Routine Rehabilitation Versus Shock Wave Therapy for Scapular Dyskinesis

NCT07633340 | Recruiting DMC

• 1 other identifier: 36264PR768/7/24
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

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, such as RC tears, labrum tears, impingement syndrome, and glenohumeral joint instability. 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.

Conditions

Scapular Dyskinesis; Shockwave Therapy

Keywords

Scapular dyskinesis

Outcome Measures

Primary Outcomes (1)

• Improvement by Scapular Assistance Test and/or Scapular Dyskinesis Test

  1 month after intervention

Study Arms (2)

Radial extracorporeal shock wave therapy/ Intervention group

ACTIVE COMPARATOR

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.

Device: Radial extracorporeal shock wave therapy (active comparator)

Sham rESWT/ Control group

SHAM COMPARATOR

Sham rESWT once weekly for one month. 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.

Other: Sham rESWT

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.

Radial extracorporeal shock wave therapy/ Intervention group

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.

Sham rESWT/ Control group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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.

You may not qualify if:

• History of shoulder or thorax trauma or surgery.
• The back pain involved the cervical spine and thoracic spine.
• Participants with neurologic deficits
• history of inflammatory conditions such as ankylosing spondylitis
• 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:

Sponsors & Collaborators

• Tanta University: lead

Study Sites (1)

Tanta University

Tanta, Egypt

RECRUITING

Central Study Contacts

Aliaa Mamdouh Abdelaziz Farag, MD

CONTACT

01069468486; aliaa.mamdouh@med.tanta.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR
• Masking Details: This is a prospective, double-blinded, placebo-controlled randomised study. The closed envelop randomization method will be used for the randomization of the patients who will be also blinded to group allocation. The assessments will be done by the first physiatrist (A), who will not be involved in patients' sessions. The randomization will be performed by the second physiatrist (B ) who will not be involved in patients'assessment and ESWT sessions . ESWT Sessions for both groups will be will be carried out by the third physiatrist (C ) who will not take part in the assessments or patients'randomization . Both (C) and (A) were blinded to group allocation. The patients will be allocated into two groups: Group I: will be exposed to rESWT once weekly for one month Group II: will be exposed to ShamrESWT once weekly for one month. During the study period, stretching exercises will be similarly given for both groups.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer

Study Record Dates

• First Submitted: June 2, 2026
• First Posted: June 8, 2026
• Study Start: June 1, 2026
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): July 1, 2026
• Last Updated: June 10, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: Data requests can be submitted starting 9 months after article publication and the data will be made accessible for up to 24 months. Extensions will be considered on a case-by-case basis
• Access Criteria: Access to trial IPD can be requested by qualified researchers engaging in independent scientific research and will be provided following review and approval of a research proposal and Statistical Analysis Plan (SAP) and execution of a Data Sharing Agreement (DSA).

Locations

EG (1)