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Efficacy of therapeutic ultrasound in the treatment of chronic calcific shoulder tendinitis: a randomized trial

BACKGROUND: Calcific shoulder tendinitis (CST) is characterized by hydroxyapatite crystals deposition in the rotator cuff tendons. Therapeutic exercises have been the mainstay of CST treatment, and evidence for therapeutic ultrasound (T-US) utilization and efficacy is lacking. AIM: This study aimed...

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Autores principales: ČOTA, Stjepan, DELIMAR, Valentina, ŽAGAR, Iva, KOVAČ DURMIŠ, Kristina, KRISTIĆ CVITANOVIĆ, Nikolina, ŽURA, Nikolino, PERIĆ, Porin, LAKTAŠIĆ ŽERJAVIĆ, Nadica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Edizioni Minerva Medica 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035437/
https://www.ncbi.nlm.nih.gov/pubmed/36723056
http://dx.doi.org/10.23736/S1973-9087.22.07715-2
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author ČOTA, Stjepan
DELIMAR, Valentina
ŽAGAR, Iva
KOVAČ DURMIŠ, Kristina
KRISTIĆ CVITANOVIĆ, Nikolina
ŽURA, Nikolino
PERIĆ, Porin
LAKTAŠIĆ ŽERJAVIĆ, Nadica
author_facet ČOTA, Stjepan
DELIMAR, Valentina
ŽAGAR, Iva
KOVAČ DURMIŠ, Kristina
KRISTIĆ CVITANOVIĆ, Nikolina
ŽURA, Nikolino
PERIĆ, Porin
LAKTAŠIĆ ŽERJAVIĆ, Nadica
author_sort ČOTA, Stjepan
collection PubMed
description BACKGROUND: Calcific shoulder tendinitis (CST) is characterized by hydroxyapatite crystals deposition in the rotator cuff tendons. Therapeutic exercises have been the mainstay of CST treatment, and evidence for therapeutic ultrasound (T-US) utilization and efficacy is lacking. AIM: This study aimed to determine whether 4500 J T-US combined with therapeutic exercises is superior to therapeutic exercises alone regarding calcification size reduction and symptom improvement in chronic symptomatic CST. DESIGN: This is a double-blind, placebo-controlled study. SETTING: This study was conducted at a University Department for Rheumatic Diseases and Rehabilitation of a University Hospital. POPULATION: Patients with chronic CST were analyzed. METHODS: After eligibility allocation, 46 patients with sonographically confirmed CST were divided into two groups (56 shoulders, 26 per group). Both groups performed the same therapeutic exercises for half an hour under physiotherapist supervision. In the treatment group T-US (4500 J, 10 minutes per session at a frequency of 1 MHz and an intensity of 1.5 W/cm(2)), and in the placebo group, sham T-US was applied for 4 weeks. Patients were assessed for: calcification size, shoulder pain, global health (GH), shoulder mobility (ROM), handgrip strength, Health Assessment Questionnaire Disability Index (HAQ-DI), Shoulder Pain and Disability Index (SPADI), and overall rehabilitation satisfaction. RESULTS: All assessed variables improved in both groups. A significantly greater reduction in calcification size was recorded in the treatment group compared to placebo: -10.92% (IQR 4.61% to 19.38%) versus -5.04% (2.30% to 7.22%), P=0.008. There was a significantly greater decrease in HAQ-DI, reduction of VAS GH, and an increase in hand grip strength in the treatment group, while no significant differences were observed for other parameters between the groups. CONCLUSIONS: Our results showed that adding the 4500 J T-US to therapeutic exercises in chronic symptomatic CST therapy resulted in greater calcification size reduction immediately following the treatment, as well as hand grip strength, HAQ-DI, and VAS GH improvement. CLINICAL REHABILITATION IMPACT: 4500 J T-US combined with therapeutic exercises is more effective in reducing calcification size than therapeutic exercises alone in the treatment of chronic symptomatic CST.
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spelling pubmed-100354372023-03-24 Efficacy of therapeutic ultrasound in the treatment of chronic calcific shoulder tendinitis: a randomized trial ČOTA, Stjepan DELIMAR, Valentina ŽAGAR, Iva KOVAČ DURMIŠ, Kristina KRISTIĆ CVITANOVIĆ, Nikolina ŽURA, Nikolino PERIĆ, Porin LAKTAŠIĆ ŽERJAVIĆ, Nadica Eur J Phys Rehabil Med Article BACKGROUND: Calcific shoulder tendinitis (CST) is characterized by hydroxyapatite crystals deposition in the rotator cuff tendons. Therapeutic exercises have been the mainstay of CST treatment, and evidence for therapeutic ultrasound (T-US) utilization and efficacy is lacking. AIM: This study aimed to determine whether 4500 J T-US combined with therapeutic exercises is superior to therapeutic exercises alone regarding calcification size reduction and symptom improvement in chronic symptomatic CST. DESIGN: This is a double-blind, placebo-controlled study. SETTING: This study was conducted at a University Department for Rheumatic Diseases and Rehabilitation of a University Hospital. POPULATION: Patients with chronic CST were analyzed. METHODS: After eligibility allocation, 46 patients with sonographically confirmed CST were divided into two groups (56 shoulders, 26 per group). Both groups performed the same therapeutic exercises for half an hour under physiotherapist supervision. In the treatment group T-US (4500 J, 10 minutes per session at a frequency of 1 MHz and an intensity of 1.5 W/cm(2)), and in the placebo group, sham T-US was applied for 4 weeks. Patients were assessed for: calcification size, shoulder pain, global health (GH), shoulder mobility (ROM), handgrip strength, Health Assessment Questionnaire Disability Index (HAQ-DI), Shoulder Pain and Disability Index (SPADI), and overall rehabilitation satisfaction. RESULTS: All assessed variables improved in both groups. A significantly greater reduction in calcification size was recorded in the treatment group compared to placebo: -10.92% (IQR 4.61% to 19.38%) versus -5.04% (2.30% to 7.22%), P=0.008. There was a significantly greater decrease in HAQ-DI, reduction of VAS GH, and an increase in hand grip strength in the treatment group, while no significant differences were observed for other parameters between the groups. CONCLUSIONS: Our results showed that adding the 4500 J T-US to therapeutic exercises in chronic symptomatic CST therapy resulted in greater calcification size reduction immediately following the treatment, as well as hand grip strength, HAQ-DI, and VAS GH improvement. CLINICAL REHABILITATION IMPACT: 4500 J T-US combined with therapeutic exercises is more effective in reducing calcification size than therapeutic exercises alone in the treatment of chronic symptomatic CST. Edizioni Minerva Medica 2023-02-01 /pmc/articles/PMC10035437/ /pubmed/36723056 http://dx.doi.org/10.23736/S1973-9087.22.07715-2 Text en 2022 THE AUTHORS https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND) 4.0 License.
spellingShingle Article
ČOTA, Stjepan
DELIMAR, Valentina
ŽAGAR, Iva
KOVAČ DURMIŠ, Kristina
KRISTIĆ CVITANOVIĆ, Nikolina
ŽURA, Nikolino
PERIĆ, Porin
LAKTAŠIĆ ŽERJAVIĆ, Nadica
Efficacy of therapeutic ultrasound in the treatment of chronic calcific shoulder tendinitis: a randomized trial
title Efficacy of therapeutic ultrasound in the treatment of chronic calcific shoulder tendinitis: a randomized trial
title_full Efficacy of therapeutic ultrasound in the treatment of chronic calcific shoulder tendinitis: a randomized trial
title_fullStr Efficacy of therapeutic ultrasound in the treatment of chronic calcific shoulder tendinitis: a randomized trial
title_full_unstemmed Efficacy of therapeutic ultrasound in the treatment of chronic calcific shoulder tendinitis: a randomized trial
title_short Efficacy of therapeutic ultrasound in the treatment of chronic calcific shoulder tendinitis: a randomized trial
title_sort efficacy of therapeutic ultrasound in the treatment of chronic calcific shoulder tendinitis: a randomized trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035437/
https://www.ncbi.nlm.nih.gov/pubmed/36723056
http://dx.doi.org/10.23736/S1973-9087.22.07715-2
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