Efficacy of radial extracorporeal shockwave therapy in rehabilitation following arthroscopic rotator cuff repair: A STROBE compliant study

Hyun-Joong Kim, Wonjae Choi, JiHye Jung, SunGeon Park, YoungLan Joo, Sangbong Lee, Seungwon Lee, Hyun-Joong Kim, Wonjae Choi, JiHye Jung, SunGeon Park, YoungLan Joo, Sangbong Lee, Seungwon Lee

Abstract

Rotator cuff tear is a common cause of shoulder pain and disability. Arthroscopic rotator cuff repair (ARCR) is performed to treat a torn tendon. Postoperative joint immobilization is essential, but it is a problem that needs to be addressed in the rehabilitation process. This study aimed to evaluate the effects of radial extracorporeal shock wave therapy (rESWT) in patients who underwent ARCR and required active movement after the immobilization period. This study was an open-label, prospective, single-arm trial of 30 inpatients aged >18 years who underwent ARCR. A total of 6 rESWT sessions, along with the conventional rehabilitation program for ARCR patients, were provided at the hospital's sports rehabilitation center for 2 weeks. The application sites of rESWT are periscapular muscles (supraspinatus, infraspinatus, teres minor, and rhomboid). Evaluations were conducted 3 time points-baseline, immediately after the first session of rESWT, and after 2 weeks of intervention. The outcome measures were the numeric pain rating scale for pain, and shoulder flexion, scaption flexion, abduction, horizontal adduction, external rotation, and internal rotation for shoulder range of motion. For shoulder function, disabilities of the arm, shoulder and hand, shoulder pain and disability index, and simple shoulder test were used, and muscle strength was expressed by grip strength. supraspinatus and infraspinatus evaluated thickness, tone, and stiffness. The muscle strength (95% CI, -3.554 to -0.073) and supraspinatus tone (P = .017) showed significant changes immediately after the first session of rESWT. Further, there was significant improvement in ROM (P < .01); shoulder function (P < .01); and muscle strength (95% CI, -3.561 to -0.625), supraspinatus stiffness (95% CI, -67.455 to -26.345), and infraspinatus stiffness (P = .045) after 2 weeks of intervention. However, muscle thickness and tone were significantly improved only in supraspinatus (P = .044, P = .040). Rehabilitation with radial extracorporeal shock wave therapy additionally applied to the periscapular muscles in patients who started active movement in rehabilitation after arthroscopic rotator cuff repair is effective for shoulder function and muscle properties (muscle strength, thickness, tone, and stiffness). However, a randomized controlled trial is needed to further assess the effects of radial extracorporeal shock wave therapy alone.

Trial registration: ClinicalTrials.gov NCT04848103.

Conflict of interest statement

The authors have no funding and conflict of interest.

Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Figures

Figure 1.
Figure 1.
Radial extracorporeal shock wave therapy application site.
Figure 2.
Figure 2.
Measurement of muscle thickness using Bodymetrix.
Figure 3.
Figure 3.
Flow diagram of participant recruitment, allocation, and analysis.

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