Original scientific paper
Clinical application of extracorporeal shock wave therapy in the treatment of shoulder calcific tendinitis: focal vs. radial shock waves
Viviana Avancini-Dobrović
orcid.org/0000-0002-9161-4328
; Centar za fizikalnu i rehabilitacijsku medicinu, KBC Rijeka, Rijeka , Hrvatska
Ivan Pavlović
; Klinički zavod za radiologiju, KBC Rijeka, Rijeka, Hrvatska
Ljubinka Frlan-Vrgoč
; Centar za fizikalnu i rehabilitacijsku medicinu, KBC Rijeka, Rijeka , Hrvatska
Tea Schnurrer-Luke-Vrbanić
orcid.org/0000-0002-9161-4328
; Centar za fizikalnu i rehabilitacijsku medicinu, KBC Rijeka, Rijeka , Hrvatska
Abstract
Aim: Comparison of effectiveness focal versus radial extracorporeal shock wave therapy in the treatment of shoulder calcific tendinitis. Shoulder calcified lesions of the rotator cuff are a common problem in physiatric and orthopedic practice. The lesions are mostly located in the supraspinatus tendon, close to the insertion area in the critical zone. Patients are usually treated conservatively by nonsteroid antiinflammator drugs, analgesic drugs, local injections, physiotherapy and rarely by applying surgical procedures. Painful shoulder gives rise to functional disabilities and may sometimes lead to pharmacological overuse. In the last twenty years, extracorporeal shock wave therapy (ESWT) has been frequently used in the treatment of calcified tendinopathies. Methods: We have evaluated the effectiveness of radial and focused ESWT on the group of 60 patients with calcific tendinitis of the shoulder, divided into two groups of 30 patients. Criotherapy, medical exercises and ESWT were applied. Patients were examined before the begining of the treatment, immediately after the treatment and 6 months later. The treatment included measurement of the range of motion (ROM) and subjective assessment of pain intensity with visual analogue scale (VAS). X-ray was done before and 6 month after treatment. Results: The study has shown the efficiency of the treatment with ESWT. The level of statistical significance was determined with ONE way ANOVA test. Discussion: ESWT applied to patients with shoulder calcific lesions of the rotator cuff resulted in pain relief and increase in the range of motion. As shown by X-ray, these results were followed by decrease in the size of the rotator cuff calcifications after treatment by radial and focused ESWT. In some patients treated with focused ESWT a complete regresion of calcification was observed. Only in patients treated with focused ESWT a statistical significant decrease of calcifications density was observed. Conclusion: In the treatment of shoulder calcific tendinitis the effectiveness of both types of shock waves has been proved, with statistically significantly better results from the focused shock wave.
Keywords
callcified tendinopathies; extracorporeal shock wave therapy; shoulder
Hrčak ID:
95734
URI
Publication date:
3.12.2012.
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