Pain, Function, and Elastosonographic Assessment After Shockwave Therapy in Non-Calcific Supraspinatus Tendinopathy: A Retrospective Observational Study

<b>Background:</b> Non-calcific supraspinatus tendinopathy (SNCCT) is a frequent cause of shoulder pain, often associated with functional impairment and reduced quality of life. Recent advancements in diagnostic imaging, including shear wave elastography (SWE), provide quantitative data...

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Main Authors: Gabriele Santilli, Antonello Ciccarelli, Milvia Martino, Patrizia Pacini, Francesco Agostini, Andrea Bernetti, Luca Giuliani, Giovanni Del Gaudio, Massimiliano Mangone, Vincenzo Colonna, Mario Vetrano, Maria Chiara Vulpiani, Giulia Stella, Samanta Taurone, Federico Vigevano, Vito Cantisani, Marco Paoloni, Pietro Fiore, Francesca Gimigliano
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Journal of Functional Morphology and Kinesiology
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Online Access:https://www.mdpi.com/2411-5142/10/1/39
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author Gabriele Santilli
Antonello Ciccarelli
Milvia Martino
Patrizia Pacini
Francesco Agostini
Andrea Bernetti
Luca Giuliani
Giovanni Del Gaudio
Massimiliano Mangone
Vincenzo Colonna
Mario Vetrano
Maria Chiara Vulpiani
Giulia Stella
Samanta Taurone
Federico Vigevano
Vito Cantisani
Marco Paoloni
Pietro Fiore
Francesca Gimigliano
author_facet Gabriele Santilli
Antonello Ciccarelli
Milvia Martino
Patrizia Pacini
Francesco Agostini
Andrea Bernetti
Luca Giuliani
Giovanni Del Gaudio
Massimiliano Mangone
Vincenzo Colonna
Mario Vetrano
Maria Chiara Vulpiani
Giulia Stella
Samanta Taurone
Federico Vigevano
Vito Cantisani
Marco Paoloni
Pietro Fiore
Francesca Gimigliano
author_sort Gabriele Santilli
collection DOAJ
description <b>Background:</b> Non-calcific supraspinatus tendinopathy (SNCCT) is a frequent cause of shoulder pain, often associated with functional impairment and reduced quality of life. Recent advancements in diagnostic imaging, including shear wave elastography (SWE), provide quantitative data on tendon stiffness and thickness, facilitating more precise evaluations. Extracorporeal shockwave therapy (ESWT) has emerged as a minimally invasive and effective treatment for SNCCT, but its effects on tendon properties measured through SWE require further investigation. <b>Objective:</b> This retrospective observational study aimed to evaluate the impact of ESWT on supraspinatus tendon characteristics in patients with SNCCT by assessing tendon thickness, SWE velocity, and clinical outcomes. Methods: This observational study enrolled 39 patients with SNCCT, aged 30–75 years, who received three ESWT sessions over 3 weeks. The intervention was delivered using a Modulith SLK system at an energy level of 0.20 mJ/mm<sup>2</sup> with 2400 pulses per session. SWE and conventional ultrasound were used to measure tendon thickness and SWEv at baseline (T0) and 6 months post-treatment (T1). Clinical outcomes were assessed using the Visual Analog Scale (VAS), Constant and Murley Score (CMS), and modified Roles and Maudsley scale. Data were analyzed using paired <i>t</i>-tests and correlation analyses. <b>Results:</b> At baseline, affected tendons exhibited increased thickness (7.5 ± 0.9 mm) and reduced SWEv (3.1 ± 0.7 m/s) compared to healthy tendons (4.5 ± 0.7 mm and 6.9 ± 1 m/s, respectively; <i>p</i> < 0.05). Six months after ESWT, tendon thickness decreased significantly (6.2 ± 0.9 mm, <i>p</i> < 0.05), and SWEv increased (5.7 ± 1.8 m/s, <i>p</i> < 0.05), indicating improved elasticity. Clinical outcomes improved significantly, with the VAS scores decreasing from 6.5 ± 1.4 to 3.2 ± 2.1, the CMS score rising from 59.1 ± 17.3 to 78.2 ± 17.7, and the modified Roles and Maudsley scale improving from 2.3 ± 0.6 to 1.5 ± 0.8 (<i>p</i> < 0.05 for all). SWEv positively correlated with the CMS (r = 0.4) and negatively with the VAS and the modified Roles and Maudsley scale (r = −0.6 and r = −0.5, respectively). <b>Conclusions:</b> ESWT significantly reduces tendon thickness and enhances elasticity, correlating with improvements in pain and functional scores. SWE proved to be a reliable method for monitoring structural and clinical changes in SNCCT. Further research, including randomized controlled trials, is recommended to confirm these findings and explore longer-term outcomes.
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spelling doaj-art-602c4d65aa09470b8e7f435e888cb7a42025-08-20T02:42:34ZengMDPI AGJournal of Functional Morphology and Kinesiology2411-51422025-01-011013910.3390/jfmk10010039Pain, Function, and Elastosonographic Assessment After Shockwave Therapy in Non-Calcific Supraspinatus Tendinopathy: A Retrospective Observational StudyGabriele Santilli0Antonello Ciccarelli1Milvia Martino2Patrizia Pacini3Francesco Agostini4Andrea Bernetti5Luca Giuliani6Giovanni Del Gaudio7Massimiliano Mangone8Vincenzo Colonna9Mario Vetrano10Maria Chiara Vulpiani11Giulia Stella12Samanta Taurone13Federico Vigevano14Vito Cantisani15Marco Paoloni16Pietro Fiore17Francesca Gimigliano18Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome “Foro Italico”, 00135 Rome, ItalyDepartment of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome “Foro Italico”, 00135 Rome, ItalyDepartment of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, ItalyDepartment of Biological and Environmental Science and Technologies, University of Salento, 73100 Lecce, ItalyDepartment of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, ItalyPhysical Medicine and Rehabilitation Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, ItalyPhysical Medicine and Rehabilitation Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, ItalyPhysical Medicine and Rehabilitation Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, ItalyNeurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyDepartment of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome “Foro Italico”, 00135 Rome, ItalyPaediatric Neurorehabilitation Department, IRCCS San Raffaele, 00163 Rome, ItalyDepartment of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, ItalyNeurorehabilitation Unit, Institute of Bari, Istituti Clinici Scientifici Maugeri IRCCS, 70124 Bari, ItalyDepartment of Physical and Mental Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy<b>Background:</b> Non-calcific supraspinatus tendinopathy (SNCCT) is a frequent cause of shoulder pain, often associated with functional impairment and reduced quality of life. Recent advancements in diagnostic imaging, including shear wave elastography (SWE), provide quantitative data on tendon stiffness and thickness, facilitating more precise evaluations. Extracorporeal shockwave therapy (ESWT) has emerged as a minimally invasive and effective treatment for SNCCT, but its effects on tendon properties measured through SWE require further investigation. <b>Objective:</b> This retrospective observational study aimed to evaluate the impact of ESWT on supraspinatus tendon characteristics in patients with SNCCT by assessing tendon thickness, SWE velocity, and clinical outcomes. Methods: This observational study enrolled 39 patients with SNCCT, aged 30–75 years, who received three ESWT sessions over 3 weeks. The intervention was delivered using a Modulith SLK system at an energy level of 0.20 mJ/mm<sup>2</sup> with 2400 pulses per session. SWE and conventional ultrasound were used to measure tendon thickness and SWEv at baseline (T0) and 6 months post-treatment (T1). Clinical outcomes were assessed using the Visual Analog Scale (VAS), Constant and Murley Score (CMS), and modified Roles and Maudsley scale. Data were analyzed using paired <i>t</i>-tests and correlation analyses. <b>Results:</b> At baseline, affected tendons exhibited increased thickness (7.5 ± 0.9 mm) and reduced SWEv (3.1 ± 0.7 m/s) compared to healthy tendons (4.5 ± 0.7 mm and 6.9 ± 1 m/s, respectively; <i>p</i> < 0.05). Six months after ESWT, tendon thickness decreased significantly (6.2 ± 0.9 mm, <i>p</i> < 0.05), and SWEv increased (5.7 ± 1.8 m/s, <i>p</i> < 0.05), indicating improved elasticity. Clinical outcomes improved significantly, with the VAS scores decreasing from 6.5 ± 1.4 to 3.2 ± 2.1, the CMS score rising from 59.1 ± 17.3 to 78.2 ± 17.7, and the modified Roles and Maudsley scale improving from 2.3 ± 0.6 to 1.5 ± 0.8 (<i>p</i> < 0.05 for all). SWEv positively correlated with the CMS (r = 0.4) and negatively with the VAS and the modified Roles and Maudsley scale (r = −0.6 and r = −0.5, respectively). <b>Conclusions:</b> ESWT significantly reduces tendon thickness and enhances elasticity, correlating with improvements in pain and functional scores. SWE proved to be a reliable method for monitoring structural and clinical changes in SNCCT. Further research, including randomized controlled trials, is recommended to confirm these findings and explore longer-term outcomes.https://www.mdpi.com/2411-5142/10/1/39supraspinatus tendinopathyextracorporeal shockwave therapyshear wave elastographytendon thicknessSWE velocityrotator cuff disorders
spellingShingle Gabriele Santilli
Antonello Ciccarelli
Milvia Martino
Patrizia Pacini
Francesco Agostini
Andrea Bernetti
Luca Giuliani
Giovanni Del Gaudio
Massimiliano Mangone
Vincenzo Colonna
Mario Vetrano
Maria Chiara Vulpiani
Giulia Stella
Samanta Taurone
Federico Vigevano
Vito Cantisani
Marco Paoloni
Pietro Fiore
Francesca Gimigliano
Pain, Function, and Elastosonographic Assessment After Shockwave Therapy in Non-Calcific Supraspinatus Tendinopathy: A Retrospective Observational Study
Journal of Functional Morphology and Kinesiology
supraspinatus tendinopathy
extracorporeal shockwave therapy
shear wave elastography
tendon thickness
SWE velocity
rotator cuff disorders
title Pain, Function, and Elastosonographic Assessment After Shockwave Therapy in Non-Calcific Supraspinatus Tendinopathy: A Retrospective Observational Study
title_full Pain, Function, and Elastosonographic Assessment After Shockwave Therapy in Non-Calcific Supraspinatus Tendinopathy: A Retrospective Observational Study
title_fullStr Pain, Function, and Elastosonographic Assessment After Shockwave Therapy in Non-Calcific Supraspinatus Tendinopathy: A Retrospective Observational Study
title_full_unstemmed Pain, Function, and Elastosonographic Assessment After Shockwave Therapy in Non-Calcific Supraspinatus Tendinopathy: A Retrospective Observational Study
title_short Pain, Function, and Elastosonographic Assessment After Shockwave Therapy in Non-Calcific Supraspinatus Tendinopathy: A Retrospective Observational Study
title_sort pain function and elastosonographic assessment after shockwave therapy in non calcific supraspinatus tendinopathy a retrospective observational study
topic supraspinatus tendinopathy
extracorporeal shockwave therapy
shear wave elastography
tendon thickness
SWE velocity
rotator cuff disorders
url https://www.mdpi.com/2411-5142/10/1/39
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