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

Eur J Phys Rehabil Med. 2018 Jun;54(3):333-340. doi: 10.23736/S1973-9087.17.04749-9. Epub 2017 Nov 29.

Abstract

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care / methods
  • Analysis of Variance
  • Athletic Tape / statistics & numerical data*
  • Calcinosis / complications
  • Calcinosis / diagnostic imaging
  • Calcinosis / pathology
  • Calcinosis / rehabilitation*
  • Combined Modality Therapy
  • Extracorporeal Shockwave Therapy / methods*
  • Female
  • Humans
  • Italy
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Pain Measurement
  • Prognosis
  • Range of Motion, Articular / physiology
  • Rehabilitation Centers
  • Risk Assessment
  • Rotator Cuff / diagnostic imaging
  • Rotator Cuff / pathology
  • Shoulder Joint / physiopathology*
  • Shoulder Pain / etiology
  • Shoulder Pain / physiopathology
  • Shoulder Pain / rehabilitation
  • Tendinopathy / complications
  • Tendinopathy / diagnostic imaging
  • Tendinopathy / pathology
  • Tendinopathy / rehabilitation*
  • Treatment Outcome