Effects of extracorporeal shock wave therapy on subacromial impingement syndrome

Objective: There are different treatment modalities for subacromial impingement syndrome (SIS) in literature. ESWT has been used since the 1990?s to treat various musculoskeletal disorders, but evidence of the efficacy is still discussed. The purpose of the study was to investigate the effects of ESWT on the pain, functional and disability levels, and quality of life in the patients with subacromial impingement syndrome (SIS) and to compare with the effectiveness of standard physiotherapy.Method: This study was carried out on 60 patients (40 females, 20 males), mean age 52,58±8,05 years, who had inclusion criteria from the patients had been diagnosed as SIS admitted to the physical therapy and rehabilitation clinic in Private Karabağlar Medicine Center. Before the beginning measurements all the patients were separated to 2 groups according to simple random table. Standard physical therapy and medium-energy shock wave therapy were given to the Group I (n=30); and standard physiotherapy and placebo ESWT were added to the Group II (n=30) one session a week for 4 weeks. The measurements were repeated after the 4 week treatment programme. In the evaluation process the demographic data of the patients, pain severity (Visual analogue scale (VAS) ), functional level (Constant Shoulder Score), upper extremity disability level (Shoulder Pain and Disability Index (SPADI) ) and quality of life (SF-36) measurement were done. Perceived symptom changes of the patients were assessed by a three points scale.Results: Before treatment, evaluations for pain severity, functional level, disability level and quality of life scores were similar and was no statistically differences between groups (p>0.05). After treatment, VAS and SPADI results were decreased, Constant Shoulder Score and SF-36 physical component and mental component results were increased of the groups and there was a statistically differences compared with before patient?s values (p<0.05). But SF-36 physical component score was statistically higher in group I and, SF 36 mental component score was statistically higher in group II after treatment (p< 0.05).Conclusion: The results of our study showed that applications of medium-enerjy ESWT and standard physiotherapy could not influce on shoulder pain, functional level and disability level of upper extremity and quality of life in patients with SIS. The studies about different sessions and dosage of ESWT treatment could be necessary for more certain results related to ESWT effectiveness.Key Words: Subacromial impingement syndrome, ESWT, Shoulder pain, Functional level, Quality of life.