journal article Nov 01, 2012

Extracorporeal Shock-Wave Therapy for Supraspinatus Calcifying Tendinitis: A Randomized Clinical Trial Comparing Two Different Energy Levels

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Abstract
BackgroundExtracorporeal shock-wave therapy (ESWT) represents a valid intervention in the treatment of people with supraspinatus calcifying tendinitis (SCT), but there is limited evidence for the useful range of ESWT doses.ObjectiveThe aim of this study was to compare 2 different ranges of energy flux density in treatment of SCT with ESWT.DesignThis study was designed as a single-blind randomized clinical trial.SettingThis study was performed in a university hospital.PatientsForty-six patients with SCT were randomly assigned to 2 groups that received different therapeutic energy doses of ESWT: (1) group A received ESWT at an energy level of 0.20 mJ/mm2, and (2) group B received ESWT at an energy level of 0.10 mJ/mm2.InterventionThe treatment protocol consisted of 4 sessions performed once a week.MeasurementsThe change in mean Constant Murley Scale (CMS) scores at 3 and 6 months was the primary endpoint. The change in the mean visual analog scale (VAS) scores from baseline to 3 and 6 months after the intervention and radiographic change in size of calcium deposits were evaluated as secondary endpoints. At 12 months, pain relief was assessed using a numeric rating scale.ResultsSignificant clinical improvement based on mean CMS scores was observed after 6 months in group A (X̅=79.43, SD=10.33) compared with group B (X̅=57.91, SD=6.53). Likewise, after 6 months, a significant decrease in VAS scores was found in group A (X̅=2.09, SD=1.54) compared with group B (X̅=5.36, SD=0.78). Calcific deposits disappeared in the same percentage of patients in both groups.LimitationsThe small sample size and lack of a control group were limitations of the study.ConclusionsIn ESWT for SCT, an energy level of 0.20 mJ/mm2 appears to be more effective than an energy level of 0.10 mJ/mm2 in pain relief and functional improvement.
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References
64
[1]
Hurt "Calcific tendinitis of the shoulder" Orthop Clin North Am (2003) 10.1016/s0030-5898(03)00089-0
[2]
Lundberg "The frozen shoulder: clinical and radiographical observations—the effect of manipulation under general anesthesia, structure and glycosaminoglycan content of the joint capsule, local bone metabolism" Acta Orthop Scand (1969) 10.3109/ort.1969.40.suppl-119.01
[3]
Rupp "Tendinosis calcarea of the rotator cuff [in German]" Orthopade (2000) 10.1007/s001320050536
[4]
McKendry "Calcifying tendinitis of the shoulder: prognostic value of clinical, histologic, and radiologic features in 57 surgically treated cases" J Rheumatol (1982)
[5]
Uhthoff "Calcifying tendinitis: a new concept of its pathogenesis" Clin Orthop Relat Res (1976)
[6]
Bosworth "Calcium deposits in the shoulder and subacromial bursitis: a survey of 12,122 cases" JAMA (1941) 10.1001/jama.1941.02820220019004
[7]
Gartner "Analysis of calcific deposits in calcifying tendinitis" Clin Orthop Relat Res (1990)
[8]
Faure "Calcified tendinitis: a review" Ann Rheum Dis (1983) 10.1136/ard.42.suppl_1.49
[9]
Diehl "Calcific tendinitis of the shoulder [in German]" Orthopade (2011) 10.1007/s00132-011-1817-3
[10]
Gimblett "A conservative management protocol for calcific tendinitis of the shoulder" J Manip Physiol Ther (1999) 10.1016/s0161-4754(99)70023-0
[11]
Bang "Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome" J Orthop Sports Phys Ther (2000) 10.2519/jospt.2000.30.3.126
[12]
Kaada "Treatment of peritendinitis calcarea of the shoulder by transcutaneous nerve stimulation" Acupunct Electrother Res (1984) 10.3727/036012984816714767
[13]
Wagenhauser "Clinical physical examination of patients with backache [in German]" Z Allgemeinmed (1972)
[14]
Rompe "Applications of extracorporeal shockwave therapy in orthopedics: Where do we stand 10 years later? [in German]" Orthopade (2002) 10.1007/s00132-002-0318-9
[15]
Gerdesmeyer "Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial" JAMA (2003) 10.1001/jama.290.19.2573
[16]
Hsu "Extracorporeal shock wave therapy for calcifying tendinitis of the shoulder" J Shoulder Elbow Surg (2008) 10.1016/j.jse.2007.03.023
[17]
Green "Systematic review of randomised controlled trials of interventions for painful shoulder: selection criteria, outcome assessment, and efficacy" BMJ (1998) 10.1136/bmj.316.7128.354
[18]
Mouzopoulos "Extracorporeal shock wave treatment for shoulder calcific tendonitis: a systematic review" Skeletal Radiol (2007) 10.1007/s00256-007-0297-3
[19]
Minilith (1997)
[20]
Rompe (1996)
[21]
Siebert (1996)
[22]
Peters "Extracorporeal shock wave therapy in calcific tendinitis of the shoulder" Skeletal Radiol (2004) 10.1007/s00256-004-0849-8
[23]
Mariotto "Extracorporeal shock wave therapy in inflammatory diseases: molecular mechanism that triggers anti-inflammatory action" Curr Med Chem (2009) 10.2174/092986709788682119
[24]
Loew "Shock-wave therapy is effective for chronic calcifying tendinitis of the shoulder" J Bone Joint Surg Br (1999) 10.1302/0301-620x.81b5.0810863
[25]
Klonschinski "Application of local anesthesia inhibits effects of low-energy extracorporeal shock wave treatment (ESWT) on nociceptors" Pain Med (2011) 10.1111/j.1526-4637.2011.01229.x
[26]
Chen "Extracorporeal shock waves promote healing of collagenase-induced Achilles tendinitis and increase TGF-beta1 and IGF-I expression" J Orthop Res (2004) 10.1016/j.orthres.2003.10.013
[27]
Ciampa "Nitric oxide mediates anti-inflammatory action of extracorporeal shock waves" FEBS Lett (2005) 10.1016/j.febslet.2005.11.023
[28]
Shock wave therapy induces neovascularization at the tendon–bone junction. A study in rabbits

Ching‐Jen Wang, Feng‐Sheng Wang, Kuender D. Yang et al.

Journal of Orthopaedic Research 2003 10.1016/s0736-0266(03)00104-9
[29]
Matsubayashi "Cross-reactivities with Cryptosporidium spp. by chicken monoclonal antibodies that recognize avian Eimeria spp" Vet Parasitol (2005) 10.1016/j.vetpar.2004.11.004
[30]
Nishida "Extracorporeal cardiac shock wave therapy markedly ameliorates ischemia-induced myocardial dysfunction in pigs in vivo" Circulation (2004) 10.1161/01.cir.0000148849.51177.97
[31]
Rompe "Musculoskeletal shock wave therapy: current database of clinical research [in German]" Z Orthop Ihre Grenzgeb (2002) 10.1055/s-2002-32477
[32]
Cosentino "Efficacy of extracorporeal shock wave treatment in calcaneal enthesophytosis" Ann Rheum Dis (2001) 10.1136/ard.60.11.1064
[33]
Cacchio "Effectiveness of radial shock-wave therapy for calcific tendinitis of the shoulder: single-blind, randomized clinical study" Phys Ther (2006) 10.1093/ptj/86.5.672
[34]
Gotte "Short-time non-enzymatic nitric oxide synthesis from L-arginine and hydrogen peroxide induced by shock waves treatment" FEBS Lett (2002) 10.1016/s0014-5793(02)02807-7
[35]
Kusnierczak "Effect of extracorporeal shockwave administration on biological behavior of bone cells in vitro [in German]" Z Orthop Ihre Grenzgeb (2000) 10.1055/s-2000-10109
[36]
Steinbach "Determination of the energy-dependent extent of vascular damage caused by high-energy shock waves in an umbilical cord model" Urol Res (1993) 10.1007/bf00307711
[37]
Haake "Side-effects of extracorporeal shock wave therapy (ESWT) in the treatment of tennis elbow" Arch Orthop Trauma Surg (2002) 10.1007/s00402-001-0362-7
[38]
Durst "Osteonecrosis of the humeral head after extracorporeal shock-wave lithotripsy" J Bone Joint Surg Br (2002) 10.1302/0301-620x.84b5.0840744
[39]
Rompe "Extracorporal shock wave therapy for calcifying tendinitis of the shoulder" Clin Orthop Relat Res (1995)
[40]
Han "J. Leonard Goldner Award 2008: effect of extracorporeal shock wave therapy on cultured tenocytes" Foot Ankle Int (2009)
[41]
Bosch "Effect of extracorporeal shock wave therapy on the biochemical composition and metabolic activity of tenocytes in normal tendinous structures in ponies" Equine Vet J (2007) 10.2746/042516407x180408
[42]
Schofer "High- versus low-energy extracorporeal shock wave therapy of rotator cuff tendinopathy: a prospective, randomised, controlled study" Acta Orthop Belg (2009)
[43]
Notarnicola "Reduced local perfusion after shock wave treatment of rotator cuff tendinopathy" Ultrasound Med Biol (2011) 10.1016/j.ultrasmedbio.2010.11.019
[44]
Rompe "Repetitive low-energy shock wave application without local anesthesia is more efficient than repetitive low-energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis" J Orthop Res (2005) 10.1016/j.orthres.2005.09.003
[45]
Beaudreuil "Contribution of clinical tests to the diagnosis of rotator cuff disease: a systematic literature review" Joint Bone Spine (2009) 10.1016/j.jbspin.2008.04.015
[46]
Dinnes "The effectiveness of diagnostic tests for the assessment of shoulder pain due to soft tissue disorders: a systematic review" Health Technol Assess (2003) 10.3310/hta7290
[47]
Gartner "Tendinosis calcarea–results of treatment with needling [in German]" Z Orthop Ihre Grenzgeb (1993)
[48]
McAteer "The acute and long-term adverse effects of shock wave lithotripsy" Semin Nephrol (2008) 10.1016/j.semnephrol.2008.01.003
[49]
Rompe "Effectiveness of extracorporeal shock wave therapy in the management of tennis elbow" Am J Sports Med (2005) 10.1177/036354650503300317
[50]
Constant "A clinical method of functional assessment of the shoulder" Clin Orthop Relat Res (1987)

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Details
Published
Nov 01, 2012
Vol/Issue
92(11)
Pages
1376-1385
Authors
Cite This Article
Francesco Ioppolo, Maria Tattoli, Luca Di Sante, et al. (2012). Extracorporeal Shock-Wave Therapy for Supraspinatus Calcifying Tendinitis: A Randomized Clinical Trial Comparing Two Different Energy Levels. Physical Therapy, 92(11), 1376-1385. https://doi.org/10.2522/ptj.20110252