N.I. Arovah, W. Kushartanti, R.L. Ambardini
Background and objective: Nonspecific low back pain (NSLBP) is a prevalent musculoskeletal condition. This study examined the immediate effects of extracorporeal shockwave therapy (ESWT), ultrasound therapy (UST), and shortwave diathermy (SWD) in sub-acute and chronic NSLBP. Materials and methods: A 2×3 factorial design was applied to 45 patients with nonspecific low back pain (NSLBP; 60% male). The independent factors were NSLBP phase (subacute vs. chronic) and treatment modality (ESWT, UST, or SWD). Outcome measures included pain intensity, assessed with the Visual Analogue Scale (VAS), and spinal range of motion (flexion, extension, lateral flexion, and rotation), measured using a goniometer. Assessments were conducted before and immediately after treatment. A split-plot repeated measures ANOVA evaluated the main and interaction effects of phase, treatment, and time on pain and range of motion. Effect sizes were calculated using Hedges’ corrected d. Results: Pain decreased significantly from baseline across all groups (p<0.001; Hedges’ d=1.344). Range of motion improved significantly in flexion (p=0.003), extension (p<0.001), left lateral flexion (p=0.025), and right rotation (p=0.008). The largest mean ROM gain was observed in extension, with ROM effect sizes ranging from 0.362 to 0.829. No significant main effects of phase or modality, and no time×phase, time×modality, or three-way interaction effects were detected, indicating no statistically detectable between-group differences in immediate responses. Conclusions: ESWT, UST, and SWD were associated with immediate post-session improvements in pain and lumbar mobility in subacute and chronic NSLBP; between-group differences were not statistically detectable, and should be interpreted as exploratory, reflecting limited statistical power. Further longitudinal research is recommended to verify long-term effectiveness. © 2026 Sociedad Española de Rehabilitación y Medicina Física. Published by Elsevier España, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
Faculty of Medicine, Universitas Negeri Yogyakarta, Indonesia
