Effects of cryo plus ultrasound therapy on pain and functioning in patients with acute long head of the biceps tendinopathy: a proof-of-concept study.

Abstract

Background: This proof-of-concept study aimed to evaluate the short-term effects of cryo-plus-ultrasound treatment on pain and functioning in patients with acute long head of biceps tendinopathy (LHBT), through clinical and instrumental assessment with measurement of shearwave sonoelastography.

Methods: Adults with anterior shoulder pain and dysfunction (symptoms persisting for at least 2 weeks), diagnosed by imaging as LHBT, were randomly assigned to the experimental group (receiving active cryo-ultrasound therapy combined with conventional physical therapy) or control group (sham cryo-ultrasound therapy combined with conventional physical therapy). Pain intensity and physical functioning were assessed by the Numeric Rating Scale (NRS), handgrip strength (HGS), Euro-QoL, QuickDASH, and tendon stiffness with a SWE assessment baseline (T0) at the end of treatment (T1), and after one month (T2) after the end of the treatment.

Results: Twenty-one patients with LHBT tendinopathy, 11 in the experimental group and 10 in the control group, were included. At T1, a similar reduction in pain and tendon stiffness was reported in both groups (NRS, experimental group:4.45±1.92 vs. control group:3.5±0.97), (SWE, experimental group: 31.44±7.8 vs. control group: 29.38±5.66). However, at T2, the experimental reported improved perceived-pain and stiffness scores compared to the control group (NRS, experimental group:2.27±0.9 vs. control group: 3.3±0.67; SWE, experimental group:24.27±5.15 vs. control group:28.1±3.75).

Conclusions: The main findings proved that a concurrent rehabilitative approach with proper physical agent modality (PAM) could provide significant results in acute LHBT with regards to pain, tendon stiffness and shoulder function. The experimental group, which synergistically received both conventional physical therapy and active cryo-ultrasound therapy, achieved similar results to the sham group at T1, but more significant improvements were observed in the active PAMs group at T2.