Effects of High-Energy Extracorporeal Shockwave Therapy on Pain, Functional Disability, Quality of Life, and Ultrasonographic Changes in Patients with Calcified Rotator Cuff Tendinopathy.

Arooj Fatima,Syed Amir Gilani,Shiza Kazmi,Haider Darain,Kamran Hanif,Ashfaq Ahmad,Stefano Brunelli

doi:10.1155/2022/1230857

Abstract

Objective The current trial was designed to evaluate the effects of high-energy shockwave therapy on objective and subjective outcomes among participants with calcified rotator cuff tendinopathy. Methods This parallel-group, randomized trial consists of 42 patients affected by calcific tendinopathies divided into two groups of 21 participants. Patients having calcified tendinopathy aged between 30 and 65 years with type A or B calcification were selected in the trial after signing the written consent form. Participants in the ESWT+RPT group received eight sessions of shockwaves, while the RPT group was treated by routine physical therapy. About 2000 shockwaves of 0.32 mJ/mm2, 120 Hz per treatment, were given as 12 sessions for the first six weeks (2 sessions/week). Pain intensity and shoulder functional ability, ultrasonographic changes, and quality of life were assessed with the numeric pain rating scale (NPRS), Constant-Murley score (CMS), ultrasonography, and Western Ontario rotator cuff index (WORC). Results There were significant differences regarding NPRS and CMS between the two groups, at baseline and 6th and 12th weeks after intervention (p < 0.05). Within-group differences also showed statistically significant results after treatment (all p < 0.05). Significant results were seen in the WORC and ultrasonographic results pre- and posttreatment; more significant findings were found in the experimental group as compared to others. Conclusion High-energy shockwave therapy has been proved to be effective and thus strongly recommended for the management of calcified rotator cuff tendinopathy, improving the pain, functionality, and quality of life of these participants and decreasing the size of calcified deposits. Shockwave therapy is proved to be superior to routine physiotherapy.

Highlights

One of the most prevalent musculoskeletal disorders is shoulder pain; almost 6.9 to 26 percent of adults experience this pain in their lifetime [1]
This prospective parallel, randomized controlled trial was approved by the Institutional Review Board Committee of the University of Lahore, and it was registered at the Iranian Registry of Clinical Trials (IRCT)
The current trial is designed to find the role of Extracorporeal shock wave therapy (ESWT) therapy in participants with calcified rotator cuff (RC) tendinopathy as it is a highly prevalent condition

Summary

Introduction

One of the most prevalent musculoskeletal disorders is shoulder pain; almost 6.9 to 26 percent of adults experience this pain in their lifetime [1]. A common cause for the painful shoulder is rotator cuff (RC) injury, and among the most vulnerable tendons is the supraspinatus tendon (ST) affecting the quality of life of the patient. Because of its location in the subacromial space, ST is considered more vulnerable [2]. In fewer cases, it can be relatively asymptomatic, and proper diagnostic imaging can be required [3]. In RC calcific tendinopathy, the deposition of hydroxyapatite crystals occurs in RC tendons, most commonly the ST and infraspinatus tendons. The prevalence of RC calcific deposits in asymptomatic adults is 7.8 percent, and with the presence of subacromial pain syndrome (SAPS), the prevalence is about 42.5 percent [4]

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Results

Discussion

Conclusion