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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

Institution:
Humanitas Research Hospital, Milan, Italy

Device and producing company:
SLK STORZ MEDICAL

Introduction:
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.

Methods:
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.

Results:
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.

Discussion:
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.

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