The effectiveness of treatment calcifying tendinitis of the shoulder with extracorporeal shock wave therapy

Uvod: Kalcinirajoči tendinitis rame je stanje, pri katerem prihaja do nalaganja kalcijevih depozitov na eno ali več mišic kit rotatorne manšete. Med glavne simptome kalcinirajočega tendinitisa rame, poleg izgube funkcije, neugodja in zmanjšanega obsega gibljivosti, uvrščamo še močne bolečine. Zdravljenje je najprej konzervativno, nato operativno, vendar se pred tem priporoča terapija z udarnimi globinskimi valovi. To so zvočni valovi z visokotlačnimi razlikami zelo kratkega trajanja, ki vplivajo na povečanje obsega gibljivosti sklepov, zmanjšanje bolečine, izboljšanje moči in kvalitete življenja. Namen: Namen diplomskega dela je opisati učinkovitost zdravljenja kalcinirajočega tendinitisa ramena z udarnimi globinskimi valovi. Metode dela: Izbrana je bila opisna metoda dela, pregled literature. Članki so bili iskani v podatkovnih zbirkah PEDro, CINAHL, MEDLINE in Cochrane Library. Vključene so bile randomizirane kontrolirane raziskave, izvedene med letom 1999 in 2017, v katerih so preučevali učinkovitost zdravljenja udarnih globinskih valov pri kalcinirajočem tendinitisu ramena. Rezultati: V analizo je bilo vključenih osem raziskav o učinkovitosti zdravljenja z udarnimi globinskimi valovi. Za ugotavljaje učinkovitosti so uporabili lestvice za ocenjevanje bolečine in funkcije ter radiološke preiskave. V dveh raziskavah so dokazali statistično pomembno izboljšanje simptomov, v treh raziskavah je do statistično pomembne razlike med skupinama prišlo le pri določenih rezultatih meritev, v treh raziskavah pa statistično pomembnih razlik med skupinama ni bilo. Razprava in zaključek: Rezultati raziskav kažejo, da so udarni globinski valovi varna in učinkovita metoda za zdravljenje kalcinirajočega tendinitisa ramena. V večini raziskav so bili končni rezultati boljši, če je bila pri terapiji uporabljena višja gostota energijskega toka ali zadostno število terapij, vendar zaradi raznolikosti uporabljenih parametrov pri vključenih raziskavah ne moremo podati zanesljivih zaključkov o optimalni terapiji. Kljub izboljšanju simptomov pri kalcinirajočem tendinitisu ramena po zdravljenju z udarnimi globinskimi valovi pa obstaja premalo dokazov o učinkovitosti terapije in primernih parametrih, zato so potrebne dodatne raziskave višje kakovosti.Introduction: Calcifying tendinitis of the shoulder is a condition, whereby calcific deposits are located in one or more of the rotator cuff tendons. Among the main symptoms of calcific tendinitis of the shoulder, besides losing function, discomfort and reduced range of flexibility we assign severe pain. Treatment is first conservative, than surgical, but before that, an extracorporeal shock wave therapy is recommended. This are sound waves with high differences of short duration that are affecting by increasing the range of flexibility of joints, minimizing pain, improvement of strength and quality of life. Purpose: The purpose of dissertation paper is describing the efficiency of treating calcifying tendinitis with extracorporeal shock wave therapy. Methods: Descriptive method has been chosen, review of literature. The articles were searched in databases PEDro, CINAHL, MEDLINE and Cochrane Library. Randomized controlled researches, performed during the year 1999 and 2017 were included in which they studied the efficiency of treatment of calcifying tendinitis with extracorporeal shock wave therapy Results: The analysis consisted of eight researches about the efficiency of treatment with shock wave therapy. For determining the efficiency, a scale for evaluation of pain and function were used along with radiological examination. In two analyses they proved statistical improvement of symptoms. In three researches there has come to statistically important difference between groups only with certain measurement results, in other three researches there were no statistically important differences between groups. Discussion and conclusion: Research results indicate that extracorporeal shock wave therapy is a safe and effective method for treatment calcifying tendinitis of the shoulder. In most researches the end results were better if there was higher energy density value used for therapy or there were a sufficient number of therapies. However due to diversity of used parameters in included researches we cannot give the reliable conclusions on optimal therapy. Despite the improvement of symptoms by calcifying tendinitis of the shoulder after treatment with extracorporeal shock wave therapy, there is still not enough evidence on effectiveness of therapy and appropriate parameters, therefore researches of higher quality are necessary