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[RC] Shock wave therapy - Ridecamp Guest

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Authors M SabetiAschraf, R Dorotka, A Goll, K Trieb
Title   Extracorporeal shock wave therapy in the treatment of calcific 
tendinitis of the rotator cuff
Full source     American Journal of Sports Medicine, 2005, Vol 33, Iss 9, pp 

Background: Low-energy extracorporeal shock wave therapy is an alternative 
treatment, with limited evidence for effectiveness, for calcific tendinitis of 
the rotator cuff. Hypothesis: Objective localization of the calcium deposit by 
3-dimensional, computer-assisted navigation reveals superior clinical and 
radiographic outcomes compared to localization through patient-to-therapist 
feedback. Study Design: Randomized controlled clinical trial; Level of 
evidence, 1. Methods: A prospective, randomized, single-blind study was carried 
out on 50 patients. The population was divided into 2 groups of equal numbers 
(navigation group and feedback group). In all patients, treatment-resistant 
pain was evident for longer than 6 months. A total of 3 therapy sessions of 
constant low-energy focused shock wave therapy was administered in weekly 
intervals in both groups. Local anesthesia was not applied. Radiographs and 
clinical assessment, including the Constant and Murley shoulder scoring system 
and the visual analog scale for pain, were performed both before therapy and 
after 12 weeks. In the navigation group; the calcium deposit was localized 
using a radiographically guided, 3-dimensional, computer-assisted device. The 
feedback group was treated after locating the point of maximum tenderness 
through palpation by the therapist with feedback from the patient. Results: 
Both groups had significant improvements in the Constant and Murley score and 
the visual analog scale after 12 weeks. The results from the navigation group 
were statistically significantly superior to those of the feedback group. In 
the navigation group, 6 calcium deposits disappeared and 9 altered, compared to 
1 disappearance and 12 alterations in the feedback group. No severe 
complications occurred. Conclusion: Three-dimensional, computer-assisted 
navigation reveals significantly better results and is therefore recommended 
when extracorporeal shock wave therapy is used in the treatment of calcific 
tendinitis of the rotator cuff.

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