RecruitingNot ApplicableNCT07633340

Routine Rehabilitation Versus Shock Wave Therapy for Scapular Dyskinesis

Routine Rehabilitation Versus Shock Wave Therapy for Patients With Scapular Dyskinesis

Sponsor

Tanta University

Enrollment

100 participants

Start Date

Jun 1, 2026

Study Type

INTERVENTIONAL

Conditions

Shockwave Therapy Scapular Dyskinesis

Summary

It has been proposed that altered scapular muscle function can contribute to alterations in shoulder kinematics, which often lead to SD and are frequently associated with other shoulder pathologies, such as RC tears, labrum tears, impingement syndrome, and glenohumeral joint instability. However, whether SD leads to the development of these diseases or is a consequence has yet to be clarified. Changes in scapular kinematics can be attributed not only to altered scapular recruitment patterns (e.g., altered serratus anterior muscle activity) or muscle performance (e.g., force imbalance in the upper and lower trapezius muscles) but also to flexibility deficits in the soft tissue surrounding the scapula, which may restrict normal scapular movement during daily activities and sport- specific movements. Although many studies have investigated the optimal management method, to date, there is no consensus. Conservative approaches involve not only physiotherapy but also other techniques, such as extracorporeal shockwave therapy.

Eligibility

Min Age: 18 Years

Inclusion Criteria1

This study included 100 patients with scapular dyskinesis. The patients were divided into 2 groups: one group was treated with ESWT and routine rehabilitation, and the second group was treated with routine rehabilitation only. Adult patients with scapular dyskinesia who exhibited signs of dyskinesia for at least 6 months before enrolment in the study will be selected.

Exclusion Criteria19

History of shoulder or thorax trauma or surgery.
The back pain involved the cervical spine and thoracic spine.
Participants with neurologic deficits
history of inflammatory conditions such as ankylosing spondylitis
- Certain situations where shockwave therapy is not recommended. These include:
Absolute contraindications:
Active infection (i.e., osteomyelitis)
Malignant tumors, particularly at the treatment site (focused shockwave)
Pregnancy
Relative Contraindications:
The brain or nerve in the treatment focus
Treatment focused on the lungs or pleura
Significant coagulopathy (increased risk of bleeding, such as haemophilia)
Epiphyseal plate in treatment focus
Important considerations:
Cardiac pacemakers or other implantable devices
Current nonsteroidal anti-inflammatory drug use
Current anticoagulation use
Recent corticosteroid injections (receiving a steroid injection into the area to be treated within the previous 12 weeks).

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Interventions

DEVICERadial extracorporeal shock wave therapy (active comparator)

Radial extracorporeal shock wave therapy (r ESWT) will be applied by Dornier AR2 machine (DornierMedTech GmbH, Wessling, Germany) under ultrasound guidance, at periscapular muscles . 1.500 pulses will be applied by an R20 probe with a focusing depth of 4cm. The intensity will be 0.10 mJ to 0.3mJ/mm2 (2.5 bar), with frequency 4 Hz every week for one month for the treatment group and without operating the machine for the sham group . No anesthetic oranalgesic drugs will be administered to patients during the therapy session. Both groups will be put under the same physiotherapeutic program performed by the same well-trained physiatrist.

OTHERSham rESWT

The Dornier AR2 machine (Dornier MedTechGmbH, Wessling, Germany) used under ultrasound guidance, at affested periscapular muscles . 1.500 pulses will be applied by anR20 probe with intensity of 0.10 mJ to0.3mJ/mm2 (2.5 bar) \& frequency 4 Hz every week for one month without operating the machine.