PHYSICAL THERAPY & REHAB
Short-term outcomes of extracorporeal shock wave therapy for the treatment of chronic non-calcific tendinopathy of the supraspinatus: A double-blind, randomized, placebo-controlled trial
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(10):26 BMC Musculoskelet Disord. 2012 Jun 6;13:86. doi: 10.1186/1471-2474-13-8620 patients with non-calcifying supraspinatus tendinopathy (NCST) were randomized to extracorporeal shock wave therapy (ESWT) or to placebo treatment. Physical, roentgenographic, MRI, and blood examinations of the shoulder, conducted at six and at twelve weeks after treatment, showed significantly better results with ESWT treatment in the total Constant and Murley Score (CMS), especially for CMS pain and ROM subscales. ESWT presented no adverse events.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sí = 1
Incierto = 0,5
No relevante = 0
No = 0
La evaluación de los criterios de información evalúa la transparencia con la que los autores informan de las características metodológicas y del ensayo dentro de la publicación. La evaluación se divide en cinco categorías que se presentan a continuación.
4/4
Randomization
3/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
3/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
El Índice de Fragilidad es una herramienta que ayuda en la interpretación de hallazgos significativos, proporcionando una medida de fuerza para un resultado. El Índice de Fragilidad representa el número de eventos consecutivos que es necesario añadir a un resultado dicotómico para que el hallazgo deje de ser significativo. Un número pequeño representa un hallazgo más débil y un número grande un hallazgo más fuerte.
¿Por qué se necesitaba ahora este estudio?
Supraspinatus tendinopathy is a common and disabling condition occurring in people after middle age. For the last 20 years, extracorporeal shock wave therapy (ESWT) has been widely used to treat enthesopathies, but a limited number of studies demonstrated effectiveness in non-calcifying supraspinatus tendinopathy (NCST). The following trial wanted to investigate the short-term efficacy and safety of low energy ESWT in patients suffering from chronic NCST.
¿Cuál era la pregunta principal de la investigación?
Is ESWT effective and safe in reducing pain and improving range of motion in patients with NCST, compared to a placebo, at 6 and 12 weeks after treatment?
¿Cuáles fueron los hallazgos importantes?
- At 3 months, the mean relative improvement in total CMS in ESWT group was significantly higher than the placebo (74.5% vs. 15.2%, p = 0.914)
- No adverse events were present, apart from slight pain increase in few patients from the ESWT group.
- ESWT group had significantly higher scores in CMS pain (p=0.039) and CMS ROM (p=0.012) subscales at 3 months.
- The use of pain medication (acetaminophen) in both groups was not significantly different (p=0.16)
¿Qué es lo que más debo recordar?
ESWT therapy is effective in short term treatment of NCST and provides improved results in CMS pain and ROM compared to a placebo. The treatment had no adverse effects.
¿Cómo afectará esto al cuidado de mis pacientes?
Low energy ESWT can reduce the pain of people suffering from non-calcifying supraspinatus tendinopathy and can play an important role in successful treatment. More studies with larger sample sizes are required to study this treatments long term effects.
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