Radial extracorporeal shockwave treatment compared with supervised exercises in patients with subacromial pain syndrome: single blind randomised study

doi:10.1136/bmj.b3360

Published 15 September 2009, doi:10.1136/bmj.b3360
Cite this as: BMJ 2009;339:b3360

Research

Radial extracorporeal shockwave treatment compared with supervised exercises in patients with subacromial pain syndrome: single blind randomised study

Kaia Engebretsen, physiotherapist¹^,2, Margreth Grotle, research leader²^,3, Erik Bautz-Holter, professor¹^,2, Leiv Sandvik, professor⁴, Niels G Juel, MD consultant¹^,2, Ole Marius Ekeberg, Research fellow¹^,2, Jens Ivar Brox, MD consultant²^,5

¹ Department of Physical Medicine and Rehabilitation, Ullevaal University Hospital, Kirkeveien 166, 0407 Oslo, Norway , ² Medical Faculty, University of Oslo, Oslo, ³ FORMI, Division for Neuroscience and Musculoskeletal Medicine, Ullevaal University Hospital, ⁴ Section for Biostatistics and Epidemiology, Ullevaal University Hospital, ⁵ Department of Orthopaedics, Section for Physical Medicine and Rehabilitation, National Hospital, Oslo

Correspondence to: K Engebretsen kaiabe{at}medisin.uio.no

Objective To compare the effectiveness of radial extracorporealshockwave treatment with that of supervised exercises in patientswith shoulder pain.

Design Single blind randomised study.

Setting Outpatient clinic of physical medicine and rehabilitationdepartment in Oslo, Norway.

Participants 104 patients with subacromial shoulder pain lastingat least three months.

Interventions Radial extracorporeal shockwave treatment: onesession weekly for four to six weeks. Supervised exercises:two 45 minute sessions weekly for up to 12 weeks.

Primary outcome measure Shoulder pain and disability index.

Results A treatment effect in favour of supervised exercisesat 6, 12, and 18 weeks was found. The adjusted treatment effectwas –8.4 (95% confidence interval –16.5 to –0.6)points. A significantly higher proportion of patients in thegroup treated with supervised exercises improved—oddsratio 3.2 (1.3 to 7.8). More patients in the shockwave treatmentgroup had additional treatment between 12 and 18 weeks—oddsratio 5.5 (1.3 to 26.4).

Conclusion Supervised exercises were more effective than radialextracorporeal shockwave treatment for short term improvementin patients with subacromial shoulder pain.

Trial registration Clinical trials NCT00653081 [ClinicalTrials.gov] .

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

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