Effects of ultrasound therapy on calcificated XXXX of the shoulder.

@entity1 @entity924 @entity730 @entity158 @entity460
In general, surgery is recommended for calcificated @entity924 of the shoulder if the @entity1 have symptoms after conservative treatments, including needle aspiration and physical therapy. Many researchers agree about the need for adequate physical therapy consisting of range of motion exercise, muscle strengthening exercises and electrophysical agents. Some researchers report that ultrasound (u/s) promotes angiogenesis and @entity460 uptake to fibroblasts, but there are few studies about u/s effects on calcificated @entity924 of the shoulder. The purpose of this study was to evaluate the u/s therapy effect on @entity730 , @entity158 during active movement, and to identify factors related to improvement in a randomized controlled fashion. We used the stratified random allocation method to assign 40 consecutive @entity1 to experimental and control groups, so each group consisted of 20 @entity1 . The experimental group was treated by u/s therapy and therapeutic exercises, and the control group was treated with therapeutic exercises only. All @entity1 in both groups came to our department 3 times per week and u/s therapy was performed 3 times per week until the end of the study. First, we classified the calcifications as type I (clearly circumscribed and with dense appearance on radiography), type II (dense or clearly circumscribed appearance) and type III (translucent or cloudy appearance without clear circumscription) according to the classification of Gartner and Heyer. Radiography was performed every one month, and the main outcome measure was the change from the base-line of the @entity730 on radiography at the end of the treatment. The three point scale of Gartner and Heyer was used, in which a score of 1 indicates no change or a worsening of the condition, a score of 2 a decrease of at least 50 percent in the area and density of the @entity730 , and a score of 3 a complete resolution of the @entity730 . We also examined the affected shoulders for presence or absence of @entity158 in active movement at the start and at the end of the study. The calcifications improved significantly and fewer @entity1 had @entity158 during active movement in the experimental group. There was a statistical significant disease duration difference from the first clinical presentation between scores 2 and 3 in the experimental group. The results of this study suggest that u/s therapy helps to resolve calcifications of shorter disease duration. Calcifications of longer disease duration tended to persist in spite of u/s therapy, but we thought treatment of 27-38 times (95% CI), until score 2 was attained, was a desirable strategy.
