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

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.

Role of extracorporeal shockwave therapy in patients with rotator cuff tendinopathy: synthetic analysis of last two decades.

OBJECTIVE: To explore current evidence on the effectiveness of shockwave therapy in patients with rotator cuff tendinopathy. METHODS: The meta-analysis study was conducted at University of Lahore from May 2019 to December 2019 and comprised search on Cochrane, Medline, Embase, Physiotherapy Evidence Databasedatabases and other sources as well as unpublished grey literature related to shockwave therapy in patients with rotator cuff tendinopathy published between 2000 and 2019. Methodological quality assessment was performed using Cochrane risk of bias tool and the included studies were critically appraised using the Physiotherapy Evidence Databasescale. RESULTS: Of the 11 studies shortlisted, data was not extractable from 2(18%). Of the 9(82%) studies analysed, 8(89%) were randomised trials and 1(11%) was randomised pilot study. Overall, 4(44.4%) studies had high quality and 5(55.6%) fell in the fair category. CONCLUSIONS: There was no consensus found on the efficacy of extracorporeal shockwave therapy compared to traditional rehabilitation among patients with rotator cuff tendinopathy.