Acetic acid iontophoresis and ultrasound for the treatment of calcifying tendinitis of the shoulder: a randomized control trial.
OBJECTIVE
To assess the effects of acetic acid iontophoresis (AAI) and ultrasound on calcifying tendinitis of the shoulder, and to determine the relation between changes in the radiological measures of calcium deposit (CD) and shoulder function.


METHODS
Randomized control trial.


METHODS
General community, private practice.


METHODS
Twenty-two adults (7 men, 15 women) with a calcifying tendinitis of the shoulder, without associated conditions, stratified according to the type of lesions (X-ray: type I, fleecy appearance: type II, homogeneous), were randomly allocated to an experimental (EXP, n = 11) or to a control (CTL, n = 10) group.


METHODS
CTL group, no treatment; EXP group, nine treatments including AAI (5% acetic acid solution via the negative electrode, 5mA galvanic current, 20 minutes) followed by continuous ultrasound (0.8w/cm2, 1MHz, 5 minutes).


METHODS
Area and density of the CD, passive shoulder abduction (range of motion [ROM]), pain intensity.


RESULTS
Significant reduction in the area and density of CD (ANCOVA, p = .01 and .03) over time in the EXP and CTL groups, but no significant difference between groups for any of the variables measured. The decrease in the area of CD in type I lesions (n = 5) was larger (Mann-Whitney U test, p < .01) than in type II (n = 16) lesions. The relation was stronger (rs = .90) between changes in area and density of CD than between ROM and pain (rs = -.67). Correlations were weak (rs = .21 to .41) between radiological and functional changes.


CONCLUSIONS
The reduction in CD area and density likely results from a natural process rather than treatment (AAI and ultrasound); type I lesions (resorptive phase) are more likely to display resorption of the CD than type II lesions (formative phase). Reduction of the CD area does not necessary result in a functional improvement.
Perron
M
M
Clinique de Physiothérapie de Charny, Canada.
Malouin
F
F
D019342:Acetic Acid / Q000627:therapeutic use*; D000328:Adult; D002114:Calcinosis / Q000150:complications*; D005260:Female; D006801:Humans; D007478:Iontophoresis; D008297:Male; D008875:Middle Aged; D012785:Shoulder Joint; D052256:Tendinopathy / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D013710:Tendons / Q000473:pathology; D017211:Treatment Failure; D014464:Ultrasonic Therapy
D019342:Acetic Acid