Three prospective RCTs with 230 participants were included in the review. However, the heterogeneity assessment indicated that one trial with the smallest sample size (n=24) was an outlier, and this was therefore excluded from the analysis.
The quality assessment scores for each individual study ranged from 33 to 73%, with a mean of 59%.
Complete recovery rates ranged from 27 to 100% for treatment groups and 24 to 85% for control groups. The pooled RD demonstrated a 17% (99% CI: 0.01, 0.32, p=0.005) improvement in clinically complete recovery for the treatment group using the random-effects model.
A sensitivity analysis including the third small sample size trial, i.e. the outlier, gave a RD of 12% (99% CI: -0.07, +0.31, p=0.11), which was not statistically significant. Analysis of 6 excluded studies (1 prospective and 5 retrospective) gave recovery rates ranging from 49 to 97% for the treatment group and 23 to 64% for the control group.
Analysis of the three trials demonstrated statistically-significant heterogeneity (p=0.06). Heterogeneity assessment indicated that one trial with the smallest sample size was an outlier, and this was therefore excluded from the analysis (RD -0.19, 95% CI: -0.58, 0.20). The resulting heterogeneity for the 2 remaining trials was minimal (p=0.20).