Comparison of the effects of Extracorporeal Shockwave Therapy and conventional physiotherapy in improvement of patients with shoulder girdle myofascial pain syndrome.

Abstract

The purpose of the present study was to compare the efficacy of Extracor poreal shockwave therapy (ESWT) in comparison with routine physiotherapy in improving the symptoms of myofascial pain syndrome of shoulder girdle. Methods: The present study was a randomized clinical trial conducted during one year in Physical Medicine and Rehabilitation outpatient Clinic of Imam Reza Hospital. Subjects with diagnosis of myofascial pain syndrome in the shoulder girdle were recruited through non-random sampling and were assigned randomly into three groups: Shockwave therapy (for three sessions along with shoulder exercises at home), Physiotherapy (routine physiotherapy for ten sessions along with shoulder exercises at home) and control. Pain intensity, ability to perform daily activities and pain pressure threshold as primay outcomes and range of motion (ROM) of the shoulder and neck, and shoulder muscles force as secondary outcomes were evaluated at before and the end of the intervention and also one month after the intervention based on the Visual Analogue Scale (VAS), Neck Disability Index (NDI), algometer, goniometer , inclinometer and physical examination respectively. Repeated measure ANOVA and sidak test were used to evaluate the trend of changes in the studied variables from the beginning to the end of the intervention and also the end of the follow up in the three groups and binary comparisons, respectively. Results: A total of 19 patients in the ESWT group, 24 in the physiotherapy group and 23 in the exercise group were finally analyzed. In the ESWT group significant improvements were achieved in all of the evaluated indices except the ROM of shoulder in the internal rotation and shoulder muscle force through the whole of the study. Comparison of changes in the pain intensity (p = 0.034), ROM of shoulder in extension (p = 0.011), ROM of neck in extension (p = 0.032) ), left lateral ROM of Neck (p = 0.017) and left rotation ROM of neck (p = 0.013) were significantly different in shockwave group between the three groups.