Extracorporeal shock wave therapy for chronic adhesive capsulitis in type 2 diabetics: a systematic review with meta-analysis.

Reno, Crystal; Swinton, Paul; Alexander, Lyndsay

Abstract

The object of this research is to assess the effectiveness of extracorporeal shock wave therapy in the treatment of chronic adhesive capsulitis in the type 2 diabetes population. A systematic review with meta-analysis was used. Two reviewers independently screened and extracted data through Covidence and the quality was evaluated using Cochrane risk-of-bias tool for randomised trials. Meta-analyses were conducted to quantify within group change and comparative effectiveness. Five hundred and seventy-four studies were identified, and seven studies included (n=352 participants). The participants were Type 2 diabetic adults (>18 years) diagnosed with primary or secondary adhesive capsulitis. Meta-analysis using Bayesian method of within group change showed consistent improvement for pain (-5.7[95%CrI: -7 to -4.5cm]), range of movement (2.6[ 95%CrI: 1.4 to 3.8]), and disability (3.6[95%CrI: 2.3 to 4.9]). Consistent evidence of improvements favouring extracorporeal shock wave therapy over conservative management was identified for all outcomes. Study heterogeneity had limited influence on non-controlled effect sizes, whereas limited controlled effect sizes lowered the confidence for outcomes of range of movement and disability. Limitations included low number of studies, poor methodological quality, and non-adherence to reporting guidelines. Extracorporeal shock wave therapy for treatment of adhesive capsulitis was shown to reduce pain and improve range of motion and disability in the type 2 diabetes population. These results should be interpreted with caution and high-quality randomised controlled studies are required to establish best-practice extracorporeal shock wave therapy protocols regarding application position, dosage, and duration.

Citation

RENO, C., SWINTON, P. and ALEXANDER, L. [2025]. Extracorporeal shock wave therapy for chronic adhesive capsulitis in type 2 diabetics: a systematic review with meta-analysis. Physical therapy and rehabilitation journal [online], (accepted).

• Journal Article Type: Article
• Acceptance Date: Feb 25, 2025
• Deposit Date: Feb 27, 2025
• Journal: Physical therapy and rehabilitation journal
• Print ISSN: 0031-9023
• Electronic ISSN: 1538-6724
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Keywords: Extracorporeal shock wave therapy; Adhesive capsulitis; Frozen shoulder; Physiotherapy; Review; Meta-analysis
• Public URL: https://rgu-repository.worktribe.com/output/2715537
• Related Public URLs: https://rgu-repository.worktribe.com/output/2715566 (PROSPERO protocol)