Article

Objective: To generate data on optimal shoulder position comparing two
ultrasound-guided extracorporeal shock wave therapy techniques for the treatment
of calcifying tendinitis of the shoulder. Design: Random assignment to two groups
of treatment with three months follow-up. Setting:
The data were collected in
outpatients. Subjects: Thirty-five subjects affected by calcifying tendinitis of
the shoulder were examined. Interventions: Each subject received three sessions
of ultrasound-guided extracorporeal shock wave therapy (performed weekly).
Neutral position technique was used in group A (n = 17, mean age 53 +/- 9.2
years) and the hyperextended internal rotation technique was used in group B (n =
18, mean age 52.2 +/- 10.8 years). Main outcome measures: The Constant and Murley
method and radiographs were used to evaluate each subject before the treatment
and at three months follow-up. Results: There were no significant differences
between changes in Constant total score and pain, activity of daily living and
range of motion subscales of the two groups. Only the pain subscale showed a
significant difference in favour of group B. Significant differences in the
radiographic outcome were observed between the two groups: the percentage of
total or subtotal resorption of the calcified deposits was 35.3% in group A
(neutral position technique) versus 66.6% in group B (hyperextended internal
rotation technique). The resorption of the calcific deposit positively influenced
the clinical outcome. Conclusions: Positioning the shoulder in hyperextension and
internal rotation during extracorporeal shock wave therapy seems to be a useful
technique to achieve resorption of calcific deposits.

Langue : ANGLAIS