Comparison of the efficacy of low intensity ESWT and low intensity laser therapy in the treatment of adhesive capsulitis: A randomized controlled trial

Adhesive capsulitis, also known as frozen shoulder, is a disease of unknown etiology. Inpathogenesis, progressive fibrosis of the glenohumeral joint leads to limitation of active and passive range of motion (ROM) and pain in the shoulder. It is classified into two groups: primary and secondary. Primary AC is more common than secondary AC. Inrecent years, extracorporealshockwavetherapy (ESWT) and laser therapy have become increasing lyimportant in reducing pain and increasing ROM by suppressing inflammation. This study was designed as a single-blind, randomized controlled trial to compare the efficacy of ESWT and Laser therapy in the treatment of adhesive capsulitis and to investigate whether they are superior to the control group. A total of 65 AC patient swere divided into 3 groups by closed envelope method. ESWT was given for 3 sessions once a week, laser for 3 weeks and 15 sessions in total, hot pack and exercisefor 3 weeksand 15 sessions in total in allgroups. The first group received low intensity ESWT, hot pack and exercise, these condgroup received low intensity Laser, hot pack and exercise, and the third group received hot pack and exercise. Pain (VAS), functionality (ConstantMurleyScore), sleepquality (Pittsburgsleepqualityindex) and quality of life (short form-36) were evaluated before treatment, at week 3 andweek 12.Inallgroups, improvement was found in pain, functionality, sleep quality and quality of life in intra group evaluation scompared top retreatment. While the improvement in the VAS score at the 3rd weekcontrolswasstatisticallysignificant in theLaserand ESWT group compared to the control group (p<0.05); no statistically significant difference was found betweenthe 12th weekscores (p>0.05). When the Constant Murley Score was analyzed, the functional improvement in the ESWT and Laser group at week 3 was significant lyhigherthan in the control group (p<0.05). At CMS week 12, thefunctionalgain in theLasergroupwassignificantlyhigherthantheothergroups (p<0.05), while there was no signifi cant difference betweenthe ESWT and Laser groups in terms of functional gain (p<0.05). There was no significant difference in post-treatment PDQI scores between the groups in sleep quality assessment (p>0.05). In the quality of life score sevaluated with SF-36, the improvement in physical parameters was higher in the laserand ESWT groups compared to the control group at 3 and 12 weeks, while there were similar results between the groups in mental parameters. Inconclusion, it was found that Laser or ESWT treatment added to exercise therapy positively affected pain, functionality and quality of life in patients with adhesive capsulitis. In terms of shoulder function, Laser therapy in addition to exercise therapy is thought to be superiorto ESWT therapy.