Capacitive resistive monopolar radiofrequency at 448 kHz plus exercising versus exercising alone for subacromial pain: A sham-controlled randomized clinical trial

Abstract

Objective To investigate the effectiveness of thermal and sub-thermal capacitive-resistive monopolar radiofrequency at 448 kHz plus exercising compared to sham radiofrequency plus exercising on pain, functionality, and quality of life in patients with subacromial pain. Design Randomized, controlled, parallel, double-blind, three-arm clinical trial. Setting Hospital and Primary Care. Subjects Eighty-one participants with subacromial pain in three intervention groups. Interventions Three interventions with capacitive-resistive radiofrequency (thermal, sub-thermal, and sham) over 9 sessions (3 per week) plus an exercising protocol identical for all groups over 15 sessions (5 per week). Outcome measures Visual analogue scale and pressure pain threshold for pain, Shoulder Pain and Disability Index and Quick-Disabilities of the Arm, Shoulder and Hand for functionality, and quality of life via the European Quality of Life-Five Dimensions were assessed at baseline, immediately posttreatment, and 1 month and 3 months post-intervention. Results No between-group differences were found in the pain visual analogue scale (F = 1.0; P = 0.37), Shoulder Pain and Disability Index (F = 1.0; P = 0.36), European Quality of Life-Five Dimensions (F = 0.76; P = 0.47), and pressure pain (F = 0.14; P = 0.86) outcomes, with a statistical power < 0.30 for all comparisons. Between-group differences were found in the Quick-Disabilities of the Arm, Shoulder and Hand (F = 3.4; P < 0.038), with an improvement of −14.1 points (confidence interval at 95% (95% CI) −28.1 to −0.1) in the thermal versus the sham group at 1 month follow-up. The mobility dimension of European Quality of Life-Five Dimensions improved in a greater proportion of participants in the thermal group (22.2% thermal, 7.4% sub-thermal, and 0.0% sham; P = 0.02) Conclusion Adding thermal radiofrequency to exercising can further improve slightly functionality and mobility in people with subacromial pain in the short term, but not pain perception. Future studies with larger sample sizes are warranted to increase statistical power.

The Efficacy of Electromagnetic Diathermy for the Treatment of Musculoskeletal Disorders: A Systematic Review with Meta-Analysis

“…In contrast, non-pooled data for improvement in function in Akyol’s 2012 study [ 76 ] reported significant changes in favour of the control sham MWD group compared with MWD at post-treatment (MD −2.35, 95% CI −3.50 to −1.20, random-effects model) and short-term follow-up (MD −4.05, 95% CI −5.23 to −2.87, random-effects model). Non-pooled data for improvement in function in Jimenez-Garcia 2008, Rabini 2012, and Avendaño-Coy 2022 [ 59 , 77 , 92 ] did not show any significant changes in favour of any considered groups at any time point ( Table 9 ).…”

“…Six studies [ 58 , 59 , 76 , 77 , 78 , 92 ] evaluated the efficacy of diathermy for treating STN. Two studies utilized SWD, 3 studies used MWD, and 1 utilized CRET.…”

“…In contrast, non-pooled data for pain relief in Rabini’s 2012 study [ 77 ] reported significant changes in favour of the control subacromial corticosteroid injections group, compared with MWD at long-term follow-up (MD 9.50, 95% CI 1.70 to 17.30, random-effects model). Non-pooled data for pain relief in Jimenez-Garcia 2008 [ 59 ], Akyol 2012 [ 76 ], and Avendaño-Coy 2022 [ 92 ] did not show any significant changes in favour of any considered groups at any time point ( Table 8 ).…”

Patellar Tendon Elasticity and Temperature Following after a 448 Kilohertz Radiofrequency Intervention on Active Healthy Subjects: An Open Controlled Clinical Trial

“…Participants received one 448 kHz CRMR intervention. Each participant was positioned in a supine posture with their knees flexed at an angle of 20 degrees [ 18 ]. Utilizing the INDIBA ® Activ 8 apparatus, characterized by a peak power of 200 W and 450 VA, continuous radiofrequency electromagnetic radiation (CRMR) at 448 kHz was administered, consistent with previous investigations [ 19 ].…”

“…The application of capacitative-resistive monopolar radiofrequency (CRMR) at 448 kHz in healthy subjects has been shown to be more effective than conventional thermotherapy at an increasing temperature in superficial and deep tissues and also blood flow in both skin and deep tissues, as well as increasing hemoglobin saturation [ 14 , 17 ]. Radiofrequency adaptations to hyperthermia are based on vasodilation, which causes increased local blood perfusion and reduced muscle tension and spasm, increasing oxygen and nutrients as well as accelerating the healing process [ 18 ]. CRMR shows an ability to improve pain, function, and quality of life in patients with musculoskeletal disorders, especially spinal disorders and knee osteoarthritis [ 17 , 19 ].…”