The effectiveness of extracorporeal shockwave treatment in subacromial impingement syndrome and its relation with acromion morphology

Abstract

Objective: The aim of this study was to evaluate the effectiveness of the extracorporeal shock wave therapy in the subacromial impingement syndrome and its relationship with the acromion morphology.

Methods: Thirty patients (24 women, 6 men) with subacromial impingement were evaluated. The average age of patients was 53.6 ± 9.8 years (range 39-80). Patients were divided into 3 groups according to the acromion morphology. ESWT 1500 at 0.12 am mL/mm² violence was applied once a week for 3 weeks. Shoulder pain and disability index (SPADI) was used to assess function and pain scores of the patients. The evaluations were made prior to and 12 weeks after the ESWT.

Results: Thirteen shoulders had type 1 acromion, 11 shoulders type 2 acromion and 6 shoulders type 3 acromion. After ESWT, the SPADI pain score decreased from 16.1 ± 5.1 (7-25) to 10.4 ± 4.9 (1-20); SPADI functional score decreased from 37.3 ± 19.8 (5-70) to 26.7 ± 17.5 (1-60); SPADI total score decreased from 53.4 ± 24.5 (14-95) to 37.1 ± 21.6 (2-74) (p < 0.05; paired t test). In each group better functional outcomes were achieved after ESWT (p < 0.05; paired t test). There were no differences between the groups according to functional outcome both before and after the ESWT treatment (p > 0.05, one way ANOVA test).

Conclusion: ESWT was found to be effective in the treatment of impingement syndrome both for pain and functional outcome in the early period regardless of acromion morphology.

Level of evidence: Level IV, Therapeutic study.

Keywords: Acromion morphology; Extracorporeal shock wave therapy(ESWT); Subacromial impingement syndrome.