A comparison of the effectiveness of radial extracorporeal shock wave therapy vs ultrasound therapy for frozen shoulder

Abstract

Objective To examine the effectiveness of radial extracorporeal shock wave therapy (rESWT) vs.ultrasound therapy (US) for frozen shoulder.Methods Sixty-five patients were randomly divided into three groups.High-dose shock wave group and low-dose shock wave group were given rESWT and joint mobilization.The pressure of 2.6-3.0 bar was applied in high-dose group,and 2.0-2.4 bar in low-dose group.2500 shots were given in the pain spots to each of the two groups,and the frequency was 10 Hz.Ultrasound therapy and joint mobilization were given in ultrasound group.Parameters were set at a 1 MHz and intensity level at 1.5 W/cm2.The assessments were performed before and immediately after treatment session,including 4 weeks and 8 weeks follow-up with visual analogue scale(VAS),activities of daily living (ADL),range of motion(ROM) and the average temperature differences in infrared thermography.The side effects were observed immediately and on the second day after treatment.Results In all of three groups,outcome measures showed significant differences between baseline and after the trearment in VAS,ADL,ROM and the average temperature differences in infrared thermography (P ＜ 0.05).Mean VAS in high-dose group and low-dose group showed significant and sustained reduction (P ＜ 0.05)(3.20±1.21,4.11 ± 1.21 after treatment,and 2.07 ± 1.44,2.36 ± 0.74 at 8th week during the followup period),whereas that in ultrasound group was 5.83 ± 1.03 after treatment and 4.25 ± 1.60 at 8th week during the follow-up period.Similar trends were found in average temperature differences.As compared with ultrasound group (0.81 ±0.77after treatmen,0.75 ±0.75 and 0.61 ±0.61 at 4th and 8th week during the follow-up period respectively),mean average temperature differences in high-dose group and lowdose group were decreased immediately after treatment,at 4th and 8th week durating the follow-up period (high-dose group:0.25 ± 0.37,0.28 ± 0.37,0.21 ± 0.24 ; low-dose group:0.09 ± 0.93,0.32 ± 0.23,0.23 ±0.22) (P ＜ 0.05).There was no significant difference between high-dose group and low-dose group in clinical efficacy (P ＞ 0.05).In high-dose group,more adverse effects occurred than in other two groups.Conclusion As compared with ultrasound therapy,rESWT appeared to have long-term effects,and is predominant in easing night pain.No statistical differences were found between high-dose group and low-dose group in chnical efficacy.However,the low-dose group had less side effects and better tolerance. Key words: Extracorporeal shock wave; Ultrasound therapy; Frozen shoulder; Infrared ray