Comparison Between Radiofrequency and Ultrasound on Shoulder Pain, Range of Motion, and Functional Outcomes in Patients with Stroke: A Narrative Review.

Stroke remains one of the leading causes of death and long-term disability worldwide, as ischemic strokes accounting for about 85% of all cases. In Egypt, stroke represents approximately 6.4% of total deaths, with a growing prevalence among younger individuals. Hemiplegic shoulder pain (HSP) is among the most frequent post-stroke complications, affecting 30–65% of patients and causing functional limitations and reduced quality of life. The pathophysiology of HSP involves spasticity, capsulitis, subluxation, rotator cuff injury, and soft tissue inflammation. Electrophysical modalities, including therapeutic ultrasound and radiofrequency (RF) therapy, are frequently applied to manage HSP by promoting tissue healing, reducing muscle spasm, and enhancing circulation. Ultrasound therapy produces deep thermal and non-thermal effects that aid in pain reduction and mobility improvement, while radiofrequency, particularly Transfer of Energy Capacitive and Resistive (TECAR) therapy, generates endogenous heat with analgesic, anti-inflammatory, and regenerative benefits. TECAR has been effective in musculoskeletal and post-stroke rehabilitation but has not been directly compared with ultrasound in HSP treatment. Therefore, this study aims to compare the effects of radiofrequency TECAR and ultrasound therapy on shoulder pain, range of motion, and functional outcomes in stroke patients, providing new insights to optimize physiotherapeutic management strategies.