Effect of Extracorporeal Shock Wave Therapy Combined with Kinesio Taping on Shoulder Function in Patients with Long-Head Biceps Tendinopathy: A Randomized Controlled Trial.

Abstract

To evaluate the main effects of extracorporeal shock wave therapy (ESWT) and Kinesio taping (KT), and their interaction on shoulder function and symptoms in adults with long-head biceps tendinopathy (LHBT). Factorial randomized controlled trial. Hospital outpatient rehabilitation department. 144 adults (18-65 years) with clinically diagnosed LHBT were randomly allocated to ESWT+KT, sham ESWT+KT, ESWT+sham KT, or double-sham groups. Thirteen participants (9.0%) were lost to follow-up; analyses followed intention-to-treat. All participants received a standardized 4-week rehabilitation program including stretching, strengthening, and manual therapy. ESWT or sham ESWT was delivered once weekly for four sessions (2000 pulses, 8 Hz, 0.12-0.25 mJ/mm²). KT or sham taping (no tension) was applied using standardized procedures. The primary outcome was the Constant-Murley Score (CMS). Secondary outcomes included pain intensity on the Numerical Rating Scale during rest, activity, and sleep, pressure pain threshold, tissue hardness, and Global Rating of Change. Outcomes were measured at baseline, immediately after intervention (week 4), and at 2-week follow-up (week 6). In the factorial mixed model, all outcomes improved over time (P<0.001). For CMS, ESWT showed a significant main effect post-treatment (mean difference 15.90, 95% CI 12.70∼19.10) and at follow-up (16.15, 13.25∼19.05), whereas KT showed no significant main effect post-treatment (2.40, -1.72∼ 6.52) or at follow-up (1.95, -1.97∼5.87). There was no evidence of an ESWT × KT interaction for CMS post-treatment (4.80, -1.55 ∼ 11.15) or at follow-up (3.70, -2.07∼9.47). For secondary outcomes, ESWT reduced pain across rest, activity, and sleep domains; KT effects were smaller, and interaction effects were outcome-dependent, with evidence consistent with additional benefit for sleep pain and patient-perceived recovery. In the short term, extracorporeal shock wave therapy improved shoulder function and reduced pain in adults with long-head biceps tendinopathy. Kinesio taping provides limited additional benefit for overall function but may improve selected pain domains and perceived recovery. Chinese Clinical Trial Registry (ChiCTR2100051324).