OTP 125: Rehabilitation Practicum Reflection on Therapeutic Methods

This assignment is a reflective journal entry analyzing the effectiveness of shockwave therapy combined with stretching exercises versus ultrasound therapy combined with stretching exercises for patients with frozen shoulder. The author describes a study involving two groups of patients, detailing the treatment protocols and observed outcomes. Group A, receiving shockwave therapy, showed better results compared to Group B, which underwent ultrasound therapy. The reflection highlights the benefits of shockwave therapy as a safe and cost-effective alternative to surgery, while also acknowledging limitations such as the small sample size and lack of standardized treatment schemes. The author concludes that both methods are effective in reducing joint pain and improving range of motion, with shockwave therapy showing promising results. The learning experience emphasizes the potential of these therapies as convenient and low-cost solutions for patients suffering from frozen shoulder, encouraging further real-life application and suggesting the importance of daily stretching exercises.

1
Introduction to Rehabilitation Practice
Author Name(s), First M. Last, Omit Titles and Degrees
Institutional Affiliation(s)

Introduction to Rehabilitation Practice
2
A brief summary of the learning experience
One of the important parts of the rehabilitation of a patient is monitoring the
health of the patient during and after the patient’s intervention.
The learning experience from this analysis is to analyze the effectiveness and
make a comparison using two types of solutions; the impact of shockwave therapy
combined with stretching exercise and ultrasound therapy combined with
stretching exercise for patients with the frozen shoulder joint.
A succinct description of critical incidents/learning opportunities
For this purpose, ten patients with the problem of the frozen shoulder were
randomly selected.
Two similar groups A and B were made, each consisting of five patients. They
were suffering from this disease for different time periods, ranging from one
month to six months.
Patients were analyzed by goniometer before and after treatment for severity of
shoulder pain using the pain scale (VAS) and motion range (ROM) of the
shoulder joint (Morishita et al., 2014).
Group A received a shock wave therapy with 2k pulses per session, and an energy
density of 0.20 MJ / mm2, a pulse-rate of 15 / s and a frequency of 1-20 Hz and
the stretching exercise.
Group B received an ultrasound at a frequency of 3 MegaHertz and the intensity
of intensity 1Watt /centimeter was applied to the pain site with ultrasound gel for
2

Introduction to Rehabilitation Practice
3
5 mins plus the same exercise. The two groups received treatment four times a
week for 4 weeks.
Group A plus exercises and group B plus exercise were both effective in
decreasing shoulder joint pain and increase ROM. However, group A people
reported better results compared to group B patients.
The most valuable thing(s) I learned was that external shock wave treatment
has a positive effect on accelerating the healing process of shoulder freezing.
Strengths: Considering the side effects of other therapies and cost such as
surgery, it can be said that. patients with a frozen shoulder which is a common
disorder may benefit from this method of treatment because it is safe, low cost, no
need for hospitalization, only a visits to the hospital on scheduled days and
practically no adverse effects during treatment (Knight Draper, 2012).
Areas requiring improvement: Several limitations in this study require
discussion. This study was conducted among a test group of people, the actual
results are to be of importance when the process is applied in real life situation.
Moreover, the study group is too small to come to the conclusion of the
effectiveness of shock wave treatment in comparison to ultrasound method.
Another disadvantage of external shock wave treatment method is that there is no
valid therapy schemes exist. There is an absence of information regarding
suggested ideal dosages, number of shocks, durations of treatment etc.
Action plan to address areas requiring improvement
It has been proved that both the methods are effective in reducing joint pain in
case of the frozen shoulder where not only pain but also the movement of the arm
3

Introduction to Rehabilitation Practice
4
is also involved ( Moya, Ramón, Guiloff, & Gerdesmeye , 2015).; shockwave
therapy should be used at a low dosage and with short durations in pathologies of
soft tissues (Louwerens, Veltman, van Noort & van den Bekerom , 2016).
Steps were taken to achieve learning objectives
The encouraging outcome of the experiment establishes my learning experience
that shockwave therapy or ultrasound therapy along with stretching exercise is an
alternate treatment methodology which is effective, convenient and a low-cost
solution to a large number of patients suffering from this disorder.
Personal views/opinions: The experiment set up is a good experience for me to
compare two different methodologies being tested simultaneously and analyze the
results to arrive at a conclusion.
Now I want to apply the learning experience in real life situation I also suggest
that if everybody spends some time in stretching exercise daily, this type of
disorder may not happen.
4

Introduction to Rehabilitation Practice
5
References:
Knight, K., Knight, K. L., & Draper, D. O. (2012). Therapeutic modalities: the art and science.
Lippincott Williams & Wilkins.
Louwerens, J. K., Veltman, E. S., van Noort, A., & van den Bekerom, M. P. (2016). The
effectiveness of high-energy extracorporeal shockwave therapy
versus ultrasound-guided needling versus arthroscopic surgery in
the management of chronic calcific rotator cuff tendinopathy: a
systematic review. Arthroscopy: The Journal of Arthroscopic &
Related Surgery, 32(1), 165-175.
Morishita, K., Karasuno, H., Yokoi, Y., Morozumi, K., Ogihara, H., & Ito, T. et al. (2014).
Effects of Therapeutic Ultrasound on Range of Motion and Stretch
Pain. Journal Of Physical Therapy Science, 26(5), 711-715. doi:
10.1589/jpts.26.711
Moya, D., Ramón, S., Guiloff, L., & Gerdesmeyer, L. (2015). Current knowledge on evidence-
based shockwave treatments for shoulder pathology. International
journal of surgery, 24, 171-178.
5