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Combination of Shockwave Therapy with Exercise in Shoulder Tendinopathy: Preliminary Results on Percieved Functional Outcome
Gianluca Ruggiero, Elisabetta Tibalt, Maria Cristina D’Agostino, Stefano Respizzi

Humanitas Research Hospital, Milan, Italy

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Purpose of the study was to investigate whether association of exercise therapy with ESWT, resulted in better and early functional outcome in patients with rotator cuff tendinopathy.

Eighteen patients (average age 57.4, 12 female, 8 male) with rotator cuff tendinopathy, were randomly assigned into two groups. Both groups (A and B) were treated with ESWT. Patients in Group B were even instructed, by a Physiotherapist, with a self-assisted exercise program and provided with a therapy kit for home exercise. A weekly session of supervised physiotherapy was scheduled in order to verify and update the exercise program. Patients were evaluated at baseline and 1 and 2 months after beginning of treatment. Clinical assessment included pain and R.O.M.
Subjective functional assessment included SST and D.A.S.H.

At 2 months follow-up the average Pain score (assessed with V.A.S.) improved 16.5% with non significant difference between two groups (16.7% in Group A and 16.4% in Group B), confirming an overall benefit in pain relief even in short term results. Subjective functional assessment increased 3.3 (SST) and 13.6 (DASH) average points in Group A (52.3% for SST and 19.8% for DASH); Group B increased 1.8 (SST) and 12.3 (DASH) average points (28.9% for SST and 18.4% for DASH). All patients completed exercise program but one patient in Group B but one patient in Group B didn't participate at final assessment at follow-up.

There is no significative evidence that association of exercise with ESWT for patients with rotator cuff tendinopathy seems to result in better functional improvement. However results in Group B (patients instructed with a home based, self- assisted rehabilitation program with PT supervising) seem to achieve better functional results in a shorter period.

Further investigations are needed to assess long term-results and different ESWT-exercise combination modalities. Updated data will be presented.
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