Effect of radial extracorporeal shockwave therapy combined with evidence-based physical therapy for adhesive capsulitis of the shoulder: A randomized controlled trial.

Abstract

Objectives: To evaluate the effect of radial extracorporeal shockwave therapy (rESWT) combined with evidence-based physical therapy (EBPT) on adhesive capsulitis (AC).

Methods: A total of 30 participants with AC were randomly assigned to receive either rESWT combined with EBPT (experimental group) or sham rESWT combined with EBPT (control group) over a 6-week intervention period. The primary outcomes included pain (assessed using the visual analogue scale) and disability (disabilities of the arm, shoulder, and hand questionnaire). The secondary outcomes were shoulder range of motion (ROM), psychological distress (depression anxiety and stress scale-12), and health-related quality of life (HRQoL; short form-12). Assessments were carried out at baseline, post-intervention, and 12 weeks post-randomization.

Results: Compared with the control group, the experimental group experienced better improvement in reduction of pain immediately post-intervention (-2.00, 95% confidence interval [CI]: [-3.43, -0.57]; p=0.008), at 12 weeks post-randomization (-3.33, 95% CI: [-4.71, -1.96]; p<0.001), and disability at 12 weeks post-randomization (-24.70, 95% CI: [-37.30, -12.10]; p<0.001). The experimental group showed better active ROM of the shoulder in flexion, abduction, and internal rotation at 12 weeks post-randomization, and better external rotation immediately post-intervention and at 12 weeks post-randomization. The experimental group achieved better passive ROM in abduction and external rotation immediately post-intervention and better flexion, abduction, external rotation, and HRQoL at 12 weeks post-randomization.

Conclusion: The rESWT and EBPT combination therapy effectively decreased pain and disability and improved ROM and HRQoL in patients with AC.ClinicalTrials.gov Reg. No. ID: NCT05771220.