 days/ once daily or every other day 3-2) Manual therapy: after each session of the assigned treatment |
1) Proportion of improved participants 2) Post-treatment |
Guo 2016 [43] |
1) 72 (36/36) 2) Shoulder impingement syndrome (clinical and imaging) 3) China |
1) Acupotomy (n = 36) versus injection therapy (n = 36) 2) 3 sessions/ 15 days/ once per 5 days 3) Injection therapy: same as those of acupuncture treatment |
1) Sub-elements of UCLA shoulder score: pain, function, active forward flexion ROM, strength of forward flexion, patient satisfaction; proportion of improved participants 2) Post-treatment |
Huang 2009 [26] |
1) 60 (30/30) 2) Supraspinatus tendinitis (clinical) 3) China |
1) Acupotomy (n = 30) versus manual therapy (n = 30) 2) Up to 5 sessions/ up to 25 days/ 5 days rest between each treatment 3) Manual therapy: 5 sessions/ 5 days/ once daily |
1) Proportion of improved participants, recurrence ratio 2) Up to 3 months post-treatment |
Huang 2013 [44] |
1) 60 (30/30) 2) Shoulder impingement syndrome (clinical) 3) China |
1) EA (n = 30) versus exercise (n = 30) 2) 24 sessions/ 4 weeks/ once a day, 1 day rest after 6 days of treatment 3) Exercise: same as those of acupuncture treatment |
1) Pain, function, proportion of improved participants 2) Post-treatment |
Johansson 2005 [45] |
1) 85 (44/41) 2) Shoulder impingement syndrome (clinical) 3) Sweden |
1) MA plus exercise (n = 44) versus ultrasound therapy plus exercise (n = 41) 2) 10 sessions/ 5 weeks/ twice a week 3-1) Ultrasound therapy: same as those of acupuncture treatment 3-2) Exercise: part I, once a day between weeks 1 and 5; part II, once every other day between weeks 4 and 5 |
1) Function 2) Up to 12 months post-randomization |
Kleinhenz 1999 [27] |
1) 52 (25/27) 2) RC tendinitis (clinical and imaging) 3) Germany |
1) MA (n = 25) versus sham acupuncture (n = 27) 2) 8 sessions/ 4 weeks/ not reported 3) Sham acupuncture: same as those of acupuncture treatment |
1) Function 2) Post-treatment |
Li 2014 [49] |
1) 104 (37/35/32) 2) Subacromial bursitis (clinical and imaging) 3) China |
1) Needle pricking plus pharmacopuncture (n = 37) versus needle pricking (n = 35) versus injection therapy (n = 32) 2) 3 sessions/ 3 weeks/ once a week 3-1) Pharmacopuncture: same as those of acupuncture treatment 3-2) Injection therapy: same as those of acupuncture treatment |
1) Proportion of improved participants 2) Up to 3 months post-treatment |
Li 2019 [38] |
1) 160 (30/30) 2) RC injury (clinical) 3) China |
1) Acupotomy plus oral Chinese herbal medicine (n = 30) versus oral Chinese herbal medicine alone (n = 30) 2) 8 sessions/ 8 weeks/ once a week 3) Oral Chinese herbal medicine: 8 weeks/ twice daily (morning & evening) |
1) Pain, function 2) Post-treatment |
Lin 2019 [39] |
1) 40 (20/20) 2) RC injury (clinical and imaging) 3) China |
1) Acupotomy (n = 20) versus electrotherapy (n = 20) 2) 2 sessions/ 2 weeks/ once a week 3) Electrotherapy: 14 sessions/ 2 weeks/ once daily |
1) Pain, function, proportion of improved participants 2) Post-treatment |
Lu, H. 2019 [28] |
1) 40 (20/20) 2) Supraspinatus tendinitis (clinical) 3) China |
1) EA plus ESWT(n = 20) versus ESWT alone (n = 20) 2) 20 sessions/ 40 days/ once every other day 3) ESWT: 6 sessions/ 6 weeks/ once a week (the next day of EA treatment) |
1) Pain, function, proportion of improved participants 2) Post-treatment |
Lu, M. 2019 [33] |
1) 60 (30/30) 2) RC tear (clinical and imaging) 3) China |
1) MA plus manual therapy (n = 30) versus manual therapy alone (n = 30) 2) 15 sessions/ 3 weeks/ 5 times a week 3) Manual therapy: same as those of acupuncture treatment |
1) Function, the thickness of bilateral RC tendons, proportion of improved participants 2) Post-treatment |
Papadopoulos 2019 [23] |
1) 40 (20/20) 2) Supraspinatus calcific tendinitis (clinical and imaging) 3) Greece |
1) EA plus oral medications and exercise (n = 20) versus oral medications and exercise alone (n = 20) 2) 6 sessions/ 3 weeks/ 2 sessions per week 3-1) Oral medications: 3 weeks/ not reported 3-2) Exercise: 3 weeks/ 5 times daily |
1) Pain, ROM (forward elevation, abduction) 2) Post-treatment |
Perez-Palomares 2017 [51] |
1) 120 (57/63) 2) RC tendinopathy or subacromial impingement syndrome (clinical and imaging) 3) Spain |
1) TrP-DN plus manual therapy (n = 57) versus manual therapy alone (n = 63) 2) 3 sessions/ 5 weeks/ at first, fourth, and seventh sessions among 10 sessions of treatment 3) Manual therapy: 10 sessions/ 5 weeks/ twice a week |
1) Pain 2) Up to 3 months post-treatment |
Shi 2019 [34] |
1) 104 (52/52) 2) RC tear (clinical and imaging) 3) China |
1) EA plus manual therapy (n = 52) versus manual therapy alone (n = 52) 2) not reported/ 6 weeks 3) Manual therapy: not reported/ 6 weeks |
1) Pain, function, ROM 2) Post-treatment |
Sun 2013 [46] |
1) 36 (12/12/12) 2) Shoulder impingement syndrome (clinical) 3) China |
1) EA plus massage and exercise (n = 12) versus EA plus MW and exercise (n = 12) versus massage, MW and exercise (n = 12) 2) 28 sessions/ 31 days/ once daily, 1 day rest between 7 days of treatment 3-1) Massage: same as those of acupuncture treatment 3-2) MW: same as those of acupuncture treatment 3-3) Exercise: not reported |
1) Sub-elements of Constant Murley score: pain, ADL, ROM, strength; proportion of improved participants 2) Mid-/post-treatment |
Wan 2017 [40] |
1) 150 (50/50/50) 2) RC injury (clinical and imaging) 3) China |
1) MA (n = 50) versus MA plus injection therapy (n = 50) versus injection therapy alone (n = 50) 2) not reported/ 20–30 days 3) Injection therapy: 4–5 sessions/ 4–5 weeks/ once a week |
1) Function, proportion of improved participants 2) Post-treatment |
Wang 2017 [29] |
1) 52 (26/26) 2) Supraspinatus tendinitis (clinical and imaging) 3) China |
1) Acupotomy (n = 26) versus no treatment (n = 26) 2) 1 session/ 1 day 3) no treatment |
1) Strain rate in the therapeutic target of the supraspinatus tendon, pain 2) Up to 12 weeks post-treatment |
Wang 2018 [35] |
1) 120 (40/40/40) 2) RC tear (clinical and imaging) 3) China |
1) EA (n = 40) versus EA plus manual therapy (n = 40) versus manual therapy alone (n = 40) 2) 30 sessions/ 6 weeks/ 5 times per week 3) Manual therapy: same as those of acupuncture treatment |
1) Pain, function, ROM 2) Post-treatment |
Yang 2019 [47] |
1) 150 (75/75) 2) Subacromial impingement syndrome (clinical) 3) China |
1) Warm needle acupuncture (n = 75) versus topical NSAID (n = 75) 2) 28 sessions/ 4 weeks/ once daily 3) Topical NSAID: 4 weeks/ 3–4 times daily |
1) Pain, function, ROM, proportion of improved participants 2) Post-treatment |
Zhang 2015 [30] |
1) 76 (19/19/19/19) 2) Supraspinatus tendinitis (clinical) 3) China |
1) Fire needle acupuncture (n = 19) versus acupotomy (n = 19) versus fire needle acupuncture plus acupotomy (n = 19) versus oral medication (n = 19) 2-1) Fire needle: 6 sessions/ 2 weeks/ 3 times a week 2-2) Acupotomy: 2 sessions/ 2 weeks/ once a week 3) Oral medication: 2 weeks/ three times a day |
1) Pain, function, proportion of improved participants 2) Post-treatment |
Zhang 2016 [31] |
1) 72 (36/36) 2) Supraspinatus tendinitis (clinical) 3) China |
1) Acupotomy plus injection therapy (n = 36) versus injection therapy alone (n = 36) 2) 3 sessions/ 3 weeks/ once a week 3) Injection therapy: same as those of acupuncture treatment |
1) Pain, function, proportion of improved participants 2) Up to 3 weeks post-treatment |
Zhang 2017 [32] |
1) 105 (35/35/35) 2) Supraspinatus tendinitis (clinical) 3) China |
1) Acupotomy (n = 35) versus acupotomy plus injection therapy (n = 35) versus injection therapy alone (n = 35) 2) 3 sessions/ 3 weeks/ once a week 3) Injection therapy: same as those of acupuncture treatment |
1) Pain, function, proportion of improved participants 2) Up to 3 weeks post-treatment |
Zhang 2016 [50] |
1) 80 (38/42) 2) Chronic shoulder pain (clinical) 3) China |
1) Contralateral MA (n = 38) versus physical therapy (n = 42) 2) 20 sessions/ 4 weeks/ 5 times a week 3) Physical therapy: 4 weeks/ daily exercise (not reported for heat or cold therapy) |
1) Pain 2) Up to 16 weeks post-randomization |
ADL, activities of daily living; EA, electroacupuncture; ESWT, extracorporeal shock wave therapy; MA, manual acupuncture; MW, microwave; NSAID, non-steroidal anti-inflammatory drug; RC, rotator cuff; ROM, range of motion; TrP-DN, trigger point dry needling; UCLA, University of California-Los Angeles.
Outcome | No. of studies/ participants | Effect size |
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Acupuncture versus non-pharmacological interventions | ||
Pain (intermediate-term) assessed with 100mm VAS | 1 study (n = 80) [50] |
Favors acupuncture MD −40.9 [95% CI −49.5, −32.3] |
Function (intermediate-term) assessed with DASH score | 1 study (n = 80) [50] |
Favors acupuncture MD −16.1 [95% CI −21.6, −10.6] |
AROM (short-term) assessed with degrees of flexion, abduction, and external rotation | 1 study (n = 40) [36] |
Shows no difference between acupuncture and control or favors control Flexion MD 1.81 [95% CI −2.64, 6.26] External rotation MD 0.97 [95% CI −2.83, 4.77] Abduction MD −11.89 [95% CI −20.15, −3.63] |
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Acupuncture versus pharmacological interventions | ||
Function (intermediate-term) assessed with ASES score | 1 study (n = 178) [41] |
Favors acupuncture MD 15.60 [95% CI 10.34, 20.86] |
Proportion of improved participants (intermediate-term) | 1 study (n = 67) [49] |
Shows no difference between acupuncture and control RR 1.07 [95% CI 0.81, 1.42] |
AROM (short-term) assessed with degrees of flexion, abduction, and external rotation | 1 study (n = 150) [47] |
Favors acupuncture Flexion MD 14.53 [95% CI 10.17, 18.89] Abduction MD 5.49 [95% CI 3.50, 7.48] External rotation MD 4.08 [95% CI 2.40, 5.76] |
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Acupuncture plus non-pharmacological interventions versus non-pharmacological interventions alone | ||
Pain (intermediate-term) assessed with NRS and VAS | 2 studies (n = 170) [48,51] |
Shows no difference between acupuncture and control MD −0.08 [95% CI −1.05, 0.89] |
Pain (long-term) assessed with NRS | 1 study (n = 50) [48] |
Shows no difference between acupuncture and control MD −0.10 [95% CI −0.90, 0.70] |
Function (intermediate-term) assessed with DASH score and CMS | 2 studies (n = 170) [48,51] |
Shows no difference between acupuncture and control MD 1.30 [95% CI −1.14, 3.74] |
Function (long-term) assessed with DASH score | 1 study (n = 50) [48] |
Favors acupuncture MD 1.72 [95% CI 1.06, 2.38] |
Proportion of improved participants (long-term) | 1 study (n = 47) [48] |
Shows no difference between acupuncture and control MD 1.21 [95% CI 0.99, 1.47] |
AROM (short-term) assessed with degrees of flexion, abduction, and external rotation | 3 studies (n = 344) [34,35,51] |
Shows no difference between acupuncture and control Flexion MD 20.60 [95% CI −16.92, 58.12] Abduction MD 9.49 [95% CI −6.98, 25.96] |
2 studies (n = 224) [34,35] |
Shows no difference between acupuncture and control External rotation MD 7.51 [95% CI −8.75, 23.76] |
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AROM (intermediate-term) assessed with degrees of flexion and abduction | 1 study (n = 120) [51] |
Shows no difference between acupuncture and control Flexion MD −1.76 [95% CI −7.88, 4.36] Abduction MD 1.77 [95% CI −7.33, 10.87] |
Effectiveness of Acupuncture for Scoliosis: A Systematic Review2022 February;39(1)
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