Supervised Exercises Compared With Radial Extracorporeal Shock-Wave Therapy for Subacromial Shoulder Pain: 1-Year Results of a Single-Blind Randomized Controlled Trial

Abstract

No significant difference was found between the SE and rESWT groups at the 1-year follow-up. More participants in the SE group had returned to work.

Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions

“…55 Within-group improvements in the SPADI were significant at 1-year follow-up; however, the between-group difference was not significant. ESWT, extracorporeal shockwave therapy; LLLT, low-level laser therapy; MT, manual therapy, including any type of mobilization, stretching or soft tissue technique applied to the shoulder and surrounding tissue, not the vertebral joints, unless otherwise specified; NS, nonsignificant; PT, physical therapy, including modalities such as heat, ultrasound, and electrotherapy, plus passive and/or active exercise, unless otherwise specified; QuickDASH, Quick Disabilities of the Shoulder and Hand Questionnaire; rESWT, radial ESWT; ROM, range of motion; SDQ, Shoulder Disability Questionnaire; SPADI, Shoulder Pain and Disability Index; SST, Simple Shoulder Test; TENS, transcutaneous nerve stimulation; TG, treatment group; VAS, visual analog scale CG, comparison group; DASH, Disabilities of the Arm, Shoulder and Hand Questionnaire; GRC, Global Rating of Change; KT, kinesiotaping; MT, manual therapy, including any type of mobilization, stretching, or soft tissue technique applied to the shoulder and surrounding tissue, not the vertebral joints, unless otherwise specified; MWM, mobilization with movement; NPRS, Numeric Pain Rating Scale; NS, nonsignificant; PT, physical therapy; including modalities such as heat, ultrasound, and electrotherapy, plus passive and/or active exercise, unless otherwise specified; SMT, spinal manipulative therapy, including manipulation and/or mobilization of vertebrae unless otherwise specified; SPADI, Shoulder Pain and Disability Index; TG, treatment group; VAS, visual analog scale for pain.…”

“…One of these was on LLLT 51 ; 1 on MT, specifically cervical mobilization 53 ; and 1 on spinal manipulation. 58 Engebretsen et al 55 reported that 2 patients in the ESWT group dropped out because of pain, with 1 crossing over to the supervised exercise group, and that 1 patient in the supervised exercise group reported increased pain. 55 Rhon et al 64 reported that in their trial of MT PT compared with CSIs, transient pain from the injection was the only adverse event reported.…”

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

“…Most multimodal programs of care (11/12 programs) included exercise. [29][30][31][32][33][34][35][36][37][38][39][40] The studies were clinically heterogeneous, and their results could not be pooled in a meta-analysis.…”

“…[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).…”