Article

Evidence from a recent randomized controlled trial indicated that
supervised exercises (SE) were more effective than radial extracorporeal
shock-wave therapy (rESWT)
for the treatment of subacromial shoulder pain in the
short to medium term. Little knowledge exists about the long-term results of
rESWT for subacromial pain. The aim of this study was to evaluate the
results of rESWT and SE provided to patients with subacromial shoulder pain after
1 year. DESIGN: This was a single-blind randomized controlled trial. SETTING: The
study was conducted in the outpatient clinic of the Physical Medicine and
Rehabilitation Department at Oslo University Hospital, Ullevaal, Norway.
PATIENTS: One hundred four patients with subacromial shoulder pain lasting at
least 3 months participated. Patients were randomly assigned to either an rESWT
group (n=52) or an SE group (n=52). INTERVENTION: The rESWT intervention
consisted of one session weekly for 4 to 6 weeks. The SE intervention consisted
of two 45-minute sessions per week for up to 12 weeks. MEASUREMENTS: The primary
outcome measure was the Shoulder Pain and Disability Index. Secondary outcome
measures were questions regarding pain and function and work status. RESULTS:
After 1 year, an intention-to-treat analysis showed no significant differences
between the 2 groups for the primary outcome measure (-7.6 points, 95% confidence
interval=-16.6 to 0.5) and pain, function, and medication use. Twenty-nine
participants (60%) in the SE group versus 24 participants (52%) in the rESWT
group were categorized as clinically improved. Thirty-eight participants in the
SE group were at work compared with 30 participants in the rESWT group (odds
ratio=1.1, 95% confidence interval=1.0 to 1.2). Fewer patients in the SE group
had received additional treatments between 18 weeks and 1 year. LIMITATIONS: The
lack of a placebo control group, the lack of a cost-benefit analysis, and the
small sample size were limitations of the study.
CONCLUSION: No significant
difference was found between the SE and rESWT groups at the 1-year follow-up.
More participants in the SE group had returned to work.

Langue : ANGLAIS