Focused Extracorporeal Shock Wave Therapy for Hemiplegic Shoulder Pain: A Randomized Crossover Pilot Study in Stroke...

Focused ESWT (F-ESWT) may be effective in relieving hemiplegic shoulder pain (HSP) in stroke patients. This study aimed to investigate the effects of F-ESWT on hemiplegic shoulder pain (HSP) and to assess potential adverse effects in stroke patients.

A double-blind, randomized crossover pilot study was conducted with six stroke patients (median age 59.5) experiencing HSP (NRS ≥4). Participants received two conditions-real F-ESWT and sham F-ESWT-3 days/week for 2 weeks, separated by a 10-day washout period. Sham F-ESWT was administered by tilting the probe. Pain and function were assessed using the NRS and Shoulder Pain and Disability Index before and after interventions.

No adverse effects occurred. Sonography revealed calcifications and tendinosis. Significant time × condition interactions were noted for NRS and disability scores (p < 0.001). NRS scores significantly reduced after real F-ESWT (p < 0.05), with no change in the sham condition. Pain improvements were observed before and after real F-ESWT sessions (p < 0.05).

These results suggest that the application of F-ESWT in patients with stroke could alleviate HSP. However, further studies are required to confirm this benefit.