The effects of extracorporeal shock wave therapy on pain and range of motion in patients with adhesive capsulitis.
Sangho Lee, Sangyong Lee, Mugeun Jeong and 2 others
PMID 29200621WHAT IT FOUND
In 30 patients with adhesive capsulitis, adding shock wave therapy to hot packs, ultrasound and interference current for four weeks lowered pain and increased shoulder movement more than those physical therapies alone.
Key findings
01Both groups had significant declines in VAS pain and significant increases in flexion and external rotation after treatment.
02After treatment, the experimental group had significantly lower VAS scores and higher flexion and external rotation than the control group.
03Post-treatment VAS pain was 2.9 cm in the experimental group and 6.3 cm in the control group; flexion was 147.7 degrees in the experimental group and 112.0 degrees in the control group; external rotation was 81.3 degrees in the experimental group and 52.2 degrees in the control group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only 30 patients, so the result is limited to a small group. The paper does not state how patients were assigned to the control and experimental groups or whether the rater was blinded. Patients were followed only for four weeks, so it is unknown whether the benefit lasted. The shock-wave group also received hot packs, ultrasound and interference current, so the result does not show that shock wave therapy alone caused the improvement. Baseline shoulder movement was not the same across the control and experimental groups: the shock-wave group started at 88.3 degrees flexion and 45.7 degrees external rotation, while the control group started at 108.4 degrees flexion and 50.0 degrees external rotation. Shock wave energy was adjusted according to patient tolerance, so the dose was not fixed across participants.
The easy way to misread this
Do not conclude that shock wave therapy alone improves adhesive capsulitis. The shock-wave group also received hot packs, ultrasound and interference current, and the control group received those same therapies, so the result is for shock waves added to that physical therapy package. The study also followed patients for only four weeks.