Usefulness of Rehabilitation in Patients with Rotator Cuff Calcific Tendinopathy after Ultrasound-Guided Percutaneous Treatment

Abstract

Objective: To evaluate the efficacy of a specific rehabilitation program for patients in whom ultrasound-guided percutaneous treatment (UGPT) was performed for rotator cuff calcific tendinopathy (RCCT). Subjects and Methods: In this prospective observational study, 86 patients (22 males and 64 females) with shoulder calcific tendinopathy treated with UGPT were enrolled. At the end of the procedure, a corticosteroid injection into the subacromial-subdeltoid bursa was performed. The patients were then asked to follow a specific rehabilitation protocol (2 times/week for 5 weeks) that focused on mobility, strength and function. At baseline and after 6 weeks, clinical parameters, visual analog scale (VAS) and Constant-Murley scale (CMS) scores and ultrasound (US) features were collected. Results: The mean age of the patients was 48.9 ± 8.4 years and their mean BMI was 22.7 ± 2.1. Considering the whole cohort, the treatment was effective, with a significant decrease in the VAS score and an improvement in the CMS score. Thereafter, on the basis of the compliance to the rehabilitation program (by self-report), 53 and 33 patients were included in the rehabilitation group (Rehab group; performed exercises ≥2 times/week) and the No Rehab group (performed exercises <2 times/week), respectively. The comparison between the groups showed that the subjects who performed the exercises regularly had better results in terms of pain and functional recovery, and less associated diseases (e.g. adhesive bursitis and tenosynovitis of the long head of the biceps) than those who were less compliant with the program. Conclusions: UGPT, followed by a specific postprocedure rehabilitation program, was an effective treatment for RCCT.

The effects of therapeutic exercise using PNF on the size of calcium deposits, pain self-awareness, and shoulder joint function in a calcific tendinitis patient: a case study

“…The cause of calcific tendonitis is not known 8 ) but studies related to conservative, noninvasive, and non-surgical interventions used to treat calcific tendonitis have proved that the absorption of calcific tendonitis occurs naturally 5 , 8 , 9 , 10 ) . Several conservative interventions for the decalcification of calcific tendonitis, pain relief, and the improvement of joint function of the area affected by calcific tendonitis have been noted, but physiotherapies to treatment these symptoms, such as manual therapy and therapeutic exercises, have only been performed in combination with other conservative interventions 8 , 9 ) , Finding cases that applied independent, aggressive, and intensive physiotherapy for the treatment of calcific tendonitis is difficult. Thus, this study intended to identify the effects of intensive and independent PNF exercise on calcific tendonitis.…”

“…The size of the patient’s calcification decreased by about 86% from 135.7 mm 2 to 19.2 mm 2 , and the subject’s VAS, SST, CMS, and PROM results improved in accordance with this decrease. Abate et al 9 ) reported there was a greater effect on the VAS and CMS scores of patients with calcific tendonitis of the rotator cuff in a group in which intervention with exercise was applied after ultrasound-guided percutaneous treatment (UGPT) than in a group in which passive exercise was applied with UGPT was applied. These results corresponded with the present study.…”

“…The traditional direction for treatment of calcific tendonitis applies a conservative treatment again in the case of failure of the initial conservative treatment or after surgery in special cases 4 , 5 , 6 , 7 ) , Recently, oral medications and noninvasive and conservative methods, such as anti-inflammatory drugs and therapeutic exercise 8 ) , a combination of ultrasound therapy and therapeutic exercise 9 ) , a combination of ultrasound therapy and mesotherapy 10 ) , and extracorporeal shock wave therapy 5 ) have been reported as effective methods to reduce the size of calcium deposits, provide pain relief, and improve shoulder function.…”

“…Proprioceptive neuromuscular facilitation (PNF) has proved to be an effective therapeutic exercise for patients with central nervous system impairments and patients with musculoskeletal diseases 11 , 12 , 13 ) . While studies have not emphasized the independent application of therapeutic exercises such as PNF for the treatment of calcific tendonitis, these exercises have been performed in combination with other exercises partially and restrictedly 8 , 9 ) . Thus, the purpose of this case study was to identify the effects of independent and intensive short-term PNF on the size of a patient’s calcium deposit, her pain self-awareness, and her shoulder joint function.…”

Ultrasound imaging-guided percutaneous treatment of rotator cuff calcific tendinitis: success in short-term outcome

“…25 Following a specific rehabilitation protocol after the procedure may also result in better outcomes. [26][27][28] Ultrasound-guided needling also showed better results in function restoration and pain relief in the short term than extracorporeal shock wave therapy, both improving clinical outcome and eliminating calcific deposit. 29 The correct selection of patients to be submitted to ultrasoundguided percutaneous treatment is crucial.…”