COMPARISON OF IMMEDIATE EFFECTS OF EXTRACORPOREAL SHOCKWAVE THERAPY AND CONVENTIONAL PHYSICAL THERAPY IN PATIENTS WITH CALCIFIC TENDINITIS OF THE SHOULDER ROTATOR CUFF

Authors

  • Maja Manoleva University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
  • Erieta Nikolic Dimitrova University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
  • Valentina Koevska University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
  • Biljana Mitrevska University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
  • Marija Gocevska University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
  • Cvetanka Gjerakaroska Savevska University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
  • Biljana Kalchovska Ivanovska University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
  • Lidija Stojanoska Matjanoska University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
  • Daniela Gecevska University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
  • Teodora Jugova University Clinic for physical medicine and rehabilitation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R. North Macedonia
  • Liljana Malinovska Nikolovska AcibademSistina Clinical Hospital, Department of pediatric cardiac surgery, Skopje, R. North Macedonia

Keywords:

calcifying tendinitis, shoulder, extracorporeal shockwave therapy

Abstract

Calcific tendinitis of the shoulder is a frequent disorder with an unknown etiology. It is usually treated with different physical therapy modalities where extracorporeal shockwave therapy comes as a new effective method.

The aim of the study was to compare extracorporeal shockwave therapy and conventional physical therapy in the treatment of calcific tendinitis of the rotator cuff of the shoulder.

The study is a prospective, monocentric clinical trial involving 40 patients with calcific tendinitis of the rotator cuff of the shoulder who were divided into two groups: group 1 (study group), 20 patients receiving extracorporeal shockwave therapy and performing shoulder exercises, and group 2 (control group), 20 patients who received conventional physical therapy with therapeutic ultrasound and diadynamic currents and performed shoulder exercises. Patients were evaluated with a Numerical Pain Scale and the range of motion in the shoulder joint was assessed. Clinical findings were evaluated before starting treatment and at the end of the treatment.

All patients after the treatment showed statistically significantly better results in the Numerical Pain Scale and the shoulder range of motion.

Extracorporeal shockwave therapy is a safe and non-invasive treatment that reduces pain and improves range of motion in the treatment of calcific tendinitis of the rotator cuff.

References

Lang G, Izadpanah K, Kubosch EJ, Maier D, Südkamp N, Ogon P. Examination of concomitant glenohumeral pathologies in patients treated arthroscopically for calcific tendinitis of the shoulder and implications for routine diagnostic joint exploration. BMC Musculoskelet Disord. 2017; 18(1): 476. doi: 10.1186/s12891-017-1839-z.

Uhthoff HK, Loehr JW. Calcific Tendinopathy of the Rotator Cuff: Pathogenesis, Diagnosis, and Management. J Am Acad Orthop Surg 1997; 5(4): 183-191. doi: 10.5 435/00124635-199707000-00001.

DE Carli A, Pulcinelli F, Rose GD, Pitino D, Ferretti A. Calcific tendinitis of the shoulder. Joints 2014; 2(3): 130-136. doi: 10.11138/jts/2014.2.3.130.

Uhthoff HK, Sarkar K. Calcifying tendinitis. Baillieres Clin Rheumatol 1989; 3(3): 567-581. doi: 10.1016/s0950-3579(89)80009-3.

Haefeli M, Elfering A. Pain assessment. Eur Spine J 2006; 15 Suppl 1(Suppl 1): S17-S24. doi: 10.1007/s00586-005-1044-x.

Maffulli N. Basic science and rotator cuff repair: where have we arrived? Med Sport Sci 2012; 57:VIII-X. PMID: 22081854.

Wu YC, Tsai WC, Tu YK, Yu TY. Comparative Effectiveness of Nonoperative Treatments for Chronic Calcific Tendinitis of the Shoulder: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2017; 98(8): 1678-1692.e6. doi: 10.1016/j.apmr.2017.02.030.

Maffulli G, Hemmings S, Maffulli N. Assessment of the Effectiveness of Extracorporeal Shock Wave Therapy (ESWT) For Soft Tissue Injuries (ASSERT): An Online Database Protocol. Transl Med UniSa 2014; 10: 46-51. PMID: 25147767; PMCID: PMC4140430.

Albert JD, Meadeb J, Guggenbuhl P, Marin F, Benkalfate T, Thomazeau H, et al. High-energy extracorporeal shock-wave therapy for calcifying tendinitis of the rotator cuff: a randomised trial. J Bone Joint Surg Br 2007; 89(3): 335-341. doi: 10.1302/ 0301-620X.89B3.18249.

Chianca V, Albano D, Messina C, Midiri F, Mauri G, Aliprandi A, et al. Rotator cuff calcific tendinopathy: from diagnosis to treatment. Acta Biomed 2018; 89(1-S): 186-196. doi: 10.23750/abm.v89i1-S.7022.

Wendelboe AM, Hegmann KT, Gren LH, Alder SC, White GL Jr, Lyon JL. Associations between body-mass index and surgery for rotator cuff tendinitis. J Bone Joint Surg Am 2004; 86(4): 743-747. doi: 10.2106/00004623-200404000-00011.

Sansone V, Maiorano E, Galluzzo A, Pascale V. Calcific tendinopathy of the shoulder: clinical perspectives into the mechanisms, pathogenesis, and treatment. Orthop Res Rev 2018; 10: 63-72. doi: 10.2147/ORR.S138225.

Kim MS, Kim IW, Lee S, Shin SJ. Diagnosis and treatment of calcific tendinitis of the shoulder. Clin Shoulder Elb 2020; 23(4): 210-216. doi: 10.5397/cise.2020.00318.

Huisstede BM, Gebremariam L, van der Sande R, Hay EM, Koes BW. Evidence for effectiveness of Extracorporal Shock-Wave Therapy (ESWT) to treat calcific and non-calcific rotator cuff tendinosis--a systematic review. Man Ther 2011; 16(5): 419-433. doi: 10.1016/j.math.2011.02.005.

Cho NS, Lee BG, Rhee YG. Radiologic course of the calcific deposits in calcific tendinitis of the shoulder: does the initial radiologic aspect affect the final results? J Shoulder Elbow Surg 2010; 19(2): 267-272. doi: 10.1016/j.jse.2009.07.008.

Rebuzzi E, Coletti N, Schiavetti S, Giusto F. Arthroscopy surgery versus shock wave therapy for chronic calcifying tendinitis of the shoulder. J Orthop Traumatol 2008; 9 (4): 179-185. doi: 10.1007/s10195-008-0024-4.

Berta L, Fazzari A, Ficco AM, Enrica PM, Catalano MG, Frairia R. Extracorporeal shock waves enhance normal fibroblast proliferation in vitro and activate mRNA expression for TGF-beta1 and for collagen types I and III. Acta Orthop 2009; 80(5): 612-617. doi: 10.3109/17453670903316793.

BrañEs J, Contreras HR, Cabello P, Antonic V, Guiloff LJ, Brañes M. Shoulder Rotator Cuff Responses to Extracorporeal Shockwave Therapy: Morphological and Immunohistochemical Analysis. Shoulder & Elbow 2012; 4(3): 163-168. doi: 10. 1111/j.1758-5740.2012.00178.x.

Chou WY, Wang CJ, Wu KT, Yang YJ, Ko JY, Siu KK. Prognostic factors for the outcome of extracorporeal shockwave therapy for calcific tendinitis of the shoulder. Bone Joint J 2017; 99-B(12): 1643-1650. doi: 10.1302/0301-620X.99B12.BJJ-2016-1178.R1.

Ebenbichler GR, Resch KL, Graninger WB. Resolution of calcium deposits after therapeutic ultrasound of the shoulder. J Rheumatol 1997; 24 (1): 235-6. PMID: 900 2055.

Calis HT, Berberoglu N, Calis M. Are ultrasound, laser and exercise superior to each other in the treatment of subacromial impingement syndrome? A randomized clinical trial. Eur J Phys Rehabil Med 2011; 47(3): 375-380. PMID: 21946399

Николиќ-Димитрова Е. Основи на физикална терапија, Ласерџет, Скопје; 2009, 80-85.

Demidaś A, Zarzycki M. Touch and Pain Sensations in Diadynamic Current (DD) and Transcutaneous Electrical Nerve Stimulation (TENS): A Randomized Study. Biomed Res Int 2019; 2019: 9073073. doi: 10.1155/2019/9073073.

Pleiner J, Crevenna R, Langenberger H, Keilani M, Nuhr M, Kainberger F, et al. Extracorporeal shockwave treatment is effective in calcific tendonitis of the shoulder. A randomized controlled trial. Wien Klin Wochenschr 2004; 116(15-16): 536-541. doi: 10.1007/BF03217707.

Malliaropoulos N, Thompson D, Meke M, Pyne D, Alaseirlis D, Atkinson H, et al. Individualised radial extracorporeal shock wave therapy (rESWT) for symptomatic calcific shoulder tendinopathy: a retrospective clinical study. BMC Musculoskelet Disord 2017; 18(1): 513. doi: 10.1186/s12891-017-1873-x.

Avancini-Dobrović V, Frlan-Vrgoc L, Stamenković D, Pavlović I, Vrbanić TS. Radial extracorporeal shock wave therapy in the treatment of shoulder calcific tendinitis. Coll Antropol 2011; 35 Suppl 2: 221-225. PMID: 22220440.

Chen CY, Hu CC, Weng PW, Huang YM, Chiang CJ, Chen CH, et al. Extracorporeal shockwave therapy improves short-term functional outcomes of shoulder adhesive capsulitis. J Shoulder Elbow Surg 2014; 23(12): 1843-1851. doi:10.1016/j.jse.2014.08.010.

Cacchio A, Paoloni M, Barile A, Don R, de Paulis F, et al. Effectiveness of radial shock-wave therapy for calcific tendinitis of the shoulder: single-blind, randomized clinical study. Phys Ther 2006 May; 86(5): 672-682. PMID: 16649891

Downloads

Published

2023-03-31

Issue

Section

Original Articles