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Routine Rehabilitation Versus Shock Wave Therapy for Scapular Dyskinesis

Sponsor: Tanta University • ClinicalTrials.gov ID: NCT07633340

Registry updated: 2026-09-30

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Description

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. 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.

Interventions

Radial extracorporeal shock wave therapy (active comparator) (Device)
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.
Sham rESWT (Other)
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.

Eligibility criteria

Inclusion Criteria: * 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 Criteria: 1. History of shoulder or thorax trauma or surgery. 2. The back pain involved the cervical spine and thoracic spine. 3. Participants with neurologic deficits 4. history of inflammatory conditions such as ankylosing spondylitis 4- 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).

Conditions

Scapular Dyskinesis Shockwave Therapy

Locations

Tanta University — Tanta, Egypt

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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