{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T09:16:24Z","timestamp":1772183784760,"version":"3.50.1"},"reference-count":68,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health (Ricerca Corrente"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background: Rotator cuff tendinopathy is a major cause of shoulder pain and disability. Focused extracorporeal shockwave therapy (ESWT) is an established conservative treatment option; however, the predictive factors influencing the treatment response remain poorly characterized. Objectives: To identify clinical, demographic, and metabolic predictors of pain reduction and functional improvement at four months following focused ESWT in patients with supraspinatus tendinopathy, with the goal of informing individualized treatment planning and early prognostic counseling. Methods: This retrospective cohort study analyzed patients with supraspinatus tendinopathy (calcific and non-calcific) treated with focused ESWT at a university rehabilitation center between June 2020 and December 2025. Outcomes were assessed at baseline and 4-month follow-up using the Visual Analog Scale (VAS), Roles and Maudsley, and Constant\u2013Murley scores. Change score analysis with covariate adjustment and backward stepwise selection were performed to identify predictors of clinical improvement. Results: A total of 239 patients (97 males [40.6%], 142 females [59.4%]; mean age 60.2 \u00b1 11.5 years; mean BMI 25.5 \u00b1 4.0 kg\/m2) were included, of whom 101 (42.3%) had calcific tendinopathy. Significant improvements were observed in all outcomes: VAS decreased from 6.50 \u00b1 1.35 to 3.96 \u00b1 2.09 (p &lt; 0.001; Cohen\u2019s d = 1.24), and Constant\u2013Murley score increased from 60.38 \u00b1 14.53 to 75.88 \u00b1 15.52 (p &lt; 0.001; Cohen\u2019s d = 1.07). Patient-reported satisfaction (Roles and Maudsley score) showed a 91.2% success rate (excellent or good outcomes). Regression analysis identified baseline severity as the strongest predictor of improvement in all models. BMI emerged as a significant predictor of functional recovery (\u03b2 = \u22120.95, p &lt; 0.001 for Constant\u2013Murley change), with each 1 kg\/m2 increase associated with approximately 1-point less improvement. Conclusions: Baseline clinical severity and body mass index were consistent predictors of ESWT effectiveness in rotator cuff tendinopathy. A lower BMI was associated with greater functional improvement, highlighting a potentially modifiable factor for treatment optimization. These findings support personalized treatment planning and early prognostic counseling in clinical practices.<\/jats:p>","DOI":"10.3390\/medsci14010114","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T08:31:19Z","timestamp":1772181079000},"page":"114","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Metabolic Predictors of Response to Focused Extracorporeal Shockwave Therapy in Rotator Cuff Tendinopathy: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1746-7398","authenticated-orcid":false,"given":"Sveva Maria","family":"Nusca","sequence":"first","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit, Sant\u2019Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Latini","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit, Sant\u2019Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2658-4860","authenticated-orcid":false,"given":"Gabriele","family":"Santilli","sequence":"additional","affiliation":[{"name":"Department of Movement, Human and Health Sciences, University of Rome \u2018Foro Italico\u2019, 00135 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gioia","family":"Beccarini","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit, Sant\u2019Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerio","family":"Bova","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit, Sant\u2019Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavia","family":"Santoboni","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit, Sant\u2019Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valter","family":"Santilli","sequence":"additional","affiliation":[{"name":"San Raffaele Sulmona, Viale dell\u2019Agricoltura, 67039 Sulmona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Felzani","sequence":"additional","affiliation":[{"name":"San Raffaele Sulmona, Viale dell\u2019Agricoltura, 67039 Sulmona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2094-4351","authenticated-orcid":false,"given":"Fabrizio","family":"Perroni","sequence":"additional","affiliation":[{"name":"Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariachiara","family":"Vulpiani","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit, Sant\u2019Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7925-7495","authenticated-orcid":false,"given":"Davide","family":"Sisti","sequence":"additional","affiliation":[{"name":"Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8680-4004","authenticated-orcid":false,"given":"Mario","family":"Vetrano","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit, Sant\u2019Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Lucas, J., van Doorn, P., Hegedus, E., Lewis, J., and van der Windt, D. 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