Effect of Extracorporeal Shockwave Therapy in Shoulder Adhesive Capsulitis Patients: A Systematic Review and Meta-Analysis

Abstract Background: Adhesive Capsulitisis a condition associated with shoulder pain and stiffness. Extracorporeal Shockwave Therapy (ESWT) is commonly used to treat many orthopedic disorders. Aim of Study: This systematic review and meta-analysis aimed to evaluate the effect of ESWT applicationon pain in-tensity level, range of motion, functional and disability level in patients with Adhesive Capsulitis. Material and Methods: Intensive search was done in elec-tronic databases: PubMed, Cochrane Library, and PEDro, Scop-us, Google Scholar, Web of Science, and Reference lists. This search was done to include randomized controlled trials (RCTs) that compare Extracorporeal Shockwave Therapy application with control, placebo, or standard care therapy for patients with shoulder Adhesive Capsulitis. Then, them ethodological quality of each included trial was assessed, and the data was extracted. Finally, the results were analyzed by pooling the data of change scores between pre- and post-intervention through calculation of the overall standardized mean differences with 95% confi-dence interval. Results: Twelve studies were included in the review, the median of the PEDro scale total scores was seven points. The use of ESWT, applied to patients with Adhesive Capsulitis was associated with favorable short-term changes in self-reported pain intensity level, ROM and overall functions in individuals with Adhesive Capsulitis, when compared control or sham in-tervention. Conclusion: The data from this systematic review and meta-analysis suggest that ESWT is superior to conventional therapy and steroids in reducing pain intensity level, improving shoulder ROM, overall functions at short-term; However, due to limited number of the included studies, these findings must be validated by more RCTs. The limitations in the studies per-formed to date suggest that future research should determine the optimal intensity and dosage of ESWT and perform longer follow-up to monitor long-term effects.