To examine the efficacy of radial extracorporeal shock wave (rESWT) on pain & disability levels in stroke patients with shoulder structural abnormalities.

Material and methods:
Methods: Thirty sub-acute stroke patients their ages between 40 to 60 years were randomly allocated into 2 equal groups after signing an institutional consent form. Real rESWT group (GA) underwent rESWT in addition to a designed program of physical therapy to shoulder joint. Control group (GB) received sham rESWT in addition to the same physical therapy program as for GA. The treatment protocol for both groups was two times per week for a whole month. Baseline and post intervention findings in both groups were assessed and compared for the primary outcomes including shoulder structural changes, pressure pain threshold (PPT) and shoulder disability measured by ultrasonography (USS), handheld algometer and shoulder pain disability index (SPADI) respectively.

Significant reduction of all post treatment SPADI scores (pain, disability & total scores) in both groups with remarkable decrease in favor to rESWT group (GA) (P < 0.05), In addition, USS scores and PPT findings showed notable preference in favor to (GA) which was demonstrated as significant decrease in USS score with increase in PPT findings only in rESWT group (GA) (P < 0.05).

The addition of radial extracorporeal shock wave (rESWT) to a designed physical therapy program is more efficient in reducing shoulder structural abnormalities, pain and disability in sub-acute stroke patients