Musculoskeletal care
Focused Extracorporeal Shock Wave Therapy Versus Therapeutic Ultrasound as Adjuncts to Exercise-Based Rehabilitation for Functional Limitation in Ankylosing Spondylitis: An Assessor-Blinded Randomized Comparative Trial
By Elmotaleb Gazar YA, Ismail S, Ghanem S and 2 others.
Abstract
Background
The comparative effectiveness of adjunctive physical modalities alongside exercise for ankylosing spondylitis (AS) remains inadequately evaluated.
Objective
To compare the relative association of focused extracorporeal shock wave therapy (ESWT) versus therapeutic ultrasound, both added to identical exercise-based rehabilitation, with long-term functional outcomes in AS.
Methods
This assessor-blinded randomized comparative trial (conducted March 2024-August 2025) evaluated 106 AS patients with chronic lumbar stiffness (90 completed 12-month follow-up). Participants received either focused ESWT (weekly × 4 weeks, n = 45) or ultrasound (3 × /week × 4 weeks, n = 45), alongside identical 12-week supervised exercise and stable pharmacotherapy. The primary outcome was functional capacity (BASFI). Secondary outcomes included disease activity (BASDAI), pain, spinal mobility (modified Schober) and disability (DFI). This trial was not prospectively registered and lacked an exercise-only control arm; therefore, findings should be interpreted as exploratory.