الفهرس 
Shock wave therapy versus corticosteroid local injection in shoulder impingement syndrome
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Abstract
Conservative treatments for shoulder impingement syndrome
(SIS) include conventional therapy (CT), local corticosteroid injection (LCI),
and extracorporeal shock wave therapy (ESWT). Objective: To investigate and
compare the efficacy of adding shockwave therapy or local corticosteroid
injection to conventional physical therapy in shoulder impingement syndrome.
Design: A prospective single-blinded randomized controlled study. Settings:
Physical therapy outpatient clinic of El-Safa Hospital, Damietta. Participants:
Sixty patients with unilateral SIS > 3 months were involved. Methods: The
patients were allocated randomly to group A (received a 4-week CT plus single
LCI, n=20), group B (received CT only, n=20), and group C (received CT plus
ESWT, one session per week for 3 weeks, n=20). Subacromial space, shoulder
pain and disability index (SPADI), and shoulder range of motion were assessed
at baseline and post-treatment follow-up at 4 and 12 weeks. Results: At both
follow-ups, the within-group analysis revealed a significant difference in all
parameters relative to baseline (P < 0.05) except the subacromial space at week
12 in the CT group. Among group analysis indicated a non-significant difference
in all measures at the 4-week follow-up (P ˃ 0.05). However, at week 12, the
ESWT group exhibited the most significant changes (P < 0.05). Conclusion:
While there is no difference between the effect of adding LCI or ESWT to CT
on a short-term basis, adding ESWT to CT induces more noticeable long-term
effects on SIS, highlighting it as the superior alternative.