***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To determine whether the addition of deep or superficial heating to stretching produces better clinical outcomes than stretching alone in the management of frozen shoulder . DESIGN A single-blinded , r and omized controlled study . SUBJECTS Thirty subjects suffering from the stiffness phase of frozen shoulder . METHODS Subjects were r and omly allocated to receive : ( i ) deep heating plus stretching ; ( ii ) superficial heating plus stretching ; or ( iii ) stretching alone . Both heating groups received the respective treatments 3 times per week for 4 weeks . All groups received a st and ard set of shoulder stretching exercises . The American Shoulder and Elbow Surgeons assessment form was recorded at the baseline , sessions 6 and 12 , and at the 4-week follow-up session . RESULTS A significant improvement was seen in all groups in all outcome measures except for that of shoulder flexion range . The improvement in the shoulder score index and in the range of motion was significantly better in the deep heating group than in the superficial heating group . CONCLUSION The addition of deep heating to stretching exercises produced a greater improvement in pain relief , and result ed in better performance in the activities of daily living and in range of motion than did superficial heating Objective To examine the prevalence of outcome reporting bias — the selection for publication of a subset of the original recorded outcome variables on the basis of the results — and its impact on Cochrane review s. Design A nine point classification system for missing outcome data in r and omised trials was developed and applied to the trials assessed in a large , unselected cohort of Cochrane systematic review s. Research ers who conducted the trials were contacted and the reason sought for the non-reporting of data . A sensitivity analysis was undertaken to assess the impact of outcome reporting bias on review s that included a single meta- analysis of the review primary outcome . Results More than half ( 157/283 ( 55 % ) ) the review s did not include full data for the review primary outcome of interest from all eligible trials . The median amount of review outcome data missing for any reason was 10 % , whereas 50 % or more of the potential data were missing in 70 ( 25 % ) review s. It was clear from the publications for 155 ( 6 % ) of the 2486 assessable trials that the research ers had measured and analysed the review primary outcome but did not report or only partially reported the results . For reports that did not mention the review primary outcome , our classification regarding the presence of outcome reporting bias was shown to have a sensitivity of 88 % ( 95 % CI 65 % to 100 % ) and specificity of 80 % ( 95 % CI 69 % to 90 % ) on the basis of responses from 62 trialists . A third of Cochrane review s ( 96/283 ( 34 % ) ) contained at least one trial with high suspicion of outcome reporting bias for the review primary outcome . In a sensitivity analysis undertaken for 81 review s with a single meta- analysis of the primary outcome of interest , the treatment effect estimate was reduced by 20 % or more in 19 ( 23 % ) . Of the 42 meta-analyses with a statistically significant result only , eight ( 19 % ) became non-significant after adjustment for outcome reporting bias and 11 ( 26 % ) would have overestimated the treatment effect by 20 % or more . Conclusions Outcome reporting bias is an under-recognised problem that affects the conclusions in a substantial proportion of Cochrane review s. Individuals conducting systematic review s need to address explicitly the issue of missing outcome data for their review to be considered a reliable source of evidence . Extra care is required during data extraction , review ers should identify when a trial reports that an outcome was measured but no results were reported or events observed , and contact with trialists should be encouraged OBJECTIVE To examine whether the addition of either electroacupuncture or interferential electrotherapy to shoulder exercises would be more effective in the management of frozen shoulder . DESIGN A double-blinded , r and omized , controlled trial . METHODS A total of 70 subjects were r and omly allocated to receive either : ( i ) electroacupuncture plus exercise ; ( ii ) interferential electrotherapy plus exercise ; or ( iii ) no treatment ( the control group ) . Subjects in groups ( i ) and ( ii ) received 10 sessions of the respective treatment , while the control group received no treatment for 4 weeks . Each subject 's score on the Constant Murley Assessment and visual analogue scale were recorded at baseline , post-treatment session and subsequent follow-up sessions . RESULTS In both the electroacupuncture and interferential electrotherapy groups , the Constant Murley Assessment score increased and the visual analogue scale score decreased significantly ( both p < 0.001 ) . No significant change was found in any outcome of the control group , and no significant difference was found between the 2 intervention groups ( all p > 0.05 ) . The observed improvement was well maintained in both intervention groups at least until the 6-month follow-up session . CONCLUSION Either electroacupuncture or interferential electrotherapy in combination with shoulder exercises is effective in treating frozen shoulder patients . However , no significant difference was found between these types of treatment As the natural history of frozen shoulder is poorly documented , a prospect i ve study of 40 patients followed up for 40 - 48 months ( mean 44 months ) is described . The range of movement was significantly less than age- and sex-matched controls . Objective restriction was severe in five patients and mild in a further 11 . Patients were often unaware that shoulder range was impaired . Dominant arm involvement , manual labour , and mobilisation physiotherapy were associated with a less satisfactory outcome . We conclude that , while objective restriction persists , there is little functional impairment in the late stage of frozen shoulder PRINCIPLE A r and omised , comparative prospect i ve clinical trial was planned to compare the early response to different rehabilitation methods for adhesive capsulitis taking into consideration the clinical efficacy and the cost effectiveness of the methods . METHODS Forty patients with adhesive capsulitis were r and omised into two treatment groups . The first group ( CYR ) received the Cyriax approach of deep friction massage and mobilisation exercises three times weekly . The second group ( PT ) had daily physical therapy including hot pack and short wave diathermy application . Both groups concluded their treatments with stretching exercises and were also instructed to a daily home exercise program . The primary end point of the study was to reach 80 % of the normal passive range of motion ( ROM ) of the shoulder in all planes within a period of two weeks . Secondary end points were the overall ROM and pain response ( spontaneous pain , night pain and pain with motion ) to each treatment . RESULTS 19 patients in the CYR group ( 95 % ) and 13 patients in the PT group ( 65 % ) reached sufficient ROM at the end of the second week ( p < 0.05 ) . The improvement in shoulder flexion , inner and outer rotation values and the decrease in pain with motion were significantly better in the CYR group after the first week of treatment . CONCLUSION The Cyriax method of rehabilitation provides a faster and better response than the conventional physical therapy methods in the early phase of treatment in adhesive capsulitis . The method is non-invasive , effective and requires fewer hospital visits for a sufficient early response OBJECTIVE To compare 2 different treatment approaches , physical therapy modalities , and joint mobilization versus whole-body cryotherapy ( WBC ) combined with physical therapy modalities and joint mobilization , for symptoms of adhesive capsulitis ( AC ) of the shoulder . DESIGN A r and omized trial . SETTING Hospital . PARTICIPANTS Patients with AC of the shoulder ( N=30 ) . INTERVENTION Patients were r and omly assigned to 2 groups . The WBC group received physical therapy modalities , passive joint mobilization of the shoulder , and WBC , whereas the non-WBC group received only physical therapy modalities and passive joint mobilization of the shoulder . MAIN OUTCOME MEASURES Visual analog scale ( VAS ) , active range of motion ( ROM ) of flexion , abduction , internal and external rotation of the shoulder , and the American Shoulder and Elbow Surgeons St and ardized Shoulder Assessment Form ( ASES ) were measured before and after the intervention . RESULTS A statistically significant difference between groups was found for the VAS , active ROM of flexion , abduction , internal rotation , and external rotation , and the ASES with greater improvements in the WBC group ( Ps<.01 ) . Overall , both groups showed a significant improvement in all outcome measures and ROM measures from pre to post at a level of P<.01 . CONCLUSIONS There is significant improvement with the addition of WBC to treatment interventions in this sample of patients The aim of this study was to compare the efficacy of sodium hyaluronate ( SH ) injection with the most common treatment methods , intraarticular steroid injection and physical therapy modalities in patients with adhesive capsulitis ( AC ) . A total of 95 shoulders of 90 patients were included in the study and were r and omized in four groups . The patients were treated with SH injection ( group 1 ) , triamsinolone acetonide ( group 2 ) or physical therapy modalities ( group 3 ) . Group 4 patients were served as controls . Pain severity , passive ranges of motion and functional considerations were measured before , and 15 days and 3 months after the treatments . In all treatment groups , there were significant improvements at both the 15th day and third month in all parameters ( for each , p<0.001 ) . The passive abduction values on the 15th day was found significantly higher in group 3 when compared with group 1 and controls ( for each , p<0.001 ) . At the third month , the passive abduction values of the groups 2 and 3 were improved when compared with the control group ( p<0.001 ) . Constant score was higher in group 3 on 15th day when compared with group 1 . At the third month , all treatment groups were improved significantly compared with control group ( p<0.001 ) . We provided the best results in physical therapy modalities applied group for AC treatment . However , we think that SH injection may be administered as an alternative treatment method Treatment strategies targeting abnormal shoulder kinematics may prevent pathology or if the pathology develops , shorten its duration . We examined the effectiveness of the end-range mobilization/scapular mobilization treatment approach ( EMSMTA ) in a subgroup of subjects with frozen shoulder syndrome ( FSS ) . Based on the kinematics criteria from a prediction method , 34 subjects with FSS were recruited . Eleven subjects were assigned to the control group , and 23 subjects who met the criteria were r and omly assigned to the criteria -control group  with a st and ardized physical therapy program or to the EMSMTA group . Subjects attended treatment sessions twice a week for 8 weeks . Range of motion ( ROM ) , disability score , and shoulder complex kinematics were obtained at the beginning , 4 weeks , and 8 weeks . Subjects in the EMSMTA group experienced greater improvement in outcomes compared with the criteria -control group at 4 weeks ( mean difference=0.2 of normalized h and -behind-back reach ) and 8 weeks ( mean difference=22.4 degrees humeral external rotation , 0.31 of normalized h and -behind-back reach , 7.5 disability , 5 degrees tipping and 0.32 rhythm ratio ) . Similar improvements were found between the EMSMTA group and control group . The EMSMTA was more effective than a st and ardized physical therapy program in a subgroup of subjects who fit the criteria from a prediction method OBJECTIVE There is a lack of evidence about the effectiveness of therapeutic ultrasound ( US ) compared with placebo US in the treatment of adhesive capsulitis . This study was performed to assess the effectiveness of therapeutic US in the treatment of adhesive capsulitis . METHODS Forty-nine patients with adhesive capsulitis were r and omized to US ( n=25 ) and sham US ( n=24 ) groups . Superficial heat and an exercise program were given to both groups . Ultrasound was applied to US group and imitative ultrasound was applied to sham US group for 2 weeks . Shoulder range of motion ( ROM ) , pain and Shoulder Pain and Disability Index ( SPADI ) were assessed at the beginning , after treatment and after 3 months ( control ) . Short Form-36 ( SF-36 ) was applied for assessing general health status at the beginning and after 3 months . Compliance with the home exercise program was recorded daily on a chart for 3 months . RESULTS Shoulder ROM , pain with motion , two subscales and total score of SPADI and physical component summary score of SF-36 were improved significantly in both groups after the treatment and after 3 months ( p<0.0001 ) . Improvements in flexion , inner and outer rotation values were significantly higher in the US group when we compared the differences between post- and pre-treatment values of shoulder ROM . The differences between control and pre-treatment values of inner and outer rotation were also significantly higher in the US group ( p=0.002 and p=0.02 respectively ) . No significant difference was detected in pain , SPADI and SF-36 scores between groups . The exercise compliance was significantly higher in the sham US group ( p=0.04 ) . CONCLUSION Our results suggest that US compared with sham US gives no relevant benefit in the treatment of adhesive capsulitis . Effectiveness of US might be masked by worse pre-treatment values of the US group and higher exercise compliance of the sham US group AIMS Numerous studies have demonstrated the utility of extremely low frequencies ( ELF ) electromagnetic fields in the treatment of pain . Moreover , the effects of these fields seems to depend on their respective codes ( frequency , intensity , waveform ) . In our study we want to assess the effects of the TAMMEF ( Therapeutic Application of a Musically Modulated Electromagnetic Field ) system , whose field is piloted by a musical signal and its parameters ( frequency , intensity , waveform ) are modified in time , r and omly varying within the respective ranges , so that all possible codes can occur during a single application . PATIENTS AND METHODS Sixty subjects , affected by shoulder periarthritis were enrolled in the study and r and 
    Output:
    
LLLT 's benefits on function were maintained at four months .