Diabetes-induced adhesive capsulitis: the role of radial extracorporeal shock wave therapy on the shoulder muscles mechanical properties

Background and Aims: The study aimed to determine thechanges in the shoulder muscle mechanical properties in patientswith diabetes-induced adhesive capsulitis when the different doseof Radial Extracorporeal Shock Wave Therapies (rESWT) applied.Methods: The randomized clinical trial conducted at OkanUniversity Research Hospital (Istanbul). Participants were ‡45years(mean 53.49 – 5.81 years), had T2D for ‡3 years (mean duration9.92 – 5.70 years), and had HbA1c£9.0% (mean 7.38 – 0.76%);were being treated with inadequately basal insulin (20.5%) and oralantidiabetic drugs (79.5%) were enrolled. The rESWT was appliedwith Enraf Nonius Endoplus device with a 25mm applicator, at 8Hz,and with 2000 beats. The participants were randomly assigned tothree groups as follows: high dose rESWT (n = 13), moderate doserESWT (n = 13) or placebo rESWT group (n = 13). The primaryoutcome was biceps brachialis, infraspinatus, deltoideus, trapeziusupper muscle properties evaluations with calibrated, MyotonProdevice for over the 4th, and 6th week of the trial. Analyses wereperformed according to intention to treat.Results: In the hrESWT group biceps brachialis, infraspinatusmuscles tone and stiffness decreased together and the trapeziusupper only has reduced tone at 4th week (p < 0.05). Only bicepsbrachialis muscle tone decreased (mean change:1.38 – 0.38,p < 0.001) in hrESWT group at the 6th week. In the mrESWTgroup, the tone of the deltoideus muscle decreased and bicepsbrachialis and deltoideus muscle stiffness decreased in the sixthweek (p < 0.001).Conclusions: In the diabetes-induced adhesive capsulitis therESWT seems like an effective treatment intervention because ofreduces the tone of the muscles around the shoulder joint andcauses increased muscle compliance.