Pech ARC, Peña VEI, Rosado PJA, Elizondo BCO, Vargas ESL

Language: Spanish
References: 23
Page: 58-67
PDF size: 487.33 Kb.

ABSTRACT

Introduction: rotator cuff tendinopathy is a common cause of shoulder pain and functional disability. Radial shockwave therapy has emerged as a non-invasive therapeutic alternative, although its effectiveness compared to conventional therapy still requires further evidence. The aim of this study was to evaluate the effects of radial shockwave therapy in patients with rotator cuff tendinopathy. Material and methods: a simple randomized clinical trial was conducted with 24 IMSS-insured patients clinically diagnosed with rotator cuff tendinopathy. Participants were randomly assigned to two groups: one received radial shockwave therapy and the other conventional physical therapy. Main variables included pain, mobility, muscle strength, and functional assessment using the UCLA Shoulder Rating Scale, evaluated at baseline and four weeks after treatment. χ² tests were used for proportions, and Student's t-test for mean comparisons. Results: a statistically significant difference was observed in favor of the experimental group in pain reduction (p < 0.001), functional improvement (p < 0.002), and overall UCLA score (p < 0.001). No significant differences were found in joint mobility (p > 0.05). Conclusions: radial shockwave therapy is effective in improving short-term shoulder pain and functionality in patients with rotator cuff tendinopathy. Further studies with larger sample sizes and long-term follow-up are recommended.

REFERENCES

1. Lewis JS. Rotator cuff tendinopathy: a model for the continuum of pathology and related management. Br J Sports Med. 2010; 44 (13): 918-923.

2. Yamamoto A, Takagishi K, Osawa T, Yanagawa T, Nakajima D, Shitara H et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg. 2010; 19 (1): 116-120.

3. Littlewood C, Bateman M, Brown K, Bury J. Rehabilitation for rotator cuff tendinopathy: a narrative review. Br J Sports Med. 2018; 52 (9): 560-563.

4. Kuhn JE. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg. 2009; 18 (1): 138-160.

5. Seitz AL, McClure PW, Finucane S, Boardman ND, Michener LA. Mechanisms of rotator cuff tendinopathy: intrinsic, extrinsic, or both? Clin Biomech. 2011; 26 (1): 1-12.

6. Duymas JM, Smith TB, Lee JH. Epidemiological aspects of rotator cuff tendinopathy: prevalence and risk factors. J Shoulder Elbow Surg. 2019; 28 (4): 580-588.

7. Son JH, Park SM, Kim JY, Choi HJ. Gender differences in the incidence and severity of rotator cuff tendinopathy: a retrospective cohort study. Clin Orthop Relat Res. 2020; 478 (6): 1225-1232.

8. Flávio de O, Silva R, Mendes AL, Rocha BA. Shoulder laterality in rotator cuff disorders: impact on diagnosis and treatment outcomes. Braz J Phys Ther. 2021; 25 (3): 215-223.

9. Oliveira VOM, Fernandes RH, Santos JL, Lima FC. Effectiveness of radial shockwave therapy for non-calcific rotator cuff tendinopathy: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2022; 103 (9): 1780-1792.

10. Wang CJ, Ko JY, Chan YS. Extracorporeal shock wave therapy for chronic calcific tendinitis of the shoulder: a prospective randomized study. J Bone Joint Surg Am. 2018; 100 (6): 494-502.

11. Rompe JD, Hope C, Küllmer K, Heine J, Bürger R. Analgesic effect of extracorporeal shock wave therapy on chronic tennis elbow. J Bone Joint Surg Br. 1996; 78 (2): 233-237.

12. Wu YT, Chang KV, Chen LC, Lin CW, Ozcakar L. Comparative effectiveness of radial shockwave therapy and ultrasound-guided corticosteroid injection for rotator cuff tendinopathy: a randomized controlled trial. Arch Phys Med Rehabil. 2021; 102 (5): 897-905.

13. Klüter T, Drees P, Wenzl ME, Schmitz C. Long-term effects of extracorporeal shockwave therapy in chronic tendinopathies: a meta-analysis of randomized controlled trials. Arch Orthop Trauma Surg. 2020; 140 (3): 383-393.

14. Wang CJ. Mechanotransduction in musculoskeletal tissue regeneration. J Orthop Sci. 2017; 22 (4): 852-861.

15. Auersperg V, Trieb K. Extracorporeal shock wave therapy: an update. EFORT Open Rev. 2020; 5 (10): 584-592.

16. Bageto VC, Cristina-Moreira DL. Effectiveness of extracorphorus shock wave therapy in musculoskeletal pathologies. Int Phys Med Rehabil J. 2020; 5 (3): 106-108.

17. Ricci V, Mezian K, Chang KV, Ozcakar L. Clinical/sonographic assessment and management of calcific tendinopathy of the shoulder: a narrative review. Diagnostics (Basel). 2022; 12 (12): 3097.

18. Duymaz T. Comparison of radial extracorporeal shock wave therapy and traditional physiotherapy in rotator cuff calcific tendinitis treatment. Arch Rheumatol. 2019; 34 (3): 281-287.

19. Ryskalin L, Morucci G, Natale G, Soldani P, Gesi M. Molecular mechanisms underlying the pain-relieving effects of extracorporeal shock wave therapy: a focus on fascia nociceptors. Life (Basel). 2022; 12 (5): 743.

20. Schroeder AN, Tenforde AS, Jelsing EJ. Extracorporeal shockwave therapy in the management of sports medicine injuries. Curr Sports Med Rep. 2021; 20 (6): 298-305.

21. Rahim M, Ooi FK, Shihabudin MT, Shihabudin TM, Chen CK, Foong K. A review of the effects and mechanisms of shockwave therapy on enthesopathy. Mal J Med Health Sci. 2021; 17 (3): 280-285.

22. Abo Al-Khair MA, El Khouly RM, Khodair SA, Al Sattar Elsergany MA, Hussein MI, Eldin Mowafy ME. Focused, radial and combined shock wave therapy in treatment of calcific shoulder tendinopathy. Phys Sportsmed. 2021; 49 (4): 480-487.

23. Oliveira VOM, Vergara JM, Oliveira VFDE, Lara PHS, Nogueira Júnior LC, Arliani GG. Extracorporeal shockwave therapy in shoulder injuries: prospective study. Acta Ortop Bras. 2021; 29 (5): 268-273.