Table 1 Summary of the retrieved trials investigating glenohumeral joint distension on patients with frozen shoulder.

Jacobs LG (1991)

Abduction and forward flexion less than 90°; external rotation less than 20°

47 participants (17/30) in total: (1) HD group: 18 (2) IA steroid group: 15 (3) Distension only group: 14

(1) HD group:55; (2) IA steroid group: 52; (3) Distension only group: 53

Landmark guidance with the posterior approach

(1) HD group: 1 ml of 40 mg triamcinolone, 6 ml 0.25% bupivacaine and 3 ml air (total 10 ml) (2) Distension only group: 6 ml 0.25% bupivacaine and 3 ml air (total 9 ml)

IA steroid group: 1 ml of 40 mg triamcinolone

No

Unclear

Severity of pain in daily activities and with resisted movement; AROM and PROM; daily use of analgesics

Gam AN (1998)

External rotation degree on the affected shoulder less than 50% of that on the asymptomatic shoulder

(1) HD group: 12 (4/8) (2) IA steroid group: 8 (3/5)

(1) HD group: 53.5 (2) IA steroid group: 47

Ultrasound guidance with the posterior approach

HD group: 20 mg of triamcinolone with 19 ml 0.5% lidocaine

IA steroid group: 20 mg of triamcinolone

No

Yes

VAS pain scores at rest and during movement, ROM limitation, daily use of analgesics

Buchbinder R (2004)

Restriction of PROM of greater than 30° in 2 or more planes of movement

(1) HD group: 25 (5/20) (2) Placebo group: 21 (4/17)

(1) HD group: 57.2 ± 8.6; (2) Placebo group: 57.5 ± 8.1

Fluoroscopic guidance with the anterior approach

HD group: 1 ml of 40 mg methylprednisolone and up to 82 ml normal saline (total volume 30–90 ml)

Placebo group: 6 ml of contrast media

Yes

Yes

SPADI; PET; pain perception; AROM

Quraishi NA (2007)

A global loss of shoulder AROM and PROM; external rotation degrees of less than 50% of the normal shoulder

36 participants (15/21) in total: (1) HD group: 19 (2) IA steroid group: 17

(1) HD group: 55.2 (2) IA steroid group: 54.5

Fluoroscopic guidance with the anterior approach

HD group: 2 ml of 2% lidocaine, 0.75 ml of 30 mg triamcinolone and then contrast media from 10 ml to 55 ml before manipulation

IA steroid group: 2 ml of 2% lidocaine and 0.75 ml of 30 mg IA triamcinolone before manipulation

No

Yes

VAS, Constant score

Tveita EK (2008)

Limitation of PROM for more than 30° in at least two of the three movements

(1) HD group: 39 (13/26) (2) IA steroid group: 37 (18/19)

(1) HD group: 52 ± 7 (2) IA steroid group: 51 ± 6

Fluoroscopic guidance with the anterior approach

HD group: 4 ml contrast medium, 2 ml of 20 mg triamcinolone, 4 ml local anesthetics and 10 ml saline

IA steroid group: 3–4 ml contrast medium, 2 ml of 20 mg triamcinolone and 3–4 ml local anesthetics

No

Yes

SPADI; PROM

Park KD (2013)

>30° of PROM limitation in the affected shoulder compared with the opposite side in at least 2 directions

(1) HD group: 45 (10/35) (2) IA steroid group: 45 (12/33)

(1) HD group: 56.33 ± 5.92 (2) IA steroid: 55.23 ± 4.69

Ultrasound guidance with the posterior approach

HD group: 18 ml of 0.5% lidocaine and 2 ml of hyaluronic acid

IA steroid group: 4 ml of 0.5% lidocaine and 1 ml of 40 mg triamcinolone

No

Unclear

SPADI, VNS, PROM

Park SW (2014)

Limitation of more than 30° in AROM compared with the opposite side in two or more directions

53 participants (13/40) in total: (1) HD + IM group: 16 (2) IM group: 14 (3) HD group: 12 (4) GPT group:11

Mean age: 56 ± 7.6 in total

Fluoroscopic guidance with the anterior approach

(1) HD + IM group: 1 mL of 40 mg triamcinolone, 3 ml of 1% lidocaine, and 10 ml of normal saline plus intensive mobilization exercise (2) HD group: 1 mL of 40 mg triamcinolone, 3 ml of 1% lidocaine, and 10 ml of normal saline

(1) IM group: Intensive mobilization without injection (2) GPT group: general physical therapy without injection

No

Unclear

VNS, AROM, SPADI, Constant score

Mun SW (2016)

Forward flexion less than 120°; <50% of external rotation and internal rotation degrees compared with the opposite side

(1) HD group: 60 (25/35) (2) IA steroid group: 61 (20/41)

(1) HD group: 52.1 ± 6.4 (2) IA steroid group: 53.9 ± 5.9

Ultrasound guidance with the posterior approach

HD group: 1 ml of 40 mg triamcinolone, 10 ml of 1% lidocaine and 30 ml saline

IA steroid group: 1 ml of 40 mg triamcinolone and 5 ml of 1% lidocaine

No

Yes

VAS, PROM

Yoon JP (2016)

Limited AROM and PROM in at least 2 directions

(1) HD group: 28 (9/19) (2) IA steroid group: 29 (11/18) (3) Subacromial steroid group: 29 (6/23)

(1) HD group: 54 ± 9 (2) IA steroid group: 53 ± 8 (3) Subacromial steroid group:57 ± 7

(1) HD group: fluoroscopic guidance with anterior approach (2) Subacromial steroid and IA steroid groups: ultrasound guidance with the anterior approach

HD group: 1 ml of 40 mg triamcilone, 4 ml 2% lidocaine and 40 ml normal saline

(1) IA steroid group: 1 ml of 40 mg triamcilone, 4 ml 2% lidocaine and 5 ml normal saline (2) Subacromial steroid group: 1 ml of 40 mg triamcilone, 4 ml 2% lidocaine and 5 ml normal saline

Yes

Yes

VAS, simple shoulder test, Constant score, PROM

Lee DH (2016)

Limitation of PROM >30° in at least 2 planes of movement

(1) HD group: 32 (11/21) (2) IA steroid group: 32 (13/19)

(1) HD group: 55.9 ± 5.2 (2) IA steroid group: 53.8 ± 4.4

Ultrasound guidance with the posterior approach

HD group: 1 ml of 40 mg triamcinolone, 6 ml of 1% lidocaine and normal saline (total volume of 25.1 ± 6.1 ml)

IA steroid group: 1 ml of 40 mg triamcinolone, 3 ml of 1% lidocaine

No

Yes

SPADI, VAS, PROM

Sharma SP (2016)

PROM reduction of more than 30% of two of three shoulder movements including abduction, external rotation and internal rotation

(1) HD group: 34 (13/21) (2) IA steroid group: 36 (15/21) (3) TAU group: 36 (17/19)

(1) HD group: 53 ± 9.2 (2) IA steroid group: 52 ± 8.3 (3) TAU group: 54 ± 6.9

Landmarks guidance with the posterior approach

HD group: 1 mL of 20 mg triamcinolone, 3 ml lidocaine and normal saline from 8 ml to 20 ml

(1) IA steroid group: 1 mL of 20 mg triamcinolone injection and 3 ml of lidocaine (2) TAU group: physical therapy and oral medication

Yes

Yes

SPADI, VNS, PROM