The purpose of the study was to find the effectiveness ESWT and Tele Rehabilitation for Supraspinatus Calcific Tendinosis and to know if tele rehabilitation can be incorporated as a exercise protocol reducing the carbon foot print.
Pre-treatment assessment was done on the day of first visit to Physical therapy OPD which included X-Ray Findings, Numerical Pain Rating Score (NPRS), Shoulder Range of Motion (ROM) with the help of Hand held Goniometer & SPADI score. The patient received 3 sittings of ESWT one per week, targeting the calcification site. The first sitting was given for 1000 shocks per session at 0.25 mJ/cm² energy density, 8–10 Hz, the second and third sitting was given for 2000 shocks per session at 0.25 mJ/cm² energy density, 12 Hz . Additionally, he participated in a daily, tele-rehabilitation program for 3 weeks in three phases, the Phase I consisted of 35 minutes of exercise protocol and 20 min of cryotherapy, the Phase II consisted of 35 minutes and the Phase III consisted of 25 minutes of exercise protocol. The program, delivered through a secure video platform, consisted of therapist-guided exercises focused on pain management, range of motion improvement, and rotator cuff strengthening. The exercises were adjusted and progressed based on weekly virtual consultations with the therapist. Patient was reassessed after three weeks at Physical therapy OPD which included X-Ray, Numerical Pain Rating Score (NPRS), Shoulder Range of Motions (ROM) with the help of Hand held Goniometer & SPADI score.
The result showed a significant in all the outcome measures. There was significant reduction in pain from NPRS 7/10 to 2/10. The range of motion (ROM ) of shoulder joint were improved to great extent i.e flexion 70 degrees to 160 degrees, Abduction 60 degrees to 165 degrees , internal and external degrees from 40 degrees to 70 degrees. The functional ability also showed significant improvement reducing the disability i.e. SPADI score 45 points to 20 points.
This case report demonstrates the promising potential of combining ESWT with tele-rehabilitation for managing shoulder calcification.
The significant improvements in pain, function, and range of motion, coupled with the patient's positive experience and the advantages of tele-rehabilitation in promoting sustainability, suggest that this combined approach warrants further investigation and clinical application. Integrating sustainable practices like tele-rehabilitation into Physical therapy can optimize resource utilization, improve access to care, and create a more patient-centred healthcare system.
ESWT
SHOULDER PAIN
