Comparison Of Two Dosimetry Of Shock Wave Therapy On Adhesive Capsulitis And Mobility Deficit- A Research Article

Abstract

Background: Adhesive capsulitis, or frozen shoulder, is a debilitating musculoskeletal condition characterized by progressive pain, stiffness, and restricted range of motion (ROM), which significantly limits upper limb functionality and quality of life. Extracorporeal Shock Wave Therapy (ESWT) has emerged as an effective non-invasive intervention, yet the optimal dosimetry for ESWT remains unclear.

Objective: This study aimed to compare the therapeutic efficacy of two different ESWT dosimetry protocols—standardized versus randomized—in reducing pain and improving shoulder mobility and functional outcomes in patients with adhesive capsulitis.

Methods: A randomized controlled trial was conducted on 120 participants diagnosed with primary adhesive capsulitis (frozen stage). Participants were randomly assigned into two groups (n=60 each). Group A received standardized ESWT with fixed parameters (0.15 mJ/mm², 10 Hz, 2000 pulses), while Group B received randomized dosimetry (0.10–0.25 mJ/mm², 5–15 Hz, 1500–2500 pulses) over a 4-week period. Both groups also underwent conventional physiotherapy. Pain, ROM (flexion, abduction, external rotation), and functional disability (SPADI score) were assessed at baseline and post-intervention using VAS, goniometry, and SPADI, respectively.

Results: Both groups demonstrated statistically significant improvements in all outcomes post-intervention (p < 0.001). However, Group B exhibited significantly greater improvements in VAS scores (mean reduction −4.1 vs. −2.9), ROM (e.g., flexion gain +45.9° vs. +28.5°), and SPADI scores (−31.4 vs. −23.7) compared to Group A (p < 0.001).

Conclusion: Both standardized and randomized ESWT protocols are effective in managing adhesive capsulitis. However, the randomized dosimetry approach yielded significantly superior clinical outcomes. These findings support the adoption of individualized, flexible ESWT parameters to enhance pain relief, shoulder mobility, and functional recovery in patients with frozen shoulder.