Effect of Extracorporeal Shock Wave Therapy in Conjunction with Kinetic Chain Based Exercises on Pain, Kinesiophobia, and Functional Outcome in Chronic Subacromial Pain Syndrome Participants -A Case Series

Abstract

Background and Objectives: Chronic Subacromial Pain Syndrome (CSAPS) is a common
condition characterized by persistent shoulder pain and functional limitations. Despite existing
non-operative treatments, patients often experience chronic pain, fear of movement
(kinesiophobia) and impact shoulder function. The primary objective of this study is to evaluate
the effects of extracorporeal shock wave therapy in conjunction with kinetic chain-based exercises
on pain, kinesiophobia, and shoulder functional outcomes in individuals with CSAPS.
Methodology: This case series included ten participants with unilateral shoulder pain lasting at
least three months. Participants received extracorporeal shock wave therapy biweekly for six
weeks alongside a structured kinetic chain exercise program. Outcome measures included the
Numeric Pain Rating Scale for pain, the Tampa Scale for fear of movement, and the Shoulder Pain
and Disability Index for functional assessment. Pre- and post-intervention data were analyzed
using paired t-tests to determine statistical significance.
Results and Discussion: Statistically significant improvements (p<0.05) were observed after the
intervention. The average NPRS score reduced from 7.5±0.84 to 1.90±0.99, showing a significant
reduction in pain. The SPADI scores exhibited a significant improvement, decreasing from
66.79±9.48 to 51.90±8.90, indicating a reduction in both shoulder pain and disability. The TSK
scores decreased from 48.10±3.03 to 37.60±4.47, indicating a decrease in kinesiophobia.
Conclusion: The combination of ESWT and kinetic chain exercises resulted in significant
enhancements in pain reduction, reduction in fear of movement, and improvement in shoulder
function. This demonstrates the potential effectiveness of this integrated strategy in controlling
CSAPS.