Radial extracorporeal shock wave therapy is more effective than a combination of physical therapy modalities for rotator cuff injury: a randomized controlled trial

Objectives This study tested the hypothesis that in treatment of rotator cuff (RC) injury, radial extracorporeal shock wave therapy (rESWT) is more effective than a combination of physical therapy modalities (PTMs; i.e., interferential current therapy, shortwave diathermy and magnetothermal therapy). Methods A total of 60 patients with RC injury without presence of full-thickness RC tear were randomly allocated to rESWT for 6 weeks (n=30; one session per week) or treatment with PTMs for 6 weeks (n=30; five sessions per week). The primary outcome measure was the ASES shoulder score. Secondary outcome measures were the VAS pain score, patient’s satisfaction, shoulder range of motion, thickness of the supraspinatus tendon and the acromiohumeral distance. All outcome measures were assessed by blinded assessors at baseline as well as at 6 weeks post-baseline (W6) and W12. Results No serious adverse events occurred during the trial. Compared to the patients in the PTMs group, the patients in the rESWT group had significantly (p<0.05) higher mean ASES total scores at W6 and W12 (power with two-sided 95% confidence interval: 65.7% at W6 and 92.8% at W12) as well as lower mean VAS pain scores, higher mean satisfaction scores and higher mean active and passive shoulder abduction values at W6 and W12. Furthermore, rESWT but not PTMs significantly reduced the mean thickness of the ST and increased the acromiohumeral distance. Conclusion In treatment of rotator cuff injury without presence of full-thickness rotator cuff tear, rESWT is more effective than the investigated combination of PTMs. Registration China Clinical Trials Registration Center (Registration number: ChiCTR2300077386; registration on 7 November 2023).