Supervised Exercises Compared With Radial Extracorporal Shock Wave Therapy (rESWT) in Patients With SIS

Supervised Exercises Compared With Radial Extracorporal Shock Wave Therapy (rESWT) in Patients With Subacromial Impingement Syndrome: A Single Blind Clinical Randomized Study

The purpose of this study is to compare Supervised Exercises with another non-operative frequently used treatment, Radial Extracorporeal Shockwave Therapy (rESWT), for patients with subacromial impingement syndrome.

Shoulder pain is, in succession to back, neck, and knee, the fourth most frequently localized musculoskeletal pain reported by patients to general practitioners and physical therapists. A majority of shoulder complaints lasts for more than three months and become chronic. Few of the different interventions for rehabilitation of chronic shoulder pain, have documented effect. Patients with shoulder pain are associated with significant disability and loss of quality of life which interfere with activities related to daily living.

Supervised exercises, a treatment method which has been compared to surgery and placebo laser, is one that has documented effect for both short (6 months) and long time (2½ years). The purpose of this study was to compare Supervised Exercises with another non-operative common used treatment method for these patients, radial Extracorporeal Shockwave Therapy (rESWT).

The study is designed as a randomised, single blind clinical controlled study.

Inclusion Criteria:

• Subacromial shoulder pain lasting for at least three months and age between 18 and 70 years.
• Dysfunction or pain on abduction
• Had a normal passive glenohumeral range of movement
• Pain during two of three isometric tests (abduction, external- or internal rotation at 0º or 30º)
• Positive Hawkins-Kennedys test.

Exclusion Criteria:

• Shoulder pain bilateral (both shoulders required treatment)
• Earlier operated in affected shoulder
• Had multidirectional instability
• Had the cervical syndrome
• Rheumatoid arthritis
• Clinical and radiological findings indicating glenohumeral - or acromioclavicular joint pathology
• Not able to understand spoken or written Norwegian
• Considerable emotional distress
• Needed anticoagulant medicine
• Being pregnant
• Had had Shock Wave Therapy or Supervised Exercises before.