الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
The shoulder joint is one of the most frequent sites of musculoskeletal pain, exceeded only by back and knee pain. Clinically supraspinatus tendinitis causes about 60% of all shoulder pain presentations. Supraspinatus is the most utilized muscle of entire shoulder complex. It provides dynamic as well as static stability to gleno-humeral joint.Extracorporeal shock wave therapy (ESWT) appears to be a promising alternative and has been proven to be beneficial in several musculoskeletal diseases and especially enthesopathies, including plantar fasciitis, elbow epicondylitis, patellar tendinitis and Achilles tendinitis. ESWT, has a positive influence on the healing of chronic tendinosis, which is characterized by insufficient inflammatory cells and hypovascularity. ESWT has been recommended as a second-line therapy before surgery is performed.
Proper home exercise programs should also be taught in conjuction with proper ergonomics. The management of a supraspinatus tendinopathy consists of different progressive exercises. There are three phases of exercise program: self-stretching, strengthening and joint mobility.The aim of this work is to evaluate the therapeutic effects of shock wave therapy, home exercises and their combination for the treatment of chronic supraspinatus tendinitis.This study was carried out on 78 patients with chronic supraspinatus tendinitis with a minimum six months duration. They were diagnosed clinically by pain in anterior region of the shoulder joint with painful arc of motion between 60° and 120° of shoulder abduction in scapular plane with point tenderness at greater tuberosity of the humerus and positive provocation tests. Diagnosis is confirmed by diagnostic muscloskeletal ultrasonography (MSK US) for shoulder joint.The participants of this study were randomly divided into three groups according to the line of treatment into shock wave therapy group ,home exercise group and combined therapy group.The results of this study could be summarized as follows: Combined therapy group: increases the gained improvements in all shoulder parameters relative to the baseline and between groups.