Der Effekt von extrakorporaler Stoßwellentherapie bei Frozen Shoulder

Zusammenfassung

Frozen Shoulder ist ein verbreitetes Krankheitsbild der Schulter, das im deutschsprachigen Raum auch als steife Schulter bezeichnet wird. Die genaue Pathophysiologie ist unbekannt. Es gibt keinen Konsens über die effektivste Therapie in der Physiotherapie. Eine Übersichtsarbeit, die die Wirkung von extrakorporaler Stoßwellentherapie (ESWT) auf Beweglichkeit und Schmerz bei Patient*innen mit Frozen Shoulder untersucht, existiert bis dato nicht. Daher ist das Ziel der Arbeit, dies zu untersuchen.

Mittels einer systematischen Literaturrecherche wurden randomisierte kontrollierte Studien (RCTs) gefunden, die den Effekt radialer (rESWT) und fokussierter ESWT (fESWT) auf Schmerz und Beweglichkeit bei Frozen Shoulder (primär und sekundär) untersuchten. Recherchiert wurde auf den medizinischen Fachdatenbanken PubMed, CINAHL, PEDro und Cochrane Library. Die methodologische Qualität der Studien wurde anhand der PEDro-Skala bewertet. Eingeschlossen wurden 9 Studien. Sechs Studien erzielten eine gute und 1 Studie eine exzellente PEDro-Bewertung. Die folgenden Zielparameter wiesen mind. signifikante Ergebnisse auf: 6/7 Studien in Außenrotation, 6/8 Studien in Flexion, 7/8 Studien in Abduktion, 7/8 Studien hinsichtlich der Schmerzmessdaten.

Unklar ist, ob die f- und rESWT unterschiedliche Effekte auf die Zielparameter Schmerz und Beweglichkeit haben. Die Unterscheidungen hinsichtlich der Dosierung, Lokalisation und Anwendungshäufigkeit der ESWT-Applikation, die potenziellen Messungenauigkeiten der Gelenkmessungen und die heterogenen Stichprobenzusammensetzungen sind weitere Parameter, die die Interpretation der Ergebnisse erschweren.

Abstract

Frozen Shoulder is a common syndrome of the shoulder. The exact pathophysiology is unknown and there is no consensus within physiotherapy as to the most effective treatment. To date, there has been no review examining the effects of extracorporeal shock wave therapy (ESWT) on mobility and pain in patients with Frozen Shoulder. Consequently, it is the aim of this paper to provide such an examination.

A systematic literature review identified randomized controlled trials (RCTs) examining the effects of radial (rESWT) and focused ESWT (fESWT) on pain and mobility in patients with (primary and secondary) Frozen Shoulder. Research was conducted on the medical databases PubMed, CINAHL, PEDro and Cochrane Library. The methodical quality of trials was assessed using the PEDro scale. 9 trials were included, of which 6 received a good and 1 an excellent PEDro rating. At least significant results were recorded for the following outcome parameters: in 6/7 trials for external rotation, 6/8 trials for flexion, 7/8 trials for abduction and 7/8 trials with regard to pain measurement data.

It is still unclear whether focused or radial ESWT have different effects on the outcome parameters pain and mobility. The interpretation of trial results was also hampered by differences in the dosage, localization and treatment frequency of ESWT applications, potential inaccuracies of joint measurements and heterogenous population samples.

Schlüsselwörter

Frozen Shoulder - adhäsive Kapsulitis - extrakorporale Stoßwellentherapie - radiale extrakorporale Stoßwellentherapie - fokussierte extrakorporale Stoßwellentherapie

Key words

Frozen Shoulder - adhesive capsulitis - extracorporeal shock wave therapy - radial extracorporeal shock wave therapy - focused extracorporeal shock wave therapy

Publication History

Received: 20 May 2021

Accepted: 30 June 2021

Article published online:
14 February 2022

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