Effectiveness of Non-surgical Management in Rotator Cuff Calcific Tendinopathy (THE EFFECT TRIAL)

NCT ID: NCT05478902

Last Updated: 2023-12-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

116 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-01

Study Completion Date

2025-05-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The aim of this study will be to compare the effectiveness of an exercise therapy program with extracorporeal shockwave therapy, ultrasound-guided percutaneous irrigation and a wait and see approach in people with rotator cuff calcific tendinopathy.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Rotator cuff calcific tendinopathy (RCCT) is a common musculoskeletal disorder caused by the presence of calcific deposits in the rotator cuff with an important impact in the quality of life of those who are suffering it. Conservative interventions such as extracorporeal shockwave therapy (ESWT) or ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) have been commonly recommended as part of the early management for this clinical condition. Exercise therapy (ET) has shown to be an effective intervention for people with rotator cuff tendinopathy, but it has not been tested in people with RCCT yet. A randomised, single-blinded four parallel group clinical trial will be conducted. Participants (n=116) will be randomised in four groups: (1) ET; (2) ESWT; (3) US-PICT or (4) control.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Rotator Cuff Tendinosis Rotator Cuff Injuries Shoulder Tendinitis Calcific Shoulder Tendinitis Calcification Tendon Calcific Tendinitis Shoulder Pain

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

exercise therapy lavage rotator cuff calcific tendinopathy shoulder calcification extracorporeal shockwave therapy ultrasound-guided percutaneous irrigation shoulder pain shape up my shoulders sums

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Exercise Therapy

This group will receive the Shape Up My Shoulders (SUMS) protocol and it will be led by a physiotherapist trained in therapeutic exercise. It will last 12 weeks and it will be divided in 3 stages.

Stage I- Early-stage rehabilitation exercises (i.e., breathing and relaxation exercises, ball rolling exercises, hand gripping exercises, mental imagery and contralateral side exercises) and Shoulder Symptom Modification Procedure (SSMP). This stage typically lasts 1 to 2 weeks.

Stage II - Isometric, eccentric and heavy slow resistance exercises. The final part of Stage II is a progression from eccentric only to eccentric and concentric contractions.

Stage III - Functional program. This stage starts in week 5 or 6 and progressed to week 12. Involves pushing, pulling, throwing, lifting, carrying, and precision (sensory-motor control) exercises.

Group Type EXPERIMENTAL

Exercise Therapy

Intervention Type PROCEDURE

Exercise protocol for rotator cuff related shoulder pain

Extracorporeal Shockwave Therapy

This group will receive high energy Extracorporeal Shockwave Therapy (ESWT) applied by an experienced physiotherapist. ESWT will be applied on the most tender point of the shoulder, located by palpation. The dose will be 1500 impulses per session without anaesthesia and an intensity between 0.15 and 0.30 mJ/mm2 depending on patient tolerance. A total of 4 treatment sessions (1 session per week) with 1 week of rest between sessions will be implemented. Patient's position during the treatment will be seated in supine position with shoulder hyperextension and internal rotation with the hand placed below the contralateral glute with the palm touching the table.

Group Type ACTIVE_COMPARATOR

Extracorporeal Shockwave Therapy

Intervention Type PROCEDURE

High Energy Extracorporeal Shockwave Therapy

Ultrasound-Guided Percutaneous Irrigation

This intervention will be performed by an experienced interventionist radiologist in two sessions. The shoulder position will be with hyperextension and internal rotation with the hand behind the back. One 20 mL syringe with saline solution, one with an anaesthetic with 20 mg/mL of mepivacaine 2% and another syringe with a corticoid injection with 40 mg/mL of triamcinolone acetonide will be prepared before the intervention. Firstly, the anaesthetic will be injected directed to the calcification. Then, the procedure will consist of injecting saline solution and aspiring the calcific deposits until it is neither possible to aspire more inside the syringe nor to detect any calcifications with ultrasound imaging. After that, a corticoid will be injected to the bursa to prevent the appearance of subacromial bursitis. Finally, an anaesthetic will be injected during the extraction of the needle.

Group Type ACTIVE_COMPARATOR

Ultrasound-Guided Percutaneous Irrigation

Intervention Type PROCEDURE

Two sessions of Ultrasound-Guided Percutaneous Irrigation

Wait and Watch group

The wait and see group will not receive any intervention and will serve as a control group to determine the natural history of RCCT. If one treatment proves to be more effective then participants in the other groups will be offered that treatment after 12 months, or before, if the investigation finishes early due to an obvious group difference and a need to break randomisation codes.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Exercise Therapy

Exercise protocol for rotator cuff related shoulder pain

Intervention Type PROCEDURE

Extracorporeal Shockwave Therapy

High Energy Extracorporeal Shockwave Therapy

Intervention Type PROCEDURE

Ultrasound-Guided Percutaneous Irrigation

Two sessions of Ultrasound-Guided Percutaneous Irrigation

Intervention Type PROCEDURE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Shape Up My Shoulders Protocol Lavage

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* calcification deposit in the rotator cuff confirmed by diagnostic imaging (ultrasound, MRI or X-ray);
* pain and loss of function in the shoulder;
* not currently receiving physiotherapy or ESWT.

Exclusion Criteria

* previous treatments on last year (e.g., injections, ESWT, US-PICT, surgery, etc.);
* other shoulder disorders or trauma (e.g., fractures, dislocations, rotator cuff tears, frozen shoulder or shoulder instability);
* known allergy to any of the pharmacological products used in the study;
* taking oral anticoagulants
* taking oral steroid within the six months prior to participation in the study;
* cancer, systemic disease, pregnancy or infection;
* neck pain.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University of Valencia

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Lirios Dueñas

PhD Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Enrique Lluch, PT, PhD

Role: STUDY_DIRECTOR

University of Valencia

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Lluis Alcanyis Hospital

Xàtiva, Valencia, Spain

Site Status RECRUITING

Universitat de Valencia

Valencia, , Spain

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Spain

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Lirios Dueñas, PT, PhD

Role: CONTACT

Phone: 0034655525373

Email: [email protected]

Iván Caballero, PT, MSc

Role: CONTACT

Phone: 0034649109143

Email: [email protected]

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Cristina Gallego, MD

Role: primary

Lirios Dueñas Moscardó, PhD

Role: primary

References

Explore related publications, articles, or registry entries linked to this study.

Sansone V, Maiorano E, Galluzzo A, Pascale V. Calcific tendinopathy of the shoulder: clinical perspectives into the mechanisms, pathogenesis, and treatment. Orthop Res Rev. 2018 Oct 3;10:63-72. doi: 10.2147/ORR.S138225. eCollection 2018.

Reference Type RESULT
PMID: 30774461 (View on PubMed)

Simpson M, Pizzari T, Cook T, Wildman S, Lewis J. Effectiveness of non-surgical interventions for rotator cuff calcific tendinopathy: A systematic review. J Rehabil Med. 2020 Oct 31;52(10):jrm00119. doi: 10.2340/16501977-2725.

Reference Type RESULT
PMID: 32830280 (View on PubMed)

Harvie P, Pollard TC, Carr AJ. Calcific tendinitis: natural history and association with endocrine disorders. J Shoulder Elbow Surg. 2007 Mar-Apr;16(2):169-73. doi: 10.1016/j.jse.2006.06.007. Epub 2006 Dec 22.

Reference Type RESULT
PMID: 17188907 (View on PubMed)

Louwerens JK, Sierevelt IN, van Hove RP, van den Bekerom MP, van Noort A. Prevalence of calcific deposits within the rotator cuff tendons in adults with and without subacromial pain syndrome: clinical and radiologic analysis of 1219 patients. J Shoulder Elbow Surg. 2015 Oct;24(10):1588-93. doi: 10.1016/j.jse.2015.02.024. Epub 2015 Apr 11.

Reference Type RESULT
PMID: 25870115 (View on PubMed)

Uhthoff HK, Loehr JW. Calcific Tendinopathy of the Rotator Cuff: Pathogenesis, Diagnosis, and Management. J Am Acad Orthop Surg. 1997 Jul;5(4):183-191. doi: 10.5435/00124635-199707000-00001.

Reference Type RESULT
PMID: 10797220 (View on PubMed)

Ioppolo F, Tattoli M, Di Sante L, Attanasi C, Venditto T, Servidio M, Cacchio A, Santilli V. Extracorporeal shock-wave therapy for supraspinatus calcifying tendinitis: a randomized clinical trial comparing two different energy levels. Phys Ther. 2012 Nov;92(11):1376-85. doi: 10.2522/ptj.20110252. Epub 2012 Jun 28.

Reference Type RESULT
PMID: 22745199 (View on PubMed)

Lafrance S, Doiron-Cadrin P, Saulnier M, Lamontagne M, Bureau NJ, Dyer JO, Roy JS, Desmeules F. Is ultrasound-guided lavage an effective intervention for rotator cuff calcific tendinopathy? A systematic review with a meta-analysis of randomised controlled trials. BMJ Open Sport Exerc Med. 2019 Mar 9;5(1):e000506. doi: 10.1136/bmjsem-2018-000506. eCollection 2019.

Reference Type RESULT
PMID: 31191964 (View on PubMed)

Caballero I, Duenas L, Balasch-Bernat M, Fernandez-Matias R, Breso-Parra L, Gallego-Terres C, Aroca Navarro JE, Navarro-Bosch M, Lewis J, Lluch Girbes E. Effectiveness of non-surgical management in rotator cuff calcific tendinopathy (the effect trial): protocol for a randomised clinical trial. BMJ Open. 2024 Jan 4;14(1):e074949. doi: 10.1136/bmjopen-2023-074949.

Reference Type DERIVED
PMID: 38176875 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

1718862

Identifier Type: -

Identifier Source: org_study_id