Comparison of Low-intensity Extracorporeal Shockwave Therapy and Low-intensity Laser Effects in Adhesive Capsulitis
Condition: Adhesive Capsulitis
MeSH terms: Bursitis
Study type: Interventional

Summary: 
      The aim of this study is to compare the effects of extracorporeal shock wave therapy(eswt)
      applied in addition to conventional physical therapy on pain, mobility, functional ability,
      sleep quality and activities of daily living in patients with adhesive capsulitis compared to
      low-level laser therapy and to investigate whether they are superior to the control group.
    

Detailed description: 
      In this study, 60 adhesive capsulitis with age range 18-65 who applied to Kırsehir Ahi Evran
      University Training and Research Hospital were examined.Adhesive capsulitis is also called
      arthrofibrosis, which involves excessive adhesion formation along the glenohumeral joint. It
      is a disease of unknown etiology and is classified as primary and secondary. Primary adhesive
      capsulitis includes cases of idiopathic origin resulting from chronic inflammation with
      fibroblast proliferation. Secondary adhesive capsulitis, central nervous system involvement,
      arm immobilized for a long time, trauma or fracture, infectious diseases, etc. Includes
      post-mortem situations.

      Adhesive capsulitis progression is characterized by four stages, each stage presenting a
      distinctive clinical picture.

      low-level laser therapy supports cell proliferation and tissue regeneration with its
      anti-inflammatory and photobiostimulation properties.The pressure waves of ESWT pass through
      fluids and soft tissues and exert their effects in areas of impedance change such as bones
      and soft tissue spaces. These waves have mechanical and cellular effects. The most important
      of these effects are temporary damage to the neuronal cell membrane or increased
      permeability. These mechanisms may facilitate neovascularization and cellular regeneration in
      tissues.
    

Intervention name(s): Low-intensity ESWT Group; Low-intensity laser Group; Conventional Control Group
Intervention type(s): Other; Other; Other
Intervention description(s): ESWT; With the MODUS ESWT system, the patient's shoulder will be in 80° passive abduction, the elbow will be in 90° flexion, and the forearm will be applied to 2 separate parts of the shoulder. The first application will be applied from front to back in the anterior shoulder joint and the upper limit of the treatment will be approximately 1 finger lateral to the coracoid process, the second application will be applied from the lateral scapula to the posterior shoulder joint (0.06 mJ/mm2, 1500 impulses, 1.5 bar).( Modus ESWT® RadialShockwaveTherapy); The laser will be made parallel to the joint line with the patient's arm, the arm will be in internal rotation at the posterior of the shoulder and the arm will be in external rotation at the anterior of the shoulder. The wavelength of 850 nm will be applied for 5 minutes in total 30 Joules.; Exercises will be started with passive ROM exercises and passive stretching exercises for the flexor, abductor, internal and external rotator muscle groups until the level of pain tolerance in the supine position. In the second week, the program will be continued with active ROM and stretching exercises. In the third week, isometric strengthening exercises for flexor, abductor, internal and external rotator muscle groups will be given along with stretching exercises. Exercises will be performed 5 days a week, 60 minutes a day, accompanied by a physiotherapist.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Three groups with a conventional therapy control group
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Rehabilitation; extracorporeal shock wave therapy; low-level laser therapy; pain