足と足首の臨床研究

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Effects of Eccentric Exercise and Extracorporeal Shock Wave Therapy onRehabilitation of Patients with Noncalcific Rotator Cuff Tendinopathy

Tien-Wen Chen, Jyong-Huei Su, Tz-Yan Lin, Cheng-Wei Lin, Pei-Shi Chou, Mao-Hsiung Huang

Objective: In this study, in order to establish a more effective therapeutic model for the patients with chronic rotator cuff tendinosis, the authors attempted to compare the therapeutic effects of general physical therapy, eccentric contraction exercise, extracorporeal shock wave therapy (ESWT) and their combination for patients with noncalcific subscapular tendinosis.
Methods: 120 patients with subscapular tendinosis Grade II tendinopathy were divided randomly into four groups: I-IV, with 30 patients in each group. In group I (GI): the patients received conventional rehabilitation program, which included 20 minute of local hot packs, 15 min interferential electrotherapy and 10 min of passive range motion exercise three times weekly for 8 weeks; in Group II: the patients received eccentric contraction exercise three times per day and a rehabilitation program as in GI; in GIII: the patients received ESWT therapy weekly except for a rehabilitation program as in GI; in GIV: they received three combination therapies including a conventional rehabilitation program, three rounds of eccentric contraction exercises per day and weekly ESWT for 8 weeks. The outcome measurements include visual analogue pain scale (VAS), range of shoulder motion, subscapular muscle peak torques, and proprioception of the affected shoulder.
Results: The results showed that the combination therapy group GII-IV all had more improvement than the conventional rehabilitation program group I. However, the integrated therapy group IV had the best improvement over GII and GIII in pain reduction and improvement of range of motion, proprioception and muscle peak torques. Additionally, group III and IV had better improvement of range of motion and muscle peak torques than did GII.
Conclusion: Eccentric exercise and ESWT had benefit in rehabilitation of patients with noncalcific subscapular tendinosis, and conventional rehabilitation combined with these two therapies will result in more therapeutic effects.