Extracorporeal Shockwave Therapy Improves Functional Outcomes of Adhesive Capsulitis of the Shoulder in Patients With Diabetes

Santoboni, Francesca; Balducci, Stefano; D’Errico, Valeria; Haxhi, Jonida; Vetrano, Mario; Piccinini, Giulia; Ferretti, Andrea; Pugliese, Giuseppe; Vulpiani, Maria Chiara

doi:10.2337/dc16-2063

Cited by 12 publications

(10 citation statements)

References 4 publications

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“…In this study, ESWT is effective, feasible, and well tolerated and served as a valid alternative to glenohumeral joint injections for participants with phase 1 and 2 frozen shoulder with diabetes without any side-effects. This study results were corroborated with other preliminary studies on diabetic frozen shoulder and without diabetes7, 10 ) .…”

Section: Discussionsupporting

confidence: 91%

“…Ultrasound therapy provided significant beneficial effect only on pain reduction or acts as a placebo and served as an effective adjunct for therapeutic exercises8 ) . Extracorporeal shock wave therapy (ESWT) has emerged as the treatment of choice for rotator cuff calcific tendinopathies for its efficacy in pain reduction, earlier return to daily activities and improved quality of life9, 10 ) . It was stated that need for more research to find the effectiveness of ESWT in frozen shoulder, non-calcific tendinopathy10, 11 ) and the further need to find the effectiveness of diabetic frozen shoulder.…”

Section: Introductionmentioning

confidence: 99%

“…Till date only one has study reported the efficacy and clinical improvements obtained by ESWT on diabetic frozen shoulder10 ) . However, no studies have reported and compared other conventional physical therapy options.…”

Section: Introductionmentioning

confidence: 99%

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

Muthukrishnan

Rashid

Al-Alkharji³

2019

J Phys Ther Sci

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[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.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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

Muthukrishnan

Rashid

Al-Alkharji³

2019

J Phys Ther Sci

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“…9 Extracorporeal shockwave therapy has also been trialled as a treatment in diabetic patients with adhesive capsulitis of the shoulder, demonstrating an improvement in functional outcomes following treatment. 13 A recent prospective randomized study compared the efficacy of 3 injection methods, intra-articular injection, subacromial injection, and hydrodilatation (HD), in the treatment of primary frozen shoulder.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

<p><em>Clostridium histolyticum</em> (AA4500) for the Treatment of Adhesive Capsulitis of the Shoulder: A Randomised Double-Blind, Placebo-Controlled Study for the Safety and Efficacy of Collagenase – Single Site Report</p>

Fitzpatrick

Richardson

Klaber

et al. 2020

DDDT

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Background/Hypothesis: Adhesive capsulitis of the shoulder results in pain and restricted movement of the glenohumeral joint. Hypothesis: There would be a difference in active range of movement in the affected shoulder of patients with adhesive capsulitis after receiving a series of injections of collagenase Clostridium histolyticum (CCH) compared to placebo. Methods: This study reports the results from a single site that was part of a 321-participant, multicenter, double-blind, prospective parallel-group, randomized controlled clinical trial. Inclusion criteria: over 18 years of age, unilateral idiopathic adhesive capsulitis for >3 months, but <12 months. Exclusion criteria: recent physical therapy, injections, subacromial impingement, calcific tendonitis or glenohumeral joint arthritis in the affected shoulder. Subjects were randomized 3:1 to receive CCH 0.58 mg or placebo under ultrasound guidance. Injections were on days 1, 22, and 43. The primary outcome measure was a functional assessment of active range of movement. Results: Overall, 37 patients were screened, 26 subjects were excluded, and 11 subjects were randomly assigned to the treatment group (n=9) or the control group (n=2). Both control and treatment groups showed improvement in ROM between baseline and day 95. In the treatment group, AROM improved from the baseline of 272.89°(SD 86.25) to 462.11°(SD 96.89) and the control group from 246.00°(SD 5.66) to 451.50°(SD 50.20) at day 95 with no statistical difference between groups p=0.78. Site data were in line with the whole study findings. Treatment-related adverse events at the injection site, including haematoma (bruising) and localised pain and swelling, were common. Conclusion: Although the participants showed improvement in function, statistical significance was neither reached in the site nor the overall study cohort. Given the adverse events and the potential risks of the procedure, we would not recommend this drug for the treatment of adhesive capsulitis of the shoulder. Level of Evidence: 2, cohort from one site of RCT.

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Review of diabetic frozen shoulder

Whelton¹,

Peach²

2017

Eur J Orthop Surg Traumatol

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Frozen shoulder is a painful debilitating condition which can be diagnosed clinically. It is a condition of chronic inflammation and proliferative fibrosis resulting in painful limitation of shoulder movements with classical clinical signs. Diabetic patients are more likely to develop the disease and more likely to require operative management. Diabetic frozen shoulder is a difficult condition to manage, and the clinician must strike a balance between improving range of movement and treating pain, but not over-treating what is an essentially self-resolving condition. Treatment options principally include physiotherapy and intra-articular injections, and progression to hydrodilatation, manipulation under anaesthetic, or arthroscopic capsular release as required. In this article, we review the available literature to assess best management, and correlate with practice at our unit, proposing a management strategy for treating patients with diabetic frozen shoulder. Management decisions should be agreed upon jointly with the patient and be based upon comorbidities, severity and the natural history of the condition.

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Extracorporeal Shockwave Therapy Improves Functional Outcomes of Adhesive Capsulitis of the Shoulder in Patients With Diabetes

Cited by 12 publications

References 4 publications

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

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

<p><em>Clostridium histolyticum</em> (AA4500) for the Treatment of Adhesive Capsulitis of the Shoulder: A Randomised Double-Blind, Placebo-Controlled Study for the Safety and Efficacy of Collagenase – Single Site Report</p>

Review of diabetic frozen shoulder

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