Nurse practitioner applies extracorporeal shock wave therapy for patients with frozen shoulder: A randomized controlled trial

BACKGROUND: Nurse practitioners (NPs) have increasingly applied extracorporeal shockwave therapy (ESWT) to treat patients with frozen shoulders in acute care settings. However, the effectiveness of NPs using ESWT in patients has not yet been examined. PURPOSE: To determine the efficacy of NP-led ESWT and identify optimal impulse dosages on pain and joint mobility in patients with frozen shoulders. METHODOLOGY: A single-blind, randomized controlled trial including 52 patients with frozen shoulders was conducted. The patients were randomly allocated equally to a high-dose ESWT (H-ESWT) or a low-dose ESWT (L-ESWT). The visual analog scale evaluated patients' pain, and joint mobility was measured with the Constant-Murley score. RESULTS: All groups significantly improved pain and joint mobility after the interventions. However, the H-ESWT group reported significantly lower pain than the L-ESWT groups only 4 and 8 weeks after intervention. In addition, the H-ESWT group showed a significantly higher improvement in joint mobility than the L-ESWT groups at pro-intervention, 1 and 2 weeks after intervention. CONCLUSIONS: Nurse practitioners applied ESWT to treat patients with frozen shoulder, effectively improving pain and joint mobility. High-dose ESWT is superior to L-ESWT in symptom improvement. This study verified the care outcomes of NPs in caring for patients with frozen shoulders. IMPLICATIONS: Nurse practitioners could be trained and implement ESWT to treat patients with frozen shoulder for symptom improvement. Health care organizations would empower or support NPs to perform the ESWT in clinical settings. Hospitals need to recognize and credit the care outcomes of NPs in caring for patients with frozen shoulders.