Başlık: Extracorporeal shockwave therapy improves short-term functional outcomes of shoulder adhesive capsulitis

• Background

  The treatment of adhesive capsulitis is a dilemma for orthopaedic rehabilitation specialists. In this study, we assessed whether extracorporeal shockwave therapy (ESWT) improves the functional outcome of primary shoulder adhesive capsulitis.

  Methods

  In this prospective, randomized, controlled, single-blind clinical trial, we enrolled 40 patients with primary adhesive capsulitis to assess whether ESWT can improve the functional outcome of primary adhesive capsulitis better than oral steroid therapy. Patients were allocated to the oral steroid group or ESWT group with randomization. Functional outcome evaluations were performed using the Constant Shoulder Score (CSS) and Oxford Shoulder Score.

  Results

  Both groups showed significant improvement in the Oxford Shoulder Score evaluation throughout the study period. In the ESWT group, the total CSS and range of motion (ROM) parameter of the CSS in the ESWT group showed significant improvement from the fourth week that was better than that in the steroid group; the activities–of–daily living (ADL) parameter of the CSS achieved significance and was better than that in the steroid group at the sixth week. For the steroid group, pain was significantly reduced from baseline to the fourth week of the study; ADL and ROM improved at the fourth to 12th week. For the ESWT group, ADL and ROM improvements were significant from baseline to the sixth week.

  Conclusion

  Our results showed that ESWT can be an alternative treatment, at least in the short-term, for primary adhesive capsulitis of the shoulder. In addition, all of the side effects of ESWT were transient and tolerable.

   
   

  Section snippets

  Materials and methods

  This study was a prospective, single-blind, randomized clinical trial, in which the investigator who performed the functional evaluations was blinded from the group assignment and from the randomization procedures. From July 2012 to June 2013, 52 patients with adhesive capsulitis from Shuang-Ho Hospital, New Taipei City, Taiwan, were enrolled in the study. The inclusion criteria were patients older than 18 years with shoulder pain and restriction in ROM (>75% ROM loss in ≥2 directions, ie,

  Results

  In this study, both groups showed significant improvements in the OSS evaluation throughout the study period. In the CSS evaluation, both groups showed functional outcome improvements after treatment, but the patients who received ESWT showed faster improvements and better final CSSs than those who received oral steroids. Before treatment, both groups had similar functional scores, and the differences were not statistically significant (P = .973 for CSS and P = .658 for OSS). After treatment

  Discussion

  Primary adhesive capsulitis, or frozen shoulder, is a common condition encountered in the outpatient orthopaedic clinic. The natural history of adhesive capsulitis, though typically described as a self-limiting disease process, is not completely known, and recent studies have shown that it can lead to longer-term disability over the course of several years.11 It is characterized by the spontaneous onset of shoulder pain and global limitation of both active and passive shoulder motion. Frozen

  Conclusion

  Patients showed functional outcome improvements regardless of whether they were treated with ESWT or oral steroids, but those who received ESWT had faster and better functional outcome improvements. In the steroid group, pain was significantly reduced in the early phase of the study (baseline to fourth week); ADL and ROM improved in the later phases (fourth to 12th week). In the ESWT group, ADL and ROM improvements were significant in the early phases of the study (baseline to sixth week).

  Disclaimer

  The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.