At 4-month follow-up, eccentric loading and low-energy SWT showed comparable results. The wait-and-see strategy was ineffective for the management of chronic recalcitrant tendinopathy of the main body of the Achilles tendon.
Eccentric loading as applied in the present study showed inferior results to low-energy shock wave therapy as applied in patients with chronic recalcitrant tendinopathy of the insertion of the Achilles tendon at four months of follow-up. Further research is warranted to better define the indications for this treatment modality.
At 4-month follow-up, eccentric loading alone was less effective when compared with a combination of eccentric loading and repetitive low-energy shock-wave treatment.
ALCIFIC TENDONITIS OF THErotator cuff is a well-known source of shoulder pain. 1 Estimates of the overall incidence vary widely, ranging between 2.5% and 20%, 1-3 depending on both clinical criteria and radiographic technique. The disease is usually selflimiting but the natural course is variable. [1][2][3][4][5] For instance, Gärtner 6 reported that calcifications with sharp margins and homogeneous or nonhomogeneous structure disappeared spontaneously in 33% of patients over a period of 3 years, but that 85% of fluffy accumulations did so during the same time period. In 1941, Bosworth 1 reported that 6.4% of calcific lesions showed spontaneous resorption.Clinically, it is important to distinguish calcific tendonitis from a rotator cuff tear as a source of shoulder pain. 7 Several authors have found no correlation between the presence of a tendon tear and calcific tendonitis. 4,[7][8][9][10] The treatment of patients with calcific tendonitis typically is conservative, including use of subacromial cortisone injections, physical therapy, Author Affiliations are listed at the end of this article.
BackgroundExtracorporeal shock wave therapy (ESWT) is an effective and safe non-invasive treatment option for tendon and other pathologies of the musculoskeletal system.Sources of dataThis systematic review used data derived from the Physiotherapy Evidence Database (PEDro; , 23 October 2015, date last accessed).Areas of agreementESWT is effective and safe. An optimum treatment protocol for ESWT appears to be three treatment sessions at 1-week intervals, with 2000 impulses per session and the highest energy flux density the patient can tolerate.Areas of controversyThe distinction between radial ESWT as ‘low-energy ESWT’ and focused ESWT as ‘high-energy ESWT’ is not correct and should be abandoned.Growing pointsThere is no scientific evidence in favour of either radial ESWT or focused ESWT with respect to treatment outcome.Areas timely for developing researchFuture randomized controlled trials should primarily address systematic tests of the aforementioned optimum treatment protocol and direct comparisons between radial and focused ESWT.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.