Effectiveness of Radial Extracorporeal Shock-Wave Therapy Versus Ultrasound-Guided Low-Dose Intra-Articular Steroid Injection in Improving Shoulder Pain, Function, and Range of Motion in Diabetic Patients With Shoulder Adhesive Capsulitis
Scientific Literature Overview RPW - Therapeutic
Authors Published Date Place of orgin
El Naggar TEDM, Maaty AIE, Mohamed AE.
J Shoulder Elbow Surg. 2020 Jul;29(7):1300-1309.
Jul 2020
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Objective
To compare the efficacy of radial extracorporeal shock-wave therapy (rESWT) vs. an ultrasound-guided low-dose intra-articular steroid injection in pain reduction and functional improvement in diabetic patients with shoulder adhesive capsulitis (AC).
Tested products
BTL-5000
Study design & methods
Double blind randomised control trial Subjects: • 103 diabetic patients with shoulder AC Methods: Subjects were randomised to receive 4 sessions of either • rESWT group (n = 52): received 4 sessions of rESWT, 1 week apart, 2000 pulses per session, 3.5 bar, 10Hz. • Steroid group (n = 51): received a single ultrasound-guided low-dose intra- articular steroid injection of 20 mg of triamcinolone acetonide.
RPW protocol: • The shock waves were delivered to 2 separate locations.
• The first 1000 impulses were applied in an anterior-to-posterior direction at the anterior shoulder joint, and the upper margin of the treatment zone was about 1 fingerbreadth lateral to the coracoid process. • The remaining 1000 impulses, of the total 2000 impulses per session, were applied in a posterior-to-anterior direction on the posterior side of the shoulder joint located beneath the lateral border of the scapular spine. Outcomes: • The primary outcome measure was functional improvement evaluated by the Quick Disabilities of the Arm, Shoulder and Hand (qDASH) score. • Secondary outcome measures were pain evaluated by the visual analog scale score and shoulder range of motion (ROM). An assessor who was blinded to treatment assignment assessed both groups at baseline and at 4, 8, and 12 weeks thereafter.
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