الفهرس 
Title : Influence Of Radial Extracorpeal Shock Wave Therapy On Sonographic Findings In Hemiplegic Shoulder Pain Patients
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Abstract
Introduction: Structural abnormalities of shoulder joint are a common complication post stroke, as a consequent pain and functional limitation became the most devastating quality of life problems for such patients. Shock wave therapy is a non-invasive method that can enhance the level of perfusion in ischemic tissues, relief inflammation and promote healing. Objectives: To assess the efficacy of radial extracorporeal shock wave therapy on shoulder structural abnormality, pain threshold, disability and shoulder range of motion (ROM) (flexion &abduction) in stroke patients. Also, to correlate between shoulder structural abnormalities and pain threshold, disability and ROM (flexion &abduction) in stroke patients. Methods: Thirty ischemic sub-acute stroke patients, their ages ranged from 40 to 60 years, were randomly allocated into two equal groups. Study group (GI) underwent radial extracorporeal shock wave therapy (rESWT) in addition to a program of therapeutic exercises directed mainly to shoulder joint. Control group (GII) received sham rESWT in addition to the same physical therapy program as GI. The treatment was conducted ”two” sessions per week for ”one” month. Pre and post intervention findings of both groups were assessed and compared for the primary outcomes including shoulder structural abnormalities. Pain pressure threshold (PPT),shoulder disability, and ROM of shoulder joint (flexion and abduction) were measured by ultrasonography (USS), handheld algometry, shoulder pain disability index (SPADI) and digital goniometer respectively. Results: A statistically significant reduction post treatment of USS Scores and all SPADI scores (pain, disability & total scores) in both groups with remarkable decrease in favor to study group (GI) (P < 0.05). A significant increase of PPT only in study group (GI) and a statistically significant increase of shoulder joint ROM (flexion and abduction) in both groups with remarkable increase in favor to study group (GI). The changes in USS scores were correlated positively with all SPADI scores (pain intensity, disability, and total scores), and negatively with both PPT and ROM of shoulder joint