High- vs Low-Dose Extracorporeal Shock Wave Therapy by Nurse Practitioners for Frozen Shoulder
Nurse practitioner applies extracorporeal shock wave therapy for patients with frozen shoulder: A randomized controlled trial.
J Am Assoc Nurse Pract . 2025 Apr 2;37(7):386-394.Fifty-two patients with adhesive capsulitis were randomized to receive high-dose ESWT (n=26) or low-dose ESWT (n=26), each delivered once by a trained nurse practitioner after standardized education and exercises. The primary outcome of interest was pain (VAS). Secondary outcomes included joint mobility/function (Constant–Murley Score), with assessments pre-, immediately post-, and at 1, 2, 4, 8, and 12 weeks. Overall, the results of the study revealed that both groups improved, but high-dose ESWT yielded lower pain at 4 and 8 weeks and greater gains in mobility from immediately post-treatment through 2 weeks. These findings suggest a clinically meaningful dose–response favoring 6,000 over 3,000 impulses when ESWT is delivered by nurse practitioners.
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