title: Arm position during extracorporeal shock wave therapy for calcifying tendinitis of the shoulder: a randomized study.
abstract: OBJECTIVE
  To generate data on optimal shoulder position comparing two ultrasound-guided extracorporeal shock wave therapy techniques for the treatment of calcifying tendinitis of the shoulder.
  
  
  METHODS
  Random assignment to two groups of treatment with three months follow-up.
  
  
  METHODS
  The data were collected in outpatients.
  
  
  METHODS
  Thirty-five subjects affected by calcifying tendinitis of the shoulder were examined.
  
  
  METHODS
  Each subject received three sessions of ultrasound-guided extracorporeal shock wave therapy (performed weekly). Neutral position technique was used in group A (n = 17, mean age 53 ± 9.2 years) and the hyperextended internal rotation technique was used in group B (n = 18, mean age 52.2 ± 10.8 years).
  
  
  METHODS
  The Constant and Murley method and radiographs were used to evaluate each subject before the treatment and at three months follow-up.
  
  
  RESULTS
  There were no significant differences between changes in Constant total score and pain, activity of daily living and range of motion subscales of the two groups. Only the pain subscale showed a significant difference in favour of group B. Significant differences in the radiographic outcome were observed between the two groups: the percentage of total or subtotal resorption of the calcified deposits was 35.3% in group A (neutral position technique) versus 66.6% in group B (hyperextended internal rotation technique). The resorption of the calcific deposit positively influenced the clinical outcome.
  
  
  CONCLUSIONS
  Positioning the shoulder in hyperextension and internal rotation during extracorporeal shock wave therapy seems to be a useful technique to achieve resorption of calcific deposits.
authors.affiliation: Center for Sports Rehabilitation, IRCCS Galeazzi Orthopedics Institute, Milan, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Tornese
authors.forename: Enrico
authors.initials: E
authors.lastname: Mattei
authors.forename: Marco
authors.initials: M
authors.lastname: Bandi
authors.forename: Alberto
authors.initials: A
authors.lastname: Zerbi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Quaglia
authors.forename: Gianluca
authors.initials: G
authors.lastname: Melegati
mesh_terms: D001132:Arm; D002114:Calcinosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D012782:Shoulder; D016037:Single-Blind Method; D052256:Tendinopathy / Q000628:therapy*