The effectiveness of extracorporeal shockwave therapy for frozen shoulder in patients with diabetes: randomized control trial

Ramprasad Muthukrishnan, Ayesha Abdul Rashid, Fatma Al-Alkharji, Ramprasad Muthukrishnan, Ayesha Abdul Rashid, Fatma Al-Alkharji

Abstract

[Purpose] This study examined the effectiveness of extracorporeal shock wave therapy versus ultrasound therapy, combined with the mobilization and therapeutic exercise in both groups, in participants with diabetic frozen shoulder. [Participants and Methods] Twenty participants with diabetic frozen shoulder were divided into an experimental group who received extracorporeal shock wave therapy, mobilization and exercises (n=10, Mean: 43.70) and the control group who received ultrasound, mobilization and exercises (n=10 Mean: 45.50). The clinical outcomes, i.e., a) pain b) active range of motions of the shoulder, c) disability scores by Disabilities of the Arm, Shoulder and Hand scale and d) global rating of change was measured weekly for four weeks. [Results] Significant improvements in pain, all active range of motions and disability scores were observed at the end of the 4th week in both groups. Additionally, the experimental group benefitted significant pain reduction (median difference: 7 in experimental versus 6 in control group), reduced number of therapy sessions and thus the costs of treatment compared to the control group. [Conclusion] Extracorporeal shock wave therapy significantly reduced pain in people with diabetic frozen shoulder with a reduction of treatment cost compared to the control group.

Keywords: Diabetes; Extracorporeal shock wave therapy; Frozen shoulder.

Conflict of interest statement

This study was supported by a research grant from Gulf Medical University.

Figures

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Fig. 1.
ESWT project flow chart.

References

    1. Kelley MJ, McClure PW, Leggin BG: Frozen shoulder: evidence and a proposed model guiding rehabilitation. J Orthop Sports Phys Ther, 2009, 39: 135–148.
    1. Zreik NH, Malik RA, Charalambous CP: Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence. Muscles Ligaments Tendons J, 2016, 6: 26–34.
    1. Smith LL, Burnet SP, McNeil JD: Musculoskeletal manifestations of diabetes mellitus. Br J Sports Med, 2003, 37: 30–35.
    1. Jain TK, Sharma NK: The effectiveness of physiotherapeutic interventions in treatment of frozen shoulder/adhesive capsulitis: a systematic review. J Back Musculoskeletal Rehabil, 2014, 27: 247–273.
    1. Page MJ, Green S, Kramer S, et al. : Electrotherapy modalities for adhesive capsulitis (frozen shoulder). Cochrane Database Syst Rev, 2014, (10): CD011324.
    1. Ebadi S, Forogh B, Fallah E, et al. : Does ultrasound therapy add to the effects of exercise and mobilization in frozen shoulder? A pilot randomized double-blind clinical trial. J Bodyw Mov Ther, 2017, 21: 781–787.
    1. Kyhlbäck M, Schröder Winter H, Thierfelder T, et al. : Physiotherapy treatment of the diabetic shoulder: a longitudinal study following patients with diabetes and shoulder pain using a pre-post treatment design. Disabil Rehabil, 2014, 36: 556–562.
    1. Chen CY, Hu CC, Weng PW, et al. : Extracorporeal shockwave therapy improves short-term functional outcomes of shoulder adhesive capsulitis. J Shoulder Elbow Surg, 2014, 23: 1843–1851.
    1. Moya D, Ramón S, Guiloff L, et al. : Current knowledge on evidence-based shockwave treatments for shoulder pathology. Int J Surg, 2015, 24: 171–178.
    1. Santoboni F, Balducci S, D’Errico V, et al. : Extracorporeal shockwave therapy improves functional outcomes of adhesive capsulitis of the shoulder in patients with diabetes. Diabetes Care, 2017, 40: e12–e13.
    1. Vahdatpour B, Taheri P, Zade AZ, et al. : Efficacy of extracorporeal shockwave therapy in frozen shoulder. Int J Prev Med, 2014, 5: 875–881.
    1. Rangan A, Goodchild L, Gibson J, et al. : Frozen shoulder. Shoulder Elbow, 2015, 7: 299–307.
    1. Occupational Therapy Assessment Guide: (Accessed Oct. 6, 2018)
    1. : . (Accessed Oct. 9, 2018)
    1. Bal A, Eksioglu E, Gulec B, et al. : Effectiveness of corticosteroid injection in adhesive capsulitis. Clin Rehabil, 2008, 22: 503–512.
    1. Dias R, Cutts S, Massoud S: Frozen shoulder. BMJ, 2005, 331: 1453–1456.
    1. Gaspar PD, Willis FB: Adhesive capsulitis and dynamic splinting: a controlled, cohort study. BMC Musculoskelet Disord, 2009, 10: 111.
    1. Kelley M, Mcclure P, Leggin B: Frozen sholder: envidence and a proposed model guiding rehabilitation. J Orthop Sports Phys Ther, 2009, 39: 135–148.
    1. Ruiz JO: Positional stretching of the coracohumeral ligament on a patient with adhesive capsulitis: a case report. J Manual Manip Ther, 2009, 17: 58–63.
    1. Vermeulen HM, Rozing PM, Obermann WR, et al. : Comparison of high-grade and low-grade mobilization techniques in the management of adhesive capsulitis of the shoulder: randomized controlled trial. Phys Ther, 2006, 86: 355–368.
    1. Physiopedia: Visual analogue scale. (Accessed Oct. 10, 2018)
    1. Orthopedic Score: The Disabilities of the Arm, Shoulder and Hand (DASH) Score. (Accessed Oct. 10, 2018)
    1. Cisco: Global rating of change scale (GROC). (Accessed Oct. 10, 2018)
    1. Tornese D, Mattei E, Bandi M, et al. : Arm position during extracorporeal shock wave therapy for calcifying tendinitis of the shoulder: a randomized study. Clin Rehabil, 2011, 25: 731–739.

Source: PubMed

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