Extracorporeal shock waves are effective for non-calcifying supraspinatus tendinopathy .
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)?
Oui = 1
Incertain = 0,5
Non pertinent = 0
Non = 0
L'évaluation des critères de rapport permet d'évaluer la transparence avec laquelle les auteurs rapportent les caractéristiques méthodologiques et les caractéristiques de l'essai dans la publication. L'évaluation est divisée en cinq catégories qui sont présentées ci-dessous.
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
L'indice de fragilité est un outil qui aide à l'interprétation des résultats significatifs, en fournissant une mesure de la force d'un résultat. L'indice de fragilité représente le nombre d'événements consécutifs qui doivent être ajoutés à un résultat dichotomique pour que le résultat ne soit plus significatif. Un petit nombre représente un résultat plus faible et un grand nombre un résultat plus fort.
Pourquoi cette étude était-elle nécessaire maintenant ?
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.
Quelle était la principale question de recherche ?
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?
- 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)
De quoi dois-je me souvenir en priorité ?
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.
Comment cela affectera-t-il les soins prodigués à mes patients ?
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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