Radial extracorporeal shockwave treatment compared with supervised exercises in patients with subacromial pain syndrome: single blind randomised study

Abstract

Objective To compare the effectiveness of radial extracorporeal shockwave treatment with that of supervised exercises in patients with shoulder pain. Design Single blind randomised study. Setting Outpatient clinic of physical medicine and rehabilitation department in Oslo, Norway. Participants 104 patients with subacromial shoulder pain lasting at least three months. Interventions Radial extracorporeal shockwave treatment: one session weekly for four to six weeks. Supervised exercises: two 45 minute sessions weekly for up to 12 weeks. Primary outcome measure Shoulder pain and disability index. Results A treatment effect in favour of supervised exercises at 6, 12, and 18 weeks was found. The adjusted treatment effect was −8.4 (95% confidence interval −16.5 to −0.6) points.

A self-managed single exercise programme versus usual physiotherapy treatment for rotator cuff tendinopathy: a randomised controlled trial (the SELF study)

“…The findings of this current study are in keeping with other similar studies where superiority of one approach over an active comparator is not apparent [20,21]. In contrast to other studies, the patient reported outcomes in terms of change in SPADI score at three months post-randomisation in this current study might be regarded as relatively meagre; 12.4 points for the self-managed exercise group and 16.7 points for the usual physiotherapy group.…”

A Preliminary Randomized Clinical Trial on the Effect of Cervicothoracic Manipulation Plus Supervised Exercises vs a Home Exercise Program for the Treatment of Shoulder Impingement

“…37 Nevertheless, surgery and exercises compared with a placebo laser have been reported to have statistical differences, 38 and an intervention with exercises produced higher improvement than shockwave therapy after 6 weeks. 39 The results in our study are similar to those reported in the treatment with proprioceptive exercises and conventional physiotherapy. 40 …”

The Effectiveness of Multimodal Care for the Management of Soft Tissue Injuries of the Shoulder: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration

“…[29][30][31][32][33][34][35][36][37][38][39][40] Three RCTs investigated participants with persistent subacromial impingement syndrome, 29,31,32,35,36 and 2 addressed subacromial impingement syndrome of variable duration. 38,39 Two RCTs studied persistent nonspecific shoulder pain, 30,33 2 targeted participants with variable duration nonspecific shoulder pain, 34,37 and 1 addressed rotator cuff tendinitis of variable duration.…”

“…Of those, 15 studies (published in 19 articles) were eligible for critical appraisal. [29][30][31][32][33][34][35][36][37][38][39][40][52][53][54][55][56][57][58] Ten studies (published in 12 articles) had low risk of bias and were included in the best evidence synthesis. [29][30][31][32][33][34][35][36][37][38][39][40] The interrater agreement for the screening of titles and abstracts was κ = 0.91 (95% CI, 0.82-1.00).…”