Comparative Efficacy Of Standardized And Randomized Shockwave Therapy In Adhesive Capsulitis: A Pilot Study

Abstract

Background

Frozen shoulder or adhesive capsulitis is a musculoskeletal disorder with pain, stiffness, and limited range of motion (ROM). It highly impairs activities of daily living and quality of life. Extracorporeal Shockwave Therapy (ESWT) has been a potential non-surgical treatment option, but the best dosing protocol standardized vs. randomized is unclear. In this study, these two methods of ESWT will be compared in relieving pain and enhancing mobility.

Methods

A single-blind randomized controlled trial involving 30 patients was performed and divided into three groups: Group 1 (Standardized ESWT), Group 2 (Randomized ESWT), and Group 3 (Exercise-only control). Treatment was for four weeks with three sessions a week. Pain and functional outcomes were evaluated using the Shoulder Pain and Disability Index (SPADI), while ROM was evaluated using a goniometer. Observations were taken on Week 0, Week 2, Week 3, and Week 4, and statistical tests were conducted with p < 0.05 set as significant.

Results

Both randomized and standardized shockwave therapy significantly alleviated pain and enhanced ROM in comparison to the exercise group (p < 0.001). SPADI scores reduced more in Group 1 (39.4) than in Group 2 (41.1), indicating marginally better pain reduction with standardized therapy. ROM improvement was equal in both shockwave groups, with Group 2 having marginally improved flexibility.

Conclusion

This research substantiates that shockwave therapy is more effective than exercise alone for the treatment of adhesive capsulitis. Systematic ESWT gave superior pain relief, but randomized ESWT gave flexibility. Long-term effects and optimization of individualized treatment should be researched in the future.