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European Journal of Physical and Rehabilitation Medicine 2018 June;54(3):333-40

DOI: 10.23736/S1973-9087.17.04749-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Effectiveness of Extracorporeal Shock Wave Therapy and kinesio taping in calcific tendinopathy of the shoulder: a randomized controlled trial

Paolo FRASSANITO 1 , Carlo CAVALIERI 1, Roberto MAESTRI 2, Guido FELICETTI 1

1 Unit of Neuromotor Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS Rehabilitation Center Montescano, Pavia, Italy; 2 Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri IRCCS Rehabilitation Center Montescano, Pavia, Italy


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BACKGROUND: Extracorporeal Shock Wave Therapy (ESWT) is effective in the treatment of calcific tendinopathy of the rotator cuff, eliciting an analgesic/anti-inflammatory action and promoting tissue regeneration. Kinesio taping (KT), another recently-introduced rehabilitative tool, exerts an analgesic and biomechanical action on joints and muscles. ESWT and KT may have a synergic effect when used in combination, but the effectiveness of the association has not been established.
AIM: The aim of this study was to test if the association of KT with ESWT is superior to ESWT alone in the treatment of rotator cuff calcific tendinopathy.
DESIGN: Randomized controlled trial.
SETTING: Rehabilitation Institute outpatients.
POPULATION: Forty-two patients with rotator cuff calcific tendinopathy were randomly assigned to the experimental group (ESWT+KT, N.=21) or control (ESWT, N.=21).
METHODS: In the experimental group, patients underwent three sessions (once a week for 3 weeks) of ESWT with KT applied at the end of each session. Controls underwent three sessions of ESWT only. All patients were assessed before treatment (T0) and at 1 (T1), 4 (T2) and 12 weeks (T3) after the end of treatment with the following outcome measures: a visual analogue scale (VAS), the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, Subjective Shoulder Rating Questionnaire (SSRQ), and Oxford Shoulder Score (OSS).
RESULTS: Both groups showed significant improvement in all outcome measures, but the time course differed between the two groups. At T1 vs. T0, the improvement was significantly better in ESWT+KT than ESWT on VAS (P=0.007), DASH (P<0.0001) and SSRQ (P=0.0001). Successive improvements at T2 vs. T1 and T3 vs. T2 did not differ significantly between the groups. At the end of follow-up, ESWT+KT still showed significantly greater improvement than ESWT on VAS (P=0.02) and SSRQ (P=0.038).
CONCLUSIONS: KT associated with ESWT seems to improve the recovery in rotator cuff calcific tendinopathy with a faster therapeutic response compared to ESWT only.
CLINICAL REHABILITATION IMPACT: Our results suggest the effectiveness of using KT as adjuvant therapy to ESWT in rotator cuff calcific tendinopathy, through enhancing the short-term analgesic action and the medium- to long-term biological-regenerative effects.


KEY WORDS: Shoulder pain - Rotator cuff - Tendinopathy - Extracorporeal shockwave therapy - Athletic taping

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