Efficacia della terapia con onde d'urto ex̀tracorporee associata a chinesiterapia nel trattamento della sindrome da conflitto subacromiale: Studio randomizzato controllato

This randomised, controlled study compares two protocols for the management of Neer stage I and II subacromial impingement. Three treatment groups each composed of 30 subjects were formed. Group A subjects followed a six-session kinesitherapy course composed of Codman exercises, stretching, isometric exercises and elastic resistance exercises for the rotators and the deltoid, and were asked to continue the exercises at home on alternate days. Group B attended three weekly Extracorporeal Shock Wave Therapy (ESWT) sessions and then followed the Group A kinesitherapy course. Group C (controls) followed some postural hygiene and joint economy suggestions given on first examination. Constant's scale was used to assess all subjects subjectively and objectively before and eight months after their treatment. Groups A and B achieved a significant Constant score improvement (p <0.000I), whereas the increase in group C was not significant (p > 0.05). Group B's improvement was also significantly better than that of group A (p <0.05). These results show that kinesitherapy is essential. The cost/benefit ratio makes its association with ESWT questionable in the routine management of subacromial impingement, though justifiable when kinesitherapy alone fails to elicit a satisfactory response.