• Physical Therapy Rehabilitation Science
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• v.13 no.3
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• pp.343-353
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• 2024

Objective: Long-term imbalances in the muscles around the neck could the functional resting length of the muscles, resulting in a chronic forward head posture. This study aimed to assess the effects of combining posture correction exercises with extracorporeal shockwave therapy on muscle activity, neck function and pain in adults with forward head posture. Design: Pretest-posttest two groups design. Methods: A total of 22 adults, diagnosed with forward head posture, participated in the study. Random assignment allocated 11 participants to the posture correction exercise (PCE) group, while the other 11 were assigned to the posture correction exercise group combined with extracorporeal shockwave therapy (ESWT). In the combined group, ESWT was administered twice a week for four weeks, delivering 1,000 impulses in a radial pattern to the levator scapulae and upper trapezius muscles. The PCE group performed a exercise program for approximately 30 minutes, three times a week, over the same four-week period. The PCE focused on strengthening weakened muscles and stretching of shortened muscles. Results: Both the PCE group and the combined group with ESWT exhibited a significant increase in lower trapezius muscle activity within groups (p<0.05). Moreover, the craniovertebral angle and neck disability index showed significant improvements in both groups (p<0.05). While the pressure pain thresholds tended to increase only in the combined group, the difference was not statistically significant (p>0.05). Conclusions: This suggests that both the PCE program and the combination with ESWT can be effective in enhancing posture and reducing pain in individuals with forward head posture.

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.356-362
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• 2022

Objective: Extracorporeal shock wave therapy (ESWT) is a nonsurgical treatment alternative to surgery for various musculoskeletal diseases that have traditionally been difficult to treat conservatively, including calcific tendinitis, tennis elbow, and plantar fasciitis. This study evaluated the effect of focused and radial shock wave therapy for calcific tendinitis of the shoulder. Design: Randomized controlled study Methods: Forty participants with calcific tendinitis were randomized into focused shock wave therapy (FSWT, n=20) and radial shock wave therapy (RSWT, n=20) groups. Patients were examined before and one week after treatment. Pain intensity was subjectively assessed using the visual analogue scale and function was assessed using the Constant-Murley score (CMS) and range of motion (ROM). Results: The results showed a significant decrease in pain and significant increase in shoulder mobility and function in both groups. However, FSWT was significantly more effective than RSWT, based on CMS and ROM assessment. Conclusions: Although it is possible to raise the energy intensity of RSWT to increase the depth at which the energy becomes dispersed, higher energy intensity is associated with a greater risk of severe neurovascular damage, and that high-intensity stimulation can cause adverse effects such as pain and petechiae. Therefore, FSWT is considered to be a safe and effective method for treating tendinous lesions while minimizing adverse effects. In conclusion, both FSWT and RSWT can reduce pain and increase mobility and function. FSWT can be considered as an alternative for calcific tendinitis of the shoulder.

• Clinical Pain
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• v.18 no.2
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• pp.138-141
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• 2019

Lateral epicondylopathy represents pain in the lateral (radial aspect) of the elbow caused by degeneration in the common extensor tendon. Calcium deposit frequently developes in lateral epicondylopathy, with the prevalence up to 46%. There are considerable debates on its treatment protocols for lateral epicondylopathy so far, likewise, the effective treatment method for calcific lateral epicondylopathy has not been established. We report here a case of chronic intractable calcific lateral epicondylopathy treated with ultrasound-guided barbotage and focused type extracorporeal shock wave therapy (ESWT). To our knowledge, this is the first report of calcific lateral epicondylopathy treated by ultrasound-guided barbotage combined with ESWT.

• Physical Therapy Rehabilitation Science
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• v.13 no.3
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• pp.294-303
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• 2024

Objective: The objective of this study is to evaluate the effects of radial shock wave therapy (RSWT) targeting multiple myofascial trigger points (MTrPs) along myofascial chains on shoulder pain, function, range of motion, and muscle strength in patients with bicipital tendinopathy. While traditional treatments primarily focus on a single MTrP, this study aims to achieve better clinical improvement by simultaneously treating multiple MTrPs along the myofascial chains. Design: A randomized controlled trial. Methods: Twenty-eight patients with bicipital tendinopathy were randomly assigned to either an experimental group (n=14) or a control group (n=14). The experimental group received RSWT targeting multiple MTrPs along myofascial chains, while the control group received RSWT focused on a single MTrP in the biceps brachii. Both groups underwent three treatment sessions over a nine-day period, with one session every three days. Outcomes, including shoulder pain, function, range of motion, and muscle strength, were measured before and after treatment to assess therapeutic effects. Results: Both groups showed significant improvements in shoulder pain, function, range of motion, and muscle strength (p<0.05). However, the experimental group demonstrated significantly greater improvements in all outcome measures compared to the control group (p<0.05). Conclusions: RSWT targeting multiple MTrPs along myofascial chains showed significantly greater effects in relieving shoulder pain, improving function, enhancing range of motion, and strengthening muscles in patients with bicipital tendinopathy compared to treatment targeting a single MTrP. Therefore, this study proposes that a comprehensive treatment strategy considering the entire myofascial pathway may be more effective in the rehabilitation of patients with bicipital tendinopathy.