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Ultrasound-guided botulinum toxin type A for shoulder pain: a meta-analysis of randomized controlled trials.

BMC musculoskeletal disorders 2026 Vol.27(1) p. 14

Zhuang S, Zhang X, Lin C, Wang Z

PMC 전문 ↗ 원문 ↗ DOI ↗

관련 도메인

보툴리눔독소 주사 Botulinum Toxin Injection

Abstract

[BACKGROUND] Shoulder pain is a very common symptom. A number of studies have demonstrated that botulinum toxin type A is effective in relieving shoulder pain. Therefore, this systematic review and meta-analysis aimed to synthesize scientific evidence and quantify the combined effects of ultrasound-guided botulinum toxin type A on shoulder pain.

[METHODS] A comprehensive literature search was conducted in databases such as PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Information Database (CNKI), Wanfang database, and VIP database (VIP) using the keywords "ultrasound", "Botulinum toxin type A", and "shoulder pain". Two reviewers independently reviewed the studies, extracted data from eligible studies, and assessed the risk of bias. A random-effects model was used to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for Visual Analog Scale (VAS), Upper Extremity Fugl-Meyer Assessment (UEFMA), Range of Motion (ROM), Modified Barthel Index (MBI). Funnel plots and sensitivity analyses were also employed to evaluate the four outcome indicators above.

[RESULTS] Out of retrieved 854 records, ten studies (involving 533 patients) were finally included. Pooled analysis showed that ultrasound-guided botulinum toxin type A was associated with large improvements in shoulder pain (SMD = -1.1; 95% CI -1.47 to -0.73; P < 0.001), UEFMA score (SMD = 1.43; 95% CI 0.49 to 2.37; P = 0.003), ROM of shoulder flexion (SMD = 1.28; 95% CI 0.63 to 1.93; P < 0.001) and external rotation (SMD = 1.66; 95%CI, 0.83 to 2.48; P < 0.001). Mild improvements were observed in ROM of shoulder abduction (SMD = 0.8; 95%CI 0.18 to 1.43; P = 0.01) and MBI score (SMD = 1.33; 95% CI 0.22 to 2.43; P = 0.02).

[CONCLUSIONS] Our meta-analysis has shown ultrasound-guided BoNT-A injections have potential benefits for reducing shoulder pain and improving upper limb function, range of motion, and quality of life. However, these findings should be interpreted cautiously due to small sample size, measured differences, substantial heterogeneity and possible publication bias. More high-quality studies with large sample size are needed to assess long-term efficacy, strengthening the evidence that ultrasound-guided BoNT-A facilitates the reduction of shoulder pain.

추출된 의학 개체 (NER)

유형영어 표현한국어 / 풀이UMLS CUI출처등장
시술 botulinum toxin 보툴리눔독소 주사 dict 5
해부 SMD → standardized mean difference scispacy 1
해부 upper limb scispacy 1
약물 SMD → standardized mean difference scispacy 1
약물 [BACKGROUND] Shoulder scispacy 1
약물 ultrasound-guided botulinum toxin type A scispacy 1
약물 CI -1.47 scispacy 1
약물 [CONCLUSIONS] scispacy 1
약물 BoNT-A scispacy 1
질환 shoulder pain C0037011
Shoulder Pain
 scispacy 1
질환 shoulder flexion scispacy 1
질환 shoulder abduction scispacy 1
질환 pain C0030193
Pain
 scispacy 1
질환 UEFMA → Upper Extremity Fugl-Meyer Assessment scispacy 1
질환 ROM → Range of Motion scispacy 1
기타 botulinum toxin type scispacy 1
기타 VIP → VIP database scispacy 1
기타 Fugl-Meyer scispacy 1
기타 patients scispacy 1
기타 BoNT-A scispacy 1

MeSH Terms

Humans; Shoulder Pain; Botulinum Toxins, Type A; Ultrasonography, Interventional; Randomized Controlled Trials as Topic; Neuromuscular Agents; Treatment Outcome; Range of Motion, Articular; Pain Measurement

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외부 PMID 30건 (DB 미수집)

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