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Shahabi S, Bagheri Lankarani K, Ezati R, ShahAli S. Reporting and Methodological Quality of Systematic Reviews and Meta-Analyses Evaluating Effects of Extracorporeal Shock Wave Therapy on Tendinopathies: A Scoping Review. J Chiropr Med 2024; 23:136-151. [PMID: 39670204 PMCID: PMC11632692 DOI: 10.1016/j.jcm.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/25/2024] [Accepted: 08/26/2024] [Indexed: 12/14/2024] Open
Abstract
Objective The purpose of this study was to evaluate the methodological and reporting quality of the published systematic reviews with or without meta-analyses (SRs/MAs) that looked at the effects of extracorporeal shock wave therapy (ESWT) on tendinopathies and to summarize its effectiveness. Methods A search of PubMed, Scopus, PEDro, Web of Science, Cochrane, Embase, and REHABDATA was conducted. SRs/MAs that assessed the effectiveness of ESWT for treating tendinopathy were included. The methodological and reporting quality of the eligible SRs/MAs were assessed using AMSTAR-2 and the PRISMA checklist. In addition, the ROBIS tool was applied to evaluate the risk of bias (RoB). Results Eighteen SRs/MAs were included. The overall methodological quality was "critically low." Furthermore, the reporting quality of the included reviews according to PRISMA criteria was not optimal. Based on the ROBIS, a total of 16.2% of the studies had a low RoB, 38.9% had an unclear RoB, and 44.4% of the studies were appraised as having a high RoB. Conclusion In this scoping review we found substantial limitations regarding the quality and RoB of SRs/MAs. Therefore, reviewers must consider the AMSTAR-2, PRISMA, and ROBIS tools to improve the quality of future studies.
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Affiliation(s)
- Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rozhin Ezati
- Department of Occupational therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shabnam ShahAli
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Xiong Y, Wen T, Jin S, Lin L, Shao Q, Peng Y, Zheng Q, Li W. Efficacy and safety of extracorporeal shock wave therapy for upper limb tendonitis: a systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne) 2024; 11:1394268. [PMID: 39139789 PMCID: PMC11319137 DOI: 10.3389/fmed.2024.1394268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/29/2024] [Indexed: 08/15/2024] Open
Abstract
Objective This study synthesized the highest level of evidence to analyse the effectiveness and safety of using extracorporeal shock wave therapy (ESWT) to treat upper limb tendonitis, which was unknown. Design We conducted a systematic review and meta-analysis of 18 randomized controlled trials (RCTs) in PubMed, Embase, Web of Science, Medline, and the Cochrane Library. Methods Two researchers performed the screening, data extraction, literature quality assessment, and heterogeneity analysis of the searched RCTs. Results The main types of morbidity included rotator cuff tendonitis, lateral epicondylitis, finger tendonitis, and long bicipital tendonitis. The results of the meta-analysis showed that ESWT was effective in relieving pain in all four types of tendonitis. In addition, ESWT was more effective in relieving pain in patients with upper limb tendonitis than placebo at the 3- and 6-month follow-ups, especially with radial ESWT (RESWT). Data analysis of the forest plot showed that the experimental group with ESWT as an intervention had a significant improvement in function in patients with rotator cuff tendonitis at the 3-month follow-up. However, subgroup analysis showed that low-energy ESWT was effective in improving function in patients with calcified and non-calcified rotator cuff tendonitis, whereas it was not effective in relieving pain. Conclusion ESWT can effectively improve the functional activity in patients with rotator cuff tendonitis and may produce positive analgesic effects in patients with upper limb tendonitis. The incidence of adverse effects is low. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023403594, identifier: PROSPERO, CRD42023403594.
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Affiliation(s)
| | | | | | | | | | | | | | - Wei Li
- Gannan Medical University, Ganzhou, Jiangxi, China
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Brindisino F, Marruganti S, Lorusso D, Cavaggion C, Ristori D. The effectiveness of extracorporeal shock wave therapy for rotator cuff calcific tendinopathy. A systematic review with meta-analysis. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2106. [PMID: 38878302 DOI: 10.1002/pri.2106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/13/2024] [Accepted: 06/02/2024] [Indexed: 06/23/2024]
Abstract
PURPOSE To investigate if Extracorporeal Shock Wave therapy (ESWT) is effective in reducing pain and disability, in improving function, quality of life and complete resorption rate of calcification in patients with Rotator Cuff Calcific Tendinopathy. To investigate which modality of ESWT brings the greatest clinical improvements between High (HE)-SWT and Low Energy (LE)-SWT and between Focal (F)-SWT and Radial (R)-SWT. METHODS MEDLINE, EMBASE, CENTRAL Database, and PEDro databases until February 2024 were searched. Study registers were further investigated. The Risk of Bias (RoB) was assessed with the Revised Cochrane RoB Tool (RoB 2). The certainty of evidence was rated with GRADE. RESULTS Twenty-one randomized controlled trials were included. None was judged as overall low RoB. Comparing ESWT and Ultrasound Guided Needling Procedures (USGNP), the pooled results reported a significant difference favoring USGNP in pain at <24 and <48 weeks (MD = 1.17, p = 0.004, I2 = 59%; MD = 1.31, p = 0.004, I2 = 42%, respectively). Comparing ESWT and sham-ESWT, the pooled results reported a clinically significant difference favoring ESWT in pain and function at 24 weeks (MD = -5.72, p < 0.00001, I2 = 0%; Standardized Mean Difference = 2.94, p = 0.02 I2 = 98%, respectively). Comparing HE-SWT and LE-SWT, HE-SWT was statistically and clinically superior in pain and function at <24 weeks (MD = -1.83, p = 0.03, I2 = 87%; MD = 14.60, p = 0.002, I2 = 77%, respectively) and showed a significantly higher complete resorption rate of calcification at 12 weeks (Risk Ratio = 2.53, p = 0.001, I2 = 0%). F-SWT and R-SWT appear equally effective in reducing pain, improving disability and resorption rate. The certainty of evidence was rated as very low through GRADE approach. CONCLUSION USGNP was statistically superior to ESWT in pain reduction at <24 and <48 weeks. ESWT was clinically better to sham-ESWT in pain reduction and function improvement at 24 weeks. HE-SWT was clinically more effective than LE-SWT in reducing pain, improving function at <24 weeks, and resolving calcific deposits at 12 weeks, while no differences between F-SWT and R-SWT were reported.
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Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, Campobasso, Italy
| | - Sharon Marruganti
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata" c/o Medicine and Surgery School, Roma, Italy
| | - Domenico Lorusso
- Operative Unit of Orthopaedic and Traumatology, Hospital "Mons. Dimiccoli", Barletta, Italy
| | - Claudia Cavaggion
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
| | - Diego Ristori
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
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Kamonseki DH, da Rocha GM, Ferreira VMLM, Ocarino JM, Pogetti LS. Extracorporeal Shockwave Therapy for the Treatment of Noncalcific Rotator Cuff Tendinopathy: A Systematic Review and Meta-analysis. Am J Phys Med Rehabil 2024; 103:471-479. [PMID: 37903597 DOI: 10.1097/phm.0000000000002361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
OBJECTIVE The aim of the systematically review the short-, intermediate-, and long-term effects of extracorporeal shockwave therapy on pain intensity and shoulder function in individuals with noncalcific rotator cuff tendinopathy. DESIGN The MEDLINE, CINAHL, SPORTDiscus, and Embase were searched from inception up to June 2023. We included randomized controlled trials that investigated the effects of extracorporeal shockwave therapy on pain intensity and shoulder function. RESULTS Nine studies were included with a total sample of 543 individuals. Extracorporeal shockwave therapy was superior to sham extracorporeal shockwave therapy in improving pain intensity at short-term follow-up (standardized mean difference = -0.28; 95% confidence interval, -0.55 to -0.01). Extracorporeal shockwave therapy was not superior to sham extracorporeal shockwave therapy in improving pain intensity at intermediate- and long-term follow-ups ( P > 0.05). Extracorporeal shockwave therapy was not superior to other treatments in improving pain intensity at short- and intermediate-term follow-ups ( P > 0.05). Extracorporeal shockwave therapy was not superior to sham extracorporeal shockwave therapy and other treatments in improving shoulder function at short-, intermediate-, and long-term follow-ups ( P > 0.05). CONCLUSIONS Moderate-certainty evidence indicated that extracorporeal shockwave therapy showed small improvement in shoulder pain over sham extracorporeal shockwave therapy at short-term follow-up. In addition, extracorporeal shockwave therapy was not superior to sham extracorporeal shockwave therapy in improving function, and it was not superior to other treatments in improving shoulder pain and function.
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Affiliation(s)
- Danilo Harudy Kamonseki
- From the Department of Physical Therapy, Universidade Federal da Paraíba, João Pessoa, Brazil (DHK); Graduate Program in Rehabilitation Science, Physical Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (GMdR, VMLMF, JMO, LSP); and Univesidade Federal de Uberlândia, Uberlândia, Brazil (LSP)
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Majidi L, Khateri S, Nikbakht N, Moradi Y, Nikoo MR. The effect of extracorporeal shock-wave therapy on pain in patients with various tendinopathies: a systematic review and meta-analysis of randomized control trials. BMC Sports Sci Med Rehabil 2024; 16:93. [PMID: 38659004 PMCID: PMC11041007 DOI: 10.1186/s13102-024-00884-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Tendinopathy is a common condition that affects the body's tendon structures, causing discomfort, restricted movement, and reduced functionality. In this study, we looked at how extracorporeal shock wave therapy (ESWT) affected pain levels in individuals with various forms of tendinopathy around the world. DESIGN This study is a comprehensive review and meta-analysis of previously published randomized controlled trials. To gather relevant data, the researchers performed keyword searches in international databases, including PubMed (Medline), Scopus, Web of Sciences, Cochrane Central Register of Controlled Trials (CENTRAL), Research Registers of ongoing trials (ClinicalTrials.gov), as well as Embase. The search was conducted up until March 2023. The quality of the selected articles was assessed using the Cochrane risk-of-bias method for randomized trials (RoB2). RESULTS Based on the results of the meta-analysis, which included 45 clinical studies, the use of ESWT was found to have a significant impact on reducing pain in various conditions. The standardized mean difference (SMD) in patients with plantar fasciitis (PF) was reduced by 1.63 (SMD: -1.63, 95% CI: -3.04, -0.21; I2: 77.36%; P heterogeneity: 0.0001). For lateral epicondylitis (LE), the SMD was 0.63 (SMD: -0.63, 95% CI: -1.11, -0.16; I2: 67.50%; P heterogeneity: 0.003). In the case of chronic Achilles tendinopathy, the SMD was 1.38 (SMD: -1.38, 95% CI: -1.66, -1.10; I2: 96.44%; P heterogeneity: 0.0001). Additionally, in individuals with rotator cuff tendinopathy, the SMD for pain reduction was 2.37 units (SMD: -2.37, 95% CI: -3.58, -1.15; I2: 98.46%; P heterogeneity: 0.0001). CONCLUSION This study suggests that ESWT can be a highly effective therapy option for relieving pain in people with tendinopathy. Nonetheless, it is encouraged to make additional recommendations based on high-quality clinical research and more accurate information in order to define the optimal therapeutic options for each type of tendinopathy.
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Affiliation(s)
- Lobat Majidi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Sorour Khateri
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hamadan University of Medical Sciences, Hamedan, Iran.
| | - Nikta Nikbakht
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Yousef Moradi
- Social Determinant of the Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Reza Nikoo
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hamadan University of Medical Sciences, Hamedan, Iran.
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Shao H, Zhang S, Chen J, Wen A, Wu Z, Huang M, Yao W, Lin Z, Liu C, Jin Z, Li Y. Radial extracorporeal shockwave therapy reduces pain and promotes proximal tendon healing after rotator cuff repair: Randomized clinical trial. Ann Phys Rehabil Med 2023; 66:101730. [PMID: 37027927 DOI: 10.1016/j.rehab.2023.101730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 11/02/2022] [Accepted: 11/10/2022] [Indexed: 04/08/2023]
Abstract
BACKGROUND Extracorporeal shockwave therapy (ESWT) is widely used to treat soft tissue disorders, but evidence for its application after rotator cuff (RC) repair is lacking. OBJECTIVES To investigate the effect of ESWT on short-term functional and structural outcomes after RC repair. METHODS Thirty-eight individuals were randomly assigned to the ESWT group (n = 19) or control group (n = 19) 3 months after RC repair. Both groups underwent 5 weeks of advanced rehabilitation and participants in the ESWT group additionally received 2000 pulses of shockwave therapy every week for 5 weeks. The primary outcome was pain measured on a visual analog scale (VAS). Secondary outcomes were range of motion (ROM), Constant score, University of California Los Angeles score (UCLA), American Shoulder and Elbow Surgeons form (ASES), and Fudan University shoulder score (FUSS). Changes in signal/noise quotient (SNQ), muscle atrophy and fatty infiltration were analyzed from MRI. All participants underwent clinical and MRI examinations 3 months (baseline) and 6 months (follow-up) post repair. RESULTS A total of 32 participants completed all assessments. Pain and function improved in both groups. At 6 months post repair, pain intensity was lower and ASES scores higher in the ESWT than in the control group (all p-values < 0.01). SNQ near the suture anchor site decreased significantly from baseline to follow-up in the ESWT group (p = 0.008) and was significantly lower than that in the control group (p = 0.036). Muscle atrophy and the fatty infiltration index did not differ between groups. CONCLUSION ESWT and exercise more effectively reduced early shoulder pain than rehabilitation alone and accelerated proximal supraspinatus tendon healing at the suture anchor site after RC repair. However, ESWT may not be more effective than advanced rehabilitation in terms of functional outcomes at the short-term follow-up.
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Affiliation(s)
- Hong Shao
- Department of Sports Medicine, Huashan Hospital, Fudan University, No12 Wulumuqi Zhong Road, Shanghai 200040, China; Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shurong Zhang
- Department of Sports Medicine, Huashan Hospital, Fudan University, No12 Wulumuqi Zhong Road, Shanghai 200040, China
| | - Jun Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, No12 Wulumuqi Zhong Road, Shanghai 200040, China
| | - Aizhen Wen
- Department of Sports Medicine, Huashan Hospital, Fudan University, No12 Wulumuqi Zhong Road, Shanghai 200040, China
| | - Ziying Wu
- Department of Sports Medicine, Huashan Hospital, Fudan University, No12 Wulumuqi Zhong Road, Shanghai 200040, China
| | - Mingru Huang
- Department of Sports Medicine, Huashan Hospital, Fudan University, No12 Wulumuqi Zhong Road, Shanghai 200040, China
| | - Wei Yao
- Department of Sports Medicine, Huashan Hospital, Fudan University, No12 Wulumuqi Zhong Road, Shanghai 200040, China
| | - Zifan Lin
- Department of Sports Medicine, Huashan Hospital, Fudan University, No12 Wulumuqi Zhong Road, Shanghai 200040, China
| | - Chang Liu
- Department of Sports Medicine, Huashan Hospital, Fudan University, No12 Wulumuqi Zhong Road, Shanghai 200040, China
| | - Zhengbiao Jin
- Department of Sports Medicine, Huashan Hospital, Fudan University, No12 Wulumuqi Zhong Road, Shanghai 200040, China
| | - Yunxia Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, No12 Wulumuqi Zhong Road, Shanghai 200040, China.
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Menekseoglu AK, Korkmaz MD, Segmen H. Clinical and electrophysiological efficacy of extracorporeal shock-wave therapy in carpal tunnel syndrome: a placebo-controlled, double-blind clinical trial. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:124-130. [PMID: 36820719 PMCID: PMC9937620 DOI: 10.1590/1806-9282.20220943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/12/2022] [Indexed: 02/19/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the efficacy of radial extracorporeal shock wave therapy on pain, functionality, and electrophysiological measurements in carpal tunnel syndrome. METHODS Between June 2021 and January 2022, a total of 66 wrists in 45 participants with mild-to-moderate carpal tunnel syndrome were included in this double-blind, prospective, randomized, placebo-controlled study. Patients were randomized into two groups, namely, the radial extracorporeal shock wave therapy (group 1, n=33) and the sham radial extracorporeal shock wave therapy (group 2, n=33). Night splints and tendon nerve gliding exercises were given to all participants. The participants were evaluated at baseline and the first month after treatment. Participants were evaluated using a visual analog scale, the Boston Carpal Tunnel Questionnaire, Leeds Neuropathic Symptom and Symptom Assessment, and electrophysiological examinations. RESULTS A total of 37 participants (a total of 55 wrists, radial extracorporeal shock wave therapy n=27, and sham radial extracorporeal shock wave therapy n=28) completed the study. After the intervention, there was a significant decrease in visual analog scale values (p<0.001) and a significant increase in Boston Carpal Tunnel Questionnaire scores (p<0.001) and Leeds Neuropathic Symptom and Symptom Assessment scores (p<0.001). In electrophysiological measurements, there was a significant decrease in median nerve sensory (p=0.002) and motor (p=0.003) distal latency, and a significant increase in median nerve sensory conduction velocity (p=0.026) was found in the radial extracorporeal shock wave therapy group. CONCLUSION This study shows that radial extracorporeal shock wave therapy has positive effects on pain, functionality, and electrophysiological measurements for mild-to-moderate carpal tunnel syndrome 1 month after application.
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Affiliation(s)
- Ahmet Kivanc Menekseoglu
- Sağlık Bilimleri Üniversitesi, İstanbul Kanuni Sultan Suleyman Training and Research Hospital, Department of Physical Medicine and Rehabilitation – Istanbul, Turkey
| | - Merve Damla Korkmaz
- Sağlık Bilimleri Üniversitesi, İstanbul Kanuni Sultan Suleyman Training and Research Hospital, Department of Physical Medicine and Rehabilitation – Istanbul, Turkey.,Corresponding author:
| | - Hatice Segmen
- Sağlık Bilimleri Üniversitesi, İstanbul Kanuni Sultan Suleyman Training and Research Hospital, Department of Neurology – Istanbul, Turkey
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Nowotny J, Kasten P. Kalkschulter – konservative und operative
Therapie. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2023. [DOI: 10.1055/a-1990-6407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Erkrankungen der Rotatorenmanschette beinhalten ein breites Spektrum, unter denen
die Kalkschulter oder Tendinosis calcarea (TC) eine häufige Pathologie
der Schulter darstellt und eine herausragende Rolle einnimmt. Das
Erscheinungsbild kann dabei enorm variieren. Die Kalkschulter kann als
Zufallsbefund bei der radiologischen Diagnostik auffallen, jedoch auch bis hin
zu einem der stärksten Schulterschmerzen avancieren. Nachfolgend wird
ein Überblick für das diagnostische und therapeutische Vorgehen
gegeben.
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Fares MY, Koa J, Abboud J. Assessment of Therapeutic Clinical Trials for Adhesive Capsulitis of the Shoulder. JSES Int 2023. [DOI: 10.1016/j.jseint.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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Owen H. Case study: Treating infraspinatus and supraspinatus trigger points and supraspinatus tendinopathy utilizing piezoelectric shockwave. Front Vet Sci 2022; 9:943276. [PMID: 36387390 PMCID: PMC9645527 DOI: 10.3389/fvets.2022.943276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/18/2022] [Indexed: 11/22/2022] Open
Abstract
Two individual case studies demonstrate piezoelectric shockwave treatment for the resolution of a supraspinatus tendinopathy and supraspinatus and infraspinatus myofascial trigger points (MTPs) via musculoskeletal ultrasound. This is the first documentation of improvement of both tendon and muscle fiber patterns in canine patients treated with piezoelectric shockwave. These cases validate the use of piezoelectric shockwave during the rehabilitation of common canine shoulder injuries.
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Effect of extracorporeal shockwave therapy on medial tibial stress syndrome: a systematic review. CURRENT ORTHOPAEDIC PRACTICE 2022. [DOI: 10.1097/bco.0000000000001127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Verstraelen F, Verhagen S, Giesberts A, Bonneux I, Koot H, Boer WD, van der Steen M. Needle aspiration of calcific deposits versus shock wave therapy for conservative therapy resistant calcifying tendinitis of the shoulder: protocol of a randomized, controlled trial. BMC Musculoskelet Disord 2022; 23:308. [PMID: 35361169 PMCID: PMC8968770 DOI: 10.1186/s12891-022-05259-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Calcific tendinitis of the shoulder (CT) is a common disorder with a large disease burden. The initial treatment is with conservative measures. However, when this fails the next step treatment remains unclear. Minimal invasive treatment modalities have emerged. Needle aspiration of the calcific deposits (NACD) and extracorporeal shock wave therapy (ESWT) have both shown good clinical results. Nonetheless, in the current orthopedic literature there are not any studies available that compare both the effectiveness and cost-effectiveness of those two treatment modalities. Therefore, our primary objective is to compare the effectiveness of NACD to ESWT. A secondary objective is to compare the cost-effectiveness of both treatment modalities and workability. METHODS Following a power calculation using the minimal clinical important difference of our primary outcome (Constant-Murley score, CMS) 140 patients will be included in the study. Enrolment is based upon strict inclusion/ exclusion criteria outlined in the Methods section. Participants will be randomized by computer in two groups (e.g. 70 patients will receive NACD and 70 patients will receive ESWT). The NACD treatment will consist of a sonographically guided removal of the calcific deposits and the ESWT treatment will be a focused ESWT. Both treatments will be conducted according to a standardized protocol, as part of care as usual in our hospital. The primary outcome will be the between group differences in functional outcome (measured with the CMS) between baseline and after 12 months follow-up. Secondary outcomes will be questionnaires regarding the clinical outcome (SST) and quality of life (EQ-5D-5L). Furthermore, NRS pain and cost related questionnaires (iPCQ and ProDisQ) will be collected during follow-up after two months, six months and at final follow-up after 12 months. DISCUSSION This study will provide more insight regarding treatment for conservative therapy resistant calcific tendinitis of the shoulder by comparing NACD to focused ESWT, which will aid the physician and patient in determining the appropriate treatment plan. TRIAL REGISTRATION Dutch trial register: NTR7093 registered on 11 March 2018.
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Affiliation(s)
- Freek Verstraelen
- Department of Orthopaedic Surgery & Trauma, Máxima MC, PO box 5600 PD, Eindhoven, the Netherlands
| | - Stéphanie Verhagen
- Department of Orthopaedic Surgery & Trauma, Máxima MC, PO box 5600 PD, Eindhoven, the Netherlands
| | - Anouk Giesberts
- Department of Orthopaedic Surgery & Trauma, Máxima MC, PO box 5600 PD, Eindhoven, the Netherlands
| | - Inge Bonneux
- Department of Orthopaedic Surgery & Trauma, Máxima MC, PO box 5600 PD, Eindhoven, the Netherlands
- Department of Orthopaedic Surgery & Trauma, Catharina Hospital Eindhoven, PO box 1350, 5602 ZA Eindhoven, The Netherlands
| | - Henk Koot
- Department of Orthopaedic Surgery & Trauma, Máxima MC, PO box 5600 PD, Eindhoven, the Netherlands
| | - Willem den Boer
- Department of Orthopaedic Surgery & Trauma, Máxima MC, PO box 5600 PD, Eindhoven, the Netherlands
| | - Marieke van der Steen
- Department of Orthopaedic Surgery & Trauma, Máxima MC, PO box 5600 PD, Eindhoven, the Netherlands
- Department of Orthopaedic Surgery & Trauma, Catharina Hospital Eindhoven, PO box 1350, 5602 ZA Eindhoven, The Netherlands
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Fontes AR, Martins ASDM, Costa BSPD, Noites A, Marques L. Comparison of the effects of shock waves versus radiofrequency on abdominal lipolysis: A randomized clinical trial. J Cosmet Dermatol 2022; 21:3821-3831. [PMID: 35255184 DOI: 10.1111/jocd.14690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/10/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND High levels of abdominal adiposity mean higher risk of developing cardiovascular diseases. Aerobic exercise per si reduces the risk of developing this type of diseases. Radiofrequency and shockwave therapy showed to be effective in the reduction of localized abdominal fat. AIM (S) To compare the effects of prescribed moderate aerobic exercise associated with 6 sessions of shockwave therapy or radiofrequency, in the subcutaneous abdominal adipose tissue, in overweight female individuals in fertile age. METHODS Randomized clinical trial, with 30 volunteers in fertile age with overweight and/or obese, randomly and equitably allocated in two experimental groups (1-shockwave therapy and 2-radiofrequency) and one control group. Aerobic physical exercise was prescribed to all groups. The values of anthropometric measurements were measured in two moments. The intervention protocol was performed in a clinic for six weeks, with one session per week. The ANOVA test, paired samples t test, Kruskal-Wallis test, and Wilcoxon test were used to compare the results, for a significance level of 0.05. RESULTS Of 28 participants completed the study. There were significant differences in waist circumference reduction between the experimental group 1 and 2 when compared to the control group (p = 0.005 and p = 0.014, respectively). There was a statistically significant reduction in navel level circumference in experimental group 1 when compared to experimental group 2 (p = 0.024) and with the control group (p = 0.016). CONCLUSION Both resources were effective in reducing abdominal measurements when compared to the control group. However, SWT was superior in reducing the navel level circumference.
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Affiliation(s)
| | | | | | - Andreia Noites
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Porto, Portugal.,Center for Rehabilitation Research (CIR)- Human Movement System (Re) habilitation, Polytechnic Institute of Porto, Porto, Portugal
| | - Leila Marques
- Manager of Aesthetics Division, BTL, Porto, Portugal
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Habibzadeh A, Mousavi-Khatir R, Saadat P, Javadian Y. The effect of radial shockwave on the median nerve pathway in patients with mild-to-moderate carpal tunnel syndrome: a randomized clinical trial. J Orthop Surg Res 2022; 17:46. [PMID: 35078486 PMCID: PMC8786622 DOI: 10.1186/s13018-022-02941-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/13/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This study aimed to evaluate the short-term effect of radial shockwave on the median nerve pathway as a new model method in patients with mild-to-moderate carpal tunnel syndrome.
Methods
In this randomized clinical trial, 60 patients were randomly allocated into three equal groups. The first group received 1500 shocks on the carpal tunnel, the second group received 1500 shocks on the carpal tunnel and median nerve pathways, and the third group was the control group. In all three groups, patients received conventional physiotherapy for ten sessions. In addition, patients in experimental groups received four sessions of radial shockwave. Pain and paresthesia intensity, sensory and motor distal latency were evaluated as primary outcomes. Boston carpal tunnel Questionnaire scores were evaluated as secondary outcomes. Evaluations were performed at baseline, 1 and 4 weeks after the end of the treatment.
Results
Pain and paresthesia intensity and Boston questionnaire score significantly decreased in all three groups, but the greater improvement was noted in shockwave groups. Sensory and motor distal latency were only improved in shockwave groups. In terms of clinical and electrophysiological parameters, two groups of shockwaves showed similar results.
Conclusions
Radial shockwave combined with conventional physiotherapy is an effective noninvasive treatment for mild-to-moderate carpal tunnel syndrome that produces greater and longer-lasting results than conventional physiotherapy alone. There were no differences observed between utilizing radial shockwave on the carpal tunnel or median nerve pathways on the palmar surface of the hand, in terms of clinical and electrophysiological measurements.
Clinical Trial registration number The study was registered at https://fa.irct.ir/user/trial/49490/view (20200706048028N1) in date of 08/24/2021.
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Joshi V, Osborne T, Tzias D. A case of non-traumatic shoulder pain. BMJ 2022; 376:e052278. [PMID: 34987027 DOI: 10.1136/bmj-2019-052278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Vanya Joshi
- Department of Radiology, Ashford and St Peter's Hospitals NHS Foundation Trust, Chertsey, Surrey, UK
| | - Thomas Osborne
- Department of Radiology, Ashford and St Peter's Hospitals NHS Foundation Trust, Chertsey, Surrey, UK
| | - Demitrios Tzias
- Department of Radiology, Ashford and St Peter's Hospitals NHS Foundation Trust, Chertsey, Surrey, UK
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Burton I. Combined extracorporeal shockwave therapy and exercise for the treatment of tendinopathy: A narrative review. SPORTS MEDICINE AND HEALTH SCIENCE 2021; 4:8-17. [PMID: 35782779 PMCID: PMC9219268 DOI: 10.1016/j.smhs.2021.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022] Open
Abstract
Tendinopathy is a chronic degenerative musculoskeletal disorder that is common in both athletes and the general population. Exercise and extracorporeal shockwave therapy (ESWT) is among the most common treatments used to mediate tendon healing and regeneration. The review presents the current understanding of mechanisms of action of ESWT and exercise in isolation and briefly synthesises evidence of their effectiveness for various tendinopathies. The central purpose of the review is to synthesize research findings investigating the combination of ESWT and exercise for five common tendinopathies (plantar heel pain, rotator cuff, lateral elbow, Achilles, and patellar tendinopathy) and provide recommendations on clinical applicability. Collectively, the available evidence indicates that ESWT combined with exercise in the form of eccentric training, tissue-specific stretching, or heavy slow resistance training are effective for specific tendinopathies and can therefore be recommended in treatment. Whilst there are at present a limited number of studies investigating combined EWST and exercise approaches, there is evidence to suggest that the combination improves outcomes in the treatment of plantar heel pain, Achilles, lateral elbow, and rotator cuff tendinopathy. However, despite overall positive outcomes in patellar tendinopathy, the combined treatment has not been shown at present to offer additional benefit over eccentric exercise alone.
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Extracorporeal Shockwave Therapy for the Treatment of Tendinopathies: Current Evidence on Effectiveness, Mechanisms, Limitations and Future Directions. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00324-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Challoumas D, Millar NL. Do we need to improve the reporting of evidence in tendinopathy management? A critical appraisal of systematic reviews with recommendations on strength of evidence assessment. BMJ Open Sport Exerc Med 2021; 7:e000920. [PMID: 33692904 PMCID: PMC7907875 DOI: 10.1136/bmjsem-2020-000920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To critically appraise the quality of published systematic reviews (SRs) of randomised controlled trials (RCTs) in tendinopathy with regard to handling and reporting of results with special emphasis on strength of evidence assessment. Data sources Medline from inception to June 2020. Study eligibility All SRs of RCTs assessing the effectiveness of any intervention(s) on any location of tendinopathy. Data extraction and synthesis Included SRs were appraised with the use of a 12-item tool devised by the authors arising from the Preferred Reporting Items in Systematic Reviews and Meta-Analyses statement and other relevant guidance. Subgroup analyses were performed based on impact factor (IF) of publishing journals and date of publication. Results A total of 57 SRs were included published in 38 journals between 2006 and 2020. The most commonly used risk-of-bias (RoB) assessment tool and strength of evidence assessment tool were the Cochrane Collaboration RoB tool and the Cochrane Collaboration Back Review Group tool, respectively. The mean score on the appraisal tool was 46.5% (range 0%–100%). SRs published in higher IF journals (>4.7) were associated with a higher mean score than those in lower IF journals (mean difference 26.4%±8.8%, p=0.004). The mean score of the 10 most recently published SRs was similar to that of the first 10 published SRs (mean difference 8.3%±13.7%, p=0.54). Only 23 SRs (40%) used the results of their RoB assessment in data synthesis and more than half (n=30; 50%) did not assess the strength of evidence of their results. Only 12 SRs (21%) assessed their strength of evidence appropriately. Conclusions In light of the poor presentation of evidence identified by our review, we provide recommendations to increase transparency and reproducibility in future SRs.
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Affiliation(s)
- Dimitris Challoumas
- Institute of Infection, Immunity and Inflammation College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Neal L Millar
- Institute of Infection, Immunity and Inflammation College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Kim MS, Kim IW, Lee S, Shin SJ. Diagnosis and treatment of calcific tendinitis of the shoulder. Clin Shoulder Elb 2020; 23:210-216. [PMID: 33330261 PMCID: PMC7726362 DOI: 10.5397/cise.2020.00318] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/16/2020] [Indexed: 11/25/2022] Open
Abstract
Calcific tendinitis is the leading cause of shoulder pain. Among patients with calcific tendinitis, 2.7%-20% are asymptomatic, and 35%-45% of patients whose calcific deposits are inadvertently discovered develop shoulder pain. If symptoms are present, complications such as decreased range of motion of the shoulder joint should be minimized while managing pain. Patients with acute calcific tendinitis respond well to conservative treatment and rarely require surgery. In contrast, patients with chronic calcific tendinitis often do not respond to conservative treatment and do require surgery. Clinical improvement takes time, even after surgical treatment. This review article summarizes the processes related to the diagnosis and treatment of calcific tendinitis with the aim of helping clinicians choose appropriate treatment options for their patients.
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Affiliation(s)
- Min-Su Kim
- Department of Orthopedic Surgery, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - In-Woo Kim
- Department of Orthopedic Surgery, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Sanghyeon Lee
- Department of Orthopedic Surgery, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Sang-Jin Shin
- Department of Orthopedic Surgery, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
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Girgis B, Duarte JA. Physical therapy for tendinopathy: An umbrella review of systematic reviews and meta-analyses. Phys Ther Sport 2020; 46:30-46. [PMID: 32877858 DOI: 10.1016/j.ptsp.2020.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/01/2020] [Accepted: 08/04/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To summarize evidence in the last decade regarding the efficacy of physical therapy interventions to treat tendinopathy, as a single disease entity, as determined in systematic reviews (SRs) and/or meta-analyses (MAs). METHODS Electronic search of PubMed, PEDro, and Scopus database was performed from year 2010 to January 2020. The methodological quality of the identified studies was assessed using the AMSTAR 2 tool. Studies scoring 9 points or higher were further analyzed using GRADE principles. RESULTS 40 SRs and/or MAs were included in qualitative synthesis, whereas only 5 MAs were included in quantitative synthesis. Low-level laser therapy (LLLT) intervention showed a pooled improvement in pain reduction of 1.53 cm; 95% CI, [1.14, 1.91] (I2 = 1.9%, p = 0.361) on visual analogue scale, and grip strength of 9.59 kg; 95% CI, [5.90, 13.27]. CONCLUSIONS Moderate-quality evidence may support these following interventions: LLLT revealed a statistically and potentially clinically significant improvement in pain and function on the short-term. Extracorporeal shockwave therapy showed a statistically significant enhancement in pain and function at all follow-up durations; however, its clinical significance was undetermined. Eccentric exercise was supported by qualitative evidence only. Caution is advised when interpreting results due to possible pathological differences in tendinopathy at each region.
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Affiliation(s)
- Beshoy Girgis
- CIAFEL, Faculty of Sport, University of Porto, R. Dr. Plácido Costa, 91, 4200-450, Porto, Portugal.
| | - José Alberto Duarte
- CIAFEL, Faculty of Sport, University of Porto, R. Dr. Plácido Costa, 91, 4200-450, Porto, Portugal.
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21
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Challoumas D, Millar NL. Risk of bias in systematic reviews of tendinopathy management: Are we comparing apples with oranges? TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Dimitris Challoumas
- Institute of Infection, Immunity and Inflammation College of Medicine, Veterinary and Life Sciences University of Glasgow Glasgow UK
| | - Neal L. Millar
- Institute of Infection, Immunity and Inflammation College of Medicine, Veterinary and Life Sciences University of Glasgow Glasgow UK
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Surace SJ, Deitch J, Johnston RV, Buchbinder R, Cochrane Musculoskeletal Group. Shock wave therapy for rotator cuff disease with or without calcification. Cochrane Database Syst Rev 2020; 3:CD008962. [PMID: 32128761 PMCID: PMC7059880 DOI: 10.1002/14651858.cd008962.pub2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Shock wave therapy has seen widespread use since the 1990s to treat various musculoskeletal disorders including rotator cuff disease, but evidence of its efficacy remains equivocal. OBJECTIVES To determine the benefits and harms of shock wave therapy for rotator cuff disease, with or without calcification, and to establish its usefulness in the context of other available treatment options. SEARCH METHODS We searched Ovid MEDLINE, Ovid Embase, CENTRAL, ClinicalTrials.gov and the WHO ICTRP up to November 2019, with no restrictions on language. We reviewed the reference lists of retrieved trials to identify potentially relevant trials. SELECTION CRITERIA We included randomised controlled trials (RCTs) and controlled clinical trials (CCTs) that used quasi-randomised methods to allocate participants, investigating participants with rotator cuff disease with or without calcific deposits. We included trials of comparisons of extracorporeal or radial shock wave therapy versus any other intervention. Major outcomes were pain relief greater than 30%, mean pain score, function, patient-reported global assessment of treatment success, quality of life, number of participants experiencing adverse events and number of withdrawals due to adverse events. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies for inclusion, extracted data and assessed the certainty of evidence using GRADE. The primary comparison was shock wave therapy compared to placebo. MAIN RESULTS Thirty-two trials (2281 participants) met our inclusion criteria. Most trials (25) included participants with rotator cuff disease and calcific deposits, five trials included participants with rotator cuff disease and no calcific deposits, and two trials included a mixed population of participants with and without calcific deposits. Twelve trials compared shock wave therapy to placebo, 11 trials compared high-dose shock wave therapy (0.2 mJ/mm² to 0.4 mJ/mm² and above) to low-dose shock wave therapy. Single trials compared shock wave therapy to ultrasound-guided glucocorticoid needling, ultrasound-guided hyaluronic acid injection, transcutaneous electric nerve stimulation (TENS), no treatment or exercise; dual session shock wave therapy to single session therapy; and different delivery methods of shock wave therapy. Our main comparison was shock wave therapy versus placebo and results are reported for the 3 month follow up. All trials were susceptible to bias; including selection (74%), performance (62%), detection (62%), and selective reporting (45%) biases. No trial measured participant-reported pain relief of 30%. However, in one trial (74 participants), at 3 months follow up, 14/34 participants reported pain relief of 50% or greater with shock wave therapy compared with 15/40 with placebo (risk ratio (RR) 1.10, 95% confidence interval (CI) 0.62 to 1.94); low-quality evidence (downgraded for bias and imprecision). Mean pain (0 to 10 scale, higher scores indicate more pain) was 3.02 points in the placebo group and 0.78 points better (0.17 better to 1.4 better; clinically important change was 1.5 points) with shock wave therapy (9 trials, 608 participants), moderate-quality evidence (downgraded for bias). Mean function (scale 0 to 100, higher scores indicate better function) was 66 points with placebo and 7.9 points better (1.6 better to 14 better, clinically important difference 10 points) with shock wave therapy (9 trials, 612 participants), moderate-quality evidence (downgraded for bias). Participant-reported success was reported by 58/150 people in shock wave therapy group compared with 35/137 people in placebo group (RR 1.59, 95% CI 0.87 to 2.91; 6 trials, 287 participants), low-quality evidence (downgraded for bias and imprecision). None of the trials measured quality of life. Withdrawal rate or adverse event rates may not differ between extracorporeal shock wave therapy and placebo, but we are uncertain due to the small number of events. There were 11/34 withdrawals in the extracorporeal shock wave therapy group compared with 13/40 withdrawals in the placebo group (RR 0.75, 95% CI 0.43 to 1.31; 7 trials, 581 participants) low-quality evidence (downgraded for bias and imprecision); and 41/156 adverse events with extracorporeal shock wave therapy compared with 10/139 adverse events in the placebo group (RR 3.61, 95% CI 2.00 to 6.52; 5 trials, 295 participants) low-quality evidence (downgraded for bias and imprecision). Subgroup analyses indicated that there were no between-group differences in pain and function outcomes in participants who did or did not have calcific deposits in the rotator cuff. AUTHORS' CONCLUSIONS Based upon the currently available low- to moderate-certainty evidence, there were very few clinically important benefits of shock wave therapy, and uncertainty regarding its safety. Wide clinical diversity and varying treatment protocols means that we do not know whether or not some trials tested subtherapeutic doses, possibly underestimating any potential benefits. Further trials of extracorporeal shock wave therapy for rotator cuff disease should be based upon a strong rationale and consideration of whether or not they would alter the conclusions of this review. A standard dose and treatment protocol should be decided upon before further research is conducted. Development of a core set of outcomes for trials of rotator cuff disease and other shoulder disorders would also facilitate our ability to synthesise the evidence.
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Affiliation(s)
- Stephen J Surace
- Monash UniversityMonash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineMelbourneAustralia
| | - Jessica Deitch
- Monash UniversityMonash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineMelbourneAustralia
| | - Renea V Johnston
- Monash UniversityMonash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineMelbourneAustralia
| | - Rachelle Buchbinder
- Monash UniversityMonash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineMelbourneAustralia
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Efficacy of Extracorporeal Shockwaves Therapy on Peripheral Nerve Regeneration. J Craniofac Surg 2020; 30:2635-2639. [PMID: 31577651 DOI: 10.1097/scs.0000000000005671] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study was conducted to determine the effects of different doses and methods of extracorporeal shock wave treatment (ESWT) on the sciatic nerve regeneration of rat model using unbiased quantitative stereological techniques and to know which method and dose were effective. METHODS Twenty-five Wistar albino rats were used in the experiment. All animals were randomly divided into 5 groups. To the first group (control, n = 5) ESWT and surgery were not applied. To 2nd group (E300*2, n = 5), twice doses of 300 impulses uESWs (unfocused) were applied. To 3rd group (E500*2, n = 5), twice doses of 500 impulses uESWs (unfocused) were applied. To 4th group (E300*2, n = 5), twice doses of 300 impulses of fESWs (focused) were applied. To 5th group (E500*2, n = 5), twice doses of 500 impulses of fESWs (focused) were applied. Rats were sacrificed and nerve samples analyzed on the 22nd day following the operation. RESULTS There is a variable increase in the axon numbers among the shockwave treated groups in compare to the control group. The focused groups showed better improvement and the 300-focused group has shown the highest regeneration rate. CONCLUSION The authors found that ESWT promotes nerve regeneration, increases the thickness of the myelin sheath and that the most effective result is in the 300 shock wave.
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Kim JC, Jung SH, Lee SU, Lee SY. Effect of extracorporeal shockwave therapy on carpal tunnel syndrome: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2019; 98:e16870. [PMID: 31415424 PMCID: PMC6831378 DOI: 10.1097/md.0000000000016870] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Although several trials have reported the use of extracorporeal shock wave therapy (ESWT) for mild to moderate carpal tunnel syndrome (CTS), little is known about the efficacy of ESWT. Thus, we performed a meta-analysis to evaluate whether ESWT can improve symptoms, functional outcomes, and electrophysiologic parameters in CTS. METHODS Six randomized controlled trials investigating the effect of ESWT on CTS were retrieved from PubMed, Embase, and the Cochrane Library. We performed a pairwise meta-analysis using fixed- or random-effects models. RESULTS ESWT showed significant overall effect size compared to the control (overall Hedge g pooled standardized mean difference (SMD) = 1.447; 95% confidence interval [CI], 0.439-2.456; P = .005). Symptoms, functional outcomes, and electrophysiologic parameters all improved with ESWT treatment. However, there was no obvious difference between the efficacy of ESWT and local corticosteroid injection (pooled SMD = 0.418; 95% CI, -0.131 to 0.968; P = .135). A publication bias was not evident in this study. CONCLUSION Our meta-analysis revealed that ESWT can improve symptoms, functional outcomes, and electrophysiologic parameters in patients with CTS. Further research is needed to confirm the long-term effects and the optimal ESWT protocol for CTS.
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Affiliation(s)
- Ju Chan Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital
| | - Se Hee Jung
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Shi-Uk Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Sang Yoon Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
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Zamzam M, El Yasaki A, El Garabawy N, El Ghandour LEE. Shockwave therapy versus local steroid injection in chronic supraspinatus tendinopathy. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2019. [DOI: 10.4103/err.err_16_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Efficacy of Extracorporeal Shockwave Therapy on Calcified and Noncalcified Shoulder Tendinosis: A Propensity Score Matched Analysis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:2958251. [PMID: 31001553 PMCID: PMC6437753 DOI: 10.1155/2019/2958251] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 02/24/2019] [Indexed: 12/18/2022]
Abstract
Background Extracorporeal shock wave therapy (ESWT) had been proved to be beneficial in calcific tendinosis; however, the treatment efficacy in noncalcific tendinosis of rotator cuff still remains controversial. The present study was to compare the outcomes ESWT among the noncalcific rotator cuff tendinosis and different types of calcific tendinosis on the basis of similar shoulder functional status. Methods A retrospective, comparative study was conducted with the enrollment of 20 patients in each group through propensity score matching in a 1:1:1 ratio from 291 patients who underwent single ESWT for painful shoulder tendinosis. The patients were divided into three groups which included noncalcified tendinosis (NCTS), type I dense calcified tendinosis of shoulder (DCTS), and type II and type III translucent calcified tendinosis of shoulder (TCTS) according to Gartner and Heyer classification. The clinical evaluation included the subjective pain score with visual analog scale (VAS) and functional outcome with Constant and Murley score (CMS). Results Twelve months after ESWT, the VAS in TCTS (1.5 ± 2.48) was statistically significant lower than NCTS (2.9 ± 2.86) and DCTS (3.8 ± 2.46) (p=.011). For the functional outcome, the overall CMS was superior in TCTS than the NCTS and DCTS (86.9 ± 19.7 versus 78.7 ± 18.3 and 71.1 ± 17.8, p=.014). Besides, the subscales of pain score, strength, and range of motion in TCTS improved significantly better than NCTS and DCTS. 70% of patients were complaint-free in TCTS group, which was higher than the NCTS group (15%) and DCTS group (25%) (p<0.05). Conclusion The present study indicated that the high-dose ESWT posed superior clinical efficacy in type II/III calcification tendinosis rather than type I calcification and noncalcific shoulder tendinosis.
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Dragičević-Cvjetković D, Erceg-Rukavina T, Manojlović S. Effects of the radial extracorporeal shock wave therapy (rESWT) in patients with calcific tendinopathy of the shoulder. SCRIPTA MEDICA 2019. [DOI: 10.5937/scriptamed50-22618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Stasinopoulos D. Can extracorporeal shock-wave therapy be used for the management of lateral elbow tendinopathy? World J Methodol 2018; 8:37-39. [PMID: 30519537 PMCID: PMC6275556 DOI: 10.5662/wjm.v8.i3.37] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 09/07/2018] [Accepted: 10/10/2018] [Indexed: 02/06/2023] Open
Abstract
Lateral elbow tendinopathy (LET) is one of the two most common tendinopathies of the upper limb. The most effective treatment in the management of LET is the exercise program. Clinicians combine exercise program with other physiotherapy, electrotherapeutic and no, techniques. Extracorporeal shock wave therapy (ESWT) is one of the most common recommended electrotherapeutic modalities for the management of LET. Further research is needed to find out the optimal treatment protocol of ESWT in the management of LET
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Affiliation(s)
- Dimitrios Stasinopoulos
- Department Health Sciences, School of Sciences, European University Cyprus, Nicosia 1516, Cyprus
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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; 10:63-72. [PMID: 30774461 PMCID: PMC6209365 DOI: 10.2147/orr.s138225] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Calcific tendinopathy (CT) of the shoulder is a common, painful condition characterized by the presence of calcium deposits in the rotator cuff tendons. Current theories indicate that CT may be the result of a cell-mediated process in which, after a stage of calcium deposition, calcifications are spontaneously resorbed. However, in a minority of cases, this self-healing process is somehow disrupted, resulting in symptoms. Recent literature shows an emerging role of biological and genetic factors underlying CT. This new evidence could supplement the classic mechanical theory of rotator cuff tendinopathy complicated by calcium precipitation, and it may also explain why the majority of the therapies currently in use are only able to provide partially satisfactory outcomes. This review aims to summarize the current knowledge about the pathological processes underlying CT of the shoulder and thereby justify the quest for advanced biological treatments of this condition when it becomes symptomatic.
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Affiliation(s)
- Valerio Sansone
- Department of Orthopaedics, University of Milan, .,Department of Orthopaedics, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy,
| | | | | | - Valerio Pascale
- Department of Orthopaedics, University of Milan, .,Department of Orthopaedics, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy,
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Klüter T, Krath A, Stukenberg M, Gollwitzer H, Harrasser N, Knobloch K, Maffulli N, Hausdorf J, Gerdesmeyer L. Electromagnetic transduction therapy and shockwave therapy in 86 patients with rotator cuff tendinopathy: A prospective randomized controlled trial. Electromagn Biol Med 2018; 37:175-183. [DOI: 10.1080/15368378.2018.1499030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Tim Klüter
- Department of Orthopaedic Surgery and Traumatology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - André Krath
- Department of Orthopaedic Surgery and Traumatology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Martin Stukenberg
- Department of Orthopaedic Surgery and Traumatology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Hans Gollwitzer
- Excellent Center of Medicine and ATOS-Clinic, München, Germany
| | - Norbert Harrasser
- Department of Orthopaedic Surgery, Klinikum rechts der Isar, München, Germany
| | | | | | - Jörg Hausdorf
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), München, Germany
| | - Ludger Gerdesmeyer
- Department of Orthopaedic Surgery and Traumatology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
- Department of Orthopaedic Surgery, Klinikum rechts der Isar, München, Germany
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Reilly JM, Bluman E, Tenforde AS. Effect of Shockwave Treatment for Management of Upper and Lower Extremity Musculoskeletal Conditions: A Narrative Review. PM R 2018; 10:1385-1403. [PMID: 29775801 DOI: 10.1016/j.pmrj.2018.05.007] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 03/22/2018] [Accepted: 05/06/2018] [Indexed: 02/08/2023]
Abstract
Extracorporeal shockwave therapy (ESWT) is a technology that was first introduced into clinical practice in 1982 for urologic conditions. Subsequent clinical applications in musculoskeletal conditions have been described in treatment of plantar fasciopathy, both upper and lower extremity tendinopathies, greater trochanteric pain syndrome, medial tibial stress syndrome, management of nonunion fractures, and joint disease including avascular necrosis. The aim of this review is to summarize the current understanding of treatment of musculoskeletal conditions with ESWT, accounting for differences in treatment protocol and energy levels. Complications from ESWT are rare but include 2 reported cases of injury to bone and Achilles tendon rupture in older adults using focused shockwave. Collectively, studies suggest ESWT is generally well-tolerated treatment strategy for multiple musculoskeletal conditions commonly seen in clinical practice. LEVEL OF EVIDENCE: III.
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Affiliation(s)
| | | | - Adam S Tenforde
- Spaulding Rehabilitation Hospital, 300 First Street, Charlestown, MA 02129(‡).
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Moon YE, Seok H, Kim SH, Lee SY, Yeo JH. Extracorporeal shock wave therapy for sacroiliac joint pain: A prospective, randomized, sham-controlled short-term trial. J Back Musculoskelet Rehabil 2018; 30:779-784. [PMID: 28372309 DOI: 10.3233/bmr-150405] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Sacroiliac joint (SIJ) pain can cause lower back pain and pelvic discomfort. However, there is no established standard treatment for SIJ pain. Extracorporeal shock wave therapy (ESWT) is a novel, non-invasive therapeutic modality for musculoskeletal disorders. The mechanism underlying shockwave therapy is not fully understood, but the frequency with which ESWT is applied clinically has increased over the years. OBJECTIVE We evaluated the efficacy of using ESWT to treating SIJ pain. METHODS Thirty patients with SIJ pain were assigned randomly to ESWT (n = 15) and sham control (n = 15) groups. The ESWT group received 2,000 shockwaves with energy set to the maximum level tolerable by the patient (energy density = 0.09-0.25 mJ/mm2). The probe was oriented perpendicular to the posterior SIJ line, and moved up and down along the joint line. The sham control group received 2,000 shockwaves with the probe oriented parallel to the posterior SIJ line. A 10-cm numeric rating scale (NRS) and the Oswestry Disability Index (ODI) scores were assessed before the intervention, and 1 and 4 weeks post-intervention. Participants were instructed to refrain from using any other conservative treatment, including anti-inflammatory medication and other physical modalities during the study. RESULTS In the ESWT group, NRS decreased significantly at post-treatment week 4 (3.64 (95% confidence interval, 2.29-4.99)) compared to baseline (6.42 (5.19-7.66); P < 0.05). ODI improved at 1 and 4 weeks compared to baseline, but not significantly. In the sham group, NRS and ODI did not differ at any post-treatment time point. There was a significant group difference in NRS at week 4 post-treatment (3.64 (2.29-4.99) in the ESWT group vs. 6.18 (5.34-7.02) in the sham control group; P < 0.05), but this was not the case for ODI. CONCLUSIONS ESWT represents a potential therapeutic option for decreasing SIJ pain.
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Affiliation(s)
- Young Eun Moon
- Department of Anesthesiology and Pain Medicine, Catholic University Seoul St. Mary's Hospital, Seoul, Korea
| | - Hyun Seok
- Department of Physical Medicine and Rehabilitation, College of Medicine, Soonchunhyang University Hospital, Bucheon, Korea
| | - Sang-Hyun Kim
- Department of Physical Medicine and Rehabilitation, College of Medicine, Soonchunhyang University Hospital, Bucheon, Korea
| | - Seung Yeol Lee
- Department of Physical Medicine and Rehabilitation, College of Medicine, Soonchunhyang University Hospital, Bucheon, Korea
| | - Jung Ho Yeo
- Department of Physical Medicine and Rehabilitation, College of Medicine, Soonchunhyang University Hospital, Bucheon, Korea
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Analgesic Effect of Extracorporeal Shock Wave Treatment Combined with Fascial Manipulation Theory for Adhesive Capsulitis of the Shoulder: A Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3450940. [PMID: 29581969 PMCID: PMC5822906 DOI: 10.1155/2018/3450940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 12/02/2017] [Accepted: 12/19/2017] [Indexed: 11/17/2022]
Abstract
Objectives This study aims to explore whether extracorporeal shockwave treatment (ESWT) based on the theory of fascial manipulation (FM) at select treatment points is superior to traditional local ESWT for pain relief in adhesive capsulitis of the shoulder. Methods Data from patients with adhesive capsulitis of the shoulder who received weekly ESWT according to fascial manipulation theory (ESWT-FM) or local extracorporeal shockwave treatment (L-ESWT) during a 5-week treatment period were evaluated. Pain-on-movement numeric rating scale (p-NRS) and range of motion (ROM) testing were performed before the treatment period, after the first treatment, and after the fifth treatment. Results There were significant reductions in pain scores in the ESWT-FM group (p < 0.05) after the first treatment, and after the fifth treatment, both groups had marked, significant improvement (p < 0.05), with a significantly greater reduction in pain (p-NRS) in the ESWT-FM group compared to the L-ESWT group (p < 0.05). There was no significant difference in terms of ROM in the L-ESWT group, while there was slight improvement of forward flexion in the ESWT-FM group after the fifth treatment. Conclusions ESWT-FM provided faster pain relief and slightly more notable improvement of function compared with L-ESWT for the patients with adhesive capsulitis of shoulder.
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Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The Role of Extracorporeal Shockwave Treatment in Musculoskeletal Disorders. J Bone Joint Surg Am 2018; 100:251-263. [PMID: 29406349 DOI: 10.2106/jbjs.17.00661] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Daniel Moya
- Buenos Aires British Hospital, Buenos Aires, Argentina
| | - Silvia Ramón
- Hospital Quirón, Barcelona, Fundación García Cugat, Spain
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Ultrasound Guidance Does Not Improve the Results of Shock Wave for Plantar Fasciitis or Calcific Achilles Tendinopathy: A Randomized Control Trial. Clin J Sport Med 2018; 28:21-27. [PMID: 28708705 DOI: 10.1097/jsm.0000000000000430] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To establish whether the use of ultrasound to direct shock waves to the area of greater calcification in calcaneal enthesopathies was more effective than the common procedure of directing shock waves to the point where the patient has the most tenderness. DESIGN Two-armed nonblinded randomized control trial with allocation concealment. SETTING The Sports Clinic at Sydney University. PATIENTS Participants 18 years or older with symptomatic plantar fasciitis (PF) (with heel spur) or calcific Achilles tendinopathy (CAT). Seventy-four of 82 cases completed treatment protocol and 6-month follow-up. INTERVENTIONS Patients were randomized to receive either ultrasound-guided (UG) or patient-guided (PG) shock wave at weekly intervals over 3 to 5 weeks. MAIN OUTCOME MEASURES Reduced pain on visual analog scale (VAS) and improved functional score on Maryland Foot Score (MFS) (for PF) or Victorian Institute of Sport Assessment-Achilles (VISA-A) (for CAT). Follow-up was at 6 weeks and 3 and 6 months. RESULTS Comparative 6-month improvements in MFS for the 47 PF cases were PG +20/100 and UG +14/100 (P = 0.20). Comparative 6-month improvement in VISA-A score for the 27 CAT cases were PG +35/100 and UG +27/100 (P = 0.37). Comparative (combined PF and CAT) 6-month improvement in VAS pain scores for all 38 PG cases were +38/100 with +37/100 for all 36 UG shock wave cases. CONCLUSIONS Although both treatment groups had good clinical outcomes in this study, results for the 2 study groups were almost identical. CLINICAL RELEVANCE This study shows that there is no major advantage in the addition of ultrasound for guiding shock waves when treating calcaneal enthesopathies (PF and CAT).
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Chou WY, Wang CJ, Wu KT, Yang YJ, Ko JY, Siu KK. Prognostic factors for the outcome of extracorporeal shockwave therapy for calcific tendinitis of the shoulder. Bone Joint J 2017; 99-B:1643-1650. [PMID: 29212688 DOI: 10.1302/0301-620x.99b12.bjj-2016-1178.r1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 06/12/2017] [Indexed: 12/22/2022]
Abstract
AIMS We conducted a study to identify factors that are prognostic of the outcome of extracorporeal shockwave therapy (ESWT) for calcific tendinitis of the shoulder. PATIENTS AND METHODS Since 1998, patients with symptomatic calcific tendinitis of the rotator cuff have been treated with ESWT using an electrohydraulic mode shockwave device. One year after ESWT, patients were grouped according to the level of resorption of calcification. RESULTS Of 241 symptomatic shoulders, complete resorption (CR) of calcification occurred in 134 (CR group). The remaining 107 shoulders had incomplete resorption (ICR) (ICR group). Gartner type I calcification was most common (64.5%) in the ICR group. The mean duration of symptoms before ESWT was significantly longer in the ICR group. Overall, 81% of the CR group and 23.4% of the ICR group were symptom free. There was a strong relationship between subsidence of symptoms and remission of calcification. Poor prognosis was significantly related to Gartner type I calcification, calcification extent > 15 mm and duration of symptoms > 11 months. CONCLUSION Patients with calcific tendinitis of the shoulder who have the factors identified for a poor outcome after ESWT should undergo a different procedure. Cite this article: Bone Joint J 2017;99-B:1643-50.
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Affiliation(s)
- W-Y Chou
- Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C-J Wang
- Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - K-T Wu
- Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Y-J Yang
- Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - J-Y Ko
- Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - K-K Siu
- Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Comparative Effectiveness of Nonoperative Treatments for Chronic Calcific Tendinitis of the Shoulder: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2017; 98:1678-1692.e6. [DOI: 10.1016/j.apmr.2017.02.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/24/2017] [Accepted: 02/10/2017] [Indexed: 11/22/2022]
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Hawk C, Minkalis AL, Khorsan R, Daniels CJ, Homack D, Gliedt JA, Hartman JA, Bhalerao S. Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions. J Manipulative Physiol Ther 2017; 40:293-319. [DOI: 10.1016/j.jmpt.2017.04.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 04/03/2017] [Accepted: 04/07/2017] [Indexed: 12/18/2022]
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Dymarek R, Taradaj J, Rosińczuk J. The Effect of Radial Extracorporeal Shock Wave Stimulation on Upper Limb Spasticity in Chronic Stroke Patients: A Single-Blind, Randomized, Placebo-Controlled Study. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:1862-1875. [PMID: 27126239 DOI: 10.1016/j.ultrasmedbio.2016.03.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 03/03/2016] [Accepted: 03/11/2016] [Indexed: 06/05/2023]
Abstract
The main purpose of this study was to determine the clinical, electrophysiological and thermal effects of radial extracorporeal shock wave (rESW) stimulation on upper limb muscles affected by spasticity in patients with chronic stroke. Patients included in the study were randomly assigned into the following two groups: 30 patients stimulated with active rESW (A); and 30 patients stimulated with placebo rESW (B). All patients were analyzed using the Modified Ashworth Scale (MAS) to test the spasticity levels of the elbow (E), radio carpal (RC) and fingers (FF) joints; surface electromyography (sEMG) was performed for the resting bioelectrical activity registration of the flexor carpi radialis (FCR) and flexor carpi ulnaris (FCU) muscles; and infrared thermal imaging (IRT) was used to assess the temperature distributions of the carpal flexor muscles (CFM). All assessments were performed at baseline (t0), immediately after rESW (t1) as well as 1 and 24 h following its finalization (t2 and t3). Patients treated with active rESW showed a statistically significant reduction in the MAS score for the RC joint at t1 and for the FF joints at t1, t2 and t3 (p < 0.05). A significant decrease in sEMG activity was observed in the FCR and FCU muscles at t1, t2 and t3 (p < 0.05); significant increases in the mean and maximum values of the IRT detection was observed using inter-group comparisons in t2 and t3 (p < 0.05). No significant alterations were observed in patients after placebo rESW stimulation (p > 0.05). Applications of rESW demonstrating positive effects at reducing the level of spastic hypertonia of the upper limb muscles in patients with chronic stroke. ESW treatments should be considered as a potential anti-spastic effect to regulate vasculature.
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Affiliation(s)
- Robert Dymarek
- Department of Nervous System Diseases, Medical University in Wroclaw, Wroclaw, Poland.
| | - Jakub Taradaj
- Department of Physiotherapy Basics, Academy of Physical Education in Katowice, Katowice, Poland
| | - Joanna Rosińczuk
- Department of Nervous System Diseases, Medical University in Wroclaw, Wroclaw, Poland
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Chung E. Pro: does shockwave therapy have a place in the treatment of Peyronie's disease? Transl Androl Urol 2016; 5:366-70. [PMID: 27298784 PMCID: PMC4893523 DOI: 10.21037/tau.2016.03.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Eric Chung
- 1 Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia ; 2 AndroUrology Centre, St Andrew's War Memorial Hospital, Brisbane, QLD, Australia
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Dimitrios S. Extracorporeal shock-wave therapy: Can it be used for the management of any calcific tendinopathy? Hong Kong Physiother J 2016; 34:47-48. [DOI: 10.1016/j.hkpj.2016.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Dymarek R, Ptaszkowski K, Słupska L, Halski T, Taradaj J, Rosińczuk J. Effects of extracorporeal shock wave on upper and lower limb spasticity in post-stroke patients: A narrative review. Top Stroke Rehabil 2016; 23:293-303. [PMID: 27077981 DOI: 10.1080/10749357.2016.1141492] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Effective treatment strategies for post-stroke muscle spasticity are still a significant interdisciplinary issue and challenge for neurologists, neurosurgeons, physiatrists nurses and physiotherapists. Extracorporeal shock wave (ESW) treatment is a well-supported physical modality used in a wide range of musculoskeletal disorders. The list of justified indications for ESW treatment and scientific areas of investigations is continuously evolving and adapting to different pathologies, including spasticity after stroke. OBJECTIVES To analyze the relevant available research and clinical studies demonstrated that the treatment potentials and effectiveness of ESW procedure including mechanisms of the anti-spastic action within hypertonic muscles after stroke. LITERATURE SEARCH A computer research was performed using MEDLINE, PubMed, PEDro, CINAHL, and EMBASE databases. Assessment of eligibility of papers was determined by two independent reviewers. The inclusion criteria comprised: publication in peer-reviewed journals, studies published in the last 10 years, involving clinical trials, full-version available and written in English only. DISCUSSION A total of 91 articles were collected, 83 of which were non relevant. Ultimately, 8 clinical studies within a total of 195 patients met inclusion criteria for this review. Only one randomized controlled trial was found and then scored using the Cochrane-based assessment. The other studies involving were analyzed separately according to their methodological quality in a descriptive manner. CONCLUSIONS ESW was found to be safe and effective. The mechanism of ESW action is still under investigation.
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Affiliation(s)
- Robert Dymarek
- a Department of Nervous System Diseases , Wroclaw Medical University , Bartla 5 Street, 51-618 Wroclaw , Poland
| | - Kuba Ptaszkowski
- b Department of Physiotherapy , Wroclaw Medical University , Grunwaldzka 2 Street, 50-355 Wroclaw , Poland
| | - Lucyna Słupska
- c Institute of Physiotherapy , Public Higher Medical Professional School in Opole , Katowicka 68 Street, 45-061 Opole , Poland
| | - Tomasz Halski
- c Institute of Physiotherapy , Public Higher Medical Professional School in Opole , Katowicka 68 Street, 45-061 Opole , Poland
| | - Jakub Taradaj
- d Department of Physiotherapy Basics , Academy School of Physical Education in Katowice , Mikolowska 65 Street, 40-065 Katowice , Poland
| | - Joanna Rosińczuk
- a Department of Nervous System Diseases , Wroclaw Medical University , Bartla 5 Street, 51-618 Wroclaw , Poland
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Can Shockwave Therapy Improve Tendon Metabolism? METABOLIC INFLUENCES ON RISK FOR TENDON DISORDERS 2016; 920:275-81. [DOI: 10.1007/978-3-319-33943-6_26] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Tendinopathy and Aging. TOPICS IN GERIATRIC REHABILITATION 2016. [DOI: 10.1097/tgr.0000000000000089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Current knowledge on evidence-based shockwave treatments for shoulder pathology. Int J Surg 2015; 24:171-8. [DOI: 10.1016/j.ijsu.2015.08.079] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 07/28/2015] [Accepted: 08/20/2015] [Indexed: 11/24/2022]
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Morton S, Chan O, Ghozlan A, Price J, Perry J, Morrissey D. High volume image guided injections and structured rehabilitation in shoulder impingement syndrome: a retrospective study. Muscles Ligaments Tendons J 2015; 5:195-9. [PMID: 26605194 DOI: 10.11138/mltj/2015.5.3.195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND the aim was to establish the effect of a high volume-image guided injection and structured rehabilitation (HVIGI&SR) on both pain and function in shoulder impingement syndrome (SIS). METHODS 44 participants treated between January 2008 and January 2012 with a >3 month history of recalcitrant ultrasound-confirmed SIS were sent a retrospective questionnaire. All participants had received a HVIGI under ultrasound-guidance consisting of 20 mls of Marcaine with 50 mg of hydrocortisone, followed by a period of physiotherapist-led rehabilitation. The validated Shoulder Pain and Disability Index (SPADI) score was used to establish the change in the score between 1 week pre-injection and 3 weeks post-injection, along with an 11-point pain scale. RESULTS 59% of participants responded. There was a clinically and statistically significant decrease in the SPADI score of 58.7 ± 29.9 (p<0.01). 76% of participants had an improvement in their score of over 50% from their initial score. There was a clinically and statistically significant improvement in pain of 5.19 ± 2.62 (p<0.01) on the numerical rating scale of pain. CONCLUSION HVIGI&SR should be considered for short-term treatment of SIS as it showed a significant improvement in both pain and function. A prolonged period of physiotherapist-led rehabilitation can then be undertaken for long term benefits.
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Affiliation(s)
- Sarah Morton
- Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK
| | - Otto Chan
- BMI London Independent Hospital, London, UK
| | - Asser Ghozlan
- Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK
| | - Jessica Price
- Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK
| | - John Perry
- Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK ; BMI London Independent Hospital, London, UK
| | - Dylan Morrissey
- Centre for Sports and Exercise Medicine William Harvey Research Institute Queen Mary University of London Mile End Hospital, London, UK ; BMI London Independent Hospital, London, UK ; Physiotherapy Department, Bart's Health NHS Trust, London, UK
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Abstract
BACKGROUND Cellulite is a multifactorial condition that is present in 80-90 % of post-pubertal women. Despite its high prevalence, it remains a major cosmetic concern for women. A wide range of products and treatments for cellulite reduction is available; however, no systematic review has been performed so far to evaluate the efficacy of the available treatment options for cellulite. OBJECTIVE The objective of this review is to provide a systematic evaluation of the scientific evidence of the efficacy of treatments for cellulite reduction. METHODS This systematic review followed the PRISMA guidelines for reporting systematic reviews and meta-analyses. Only original articles in English or German reporting data on the efficacy of cellulite treatments from in vivo human studies were considered. In total, 67 articles were analyzed for the following information: therapy, presence of a control group, randomization, blinding, sample size, description of statistical methods, results, and level of evidence. RESULTS Most of the evaluated studies, including laser- and light-based modalities, radiofrequency, and others had important methodological flaws; some did not use cellulite severity as an endpoint or did not provide sufficient statistical analyses. Of the 67 studies analyzed in this review, only 19 were placebo-controlled studies with randomization. Some evidence for potential benefit was only seen for acoustic wave therapy (AWT) and the 1440 nm Nd:YAG minimally invasive laser. CONCLUSION This article provides a systematic evaluation of the scientific evidence of the efficacy of treatment for cellulite reduction. No clear evidence of good efficacy could be identified in any of the evaluated cellulite treatments.
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Affiliation(s)
| | - Nils Krueger
- Rosenpark Research, Wilhelminenstraße 13, 64283, Darmstadt, Germany
| | - Neil S Sadick
- Sadick Dermatology, 911 Park Avenue, New York, NY, USA
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Vinanti GB, Pavan D, Rossato A, Biz C. Atypical localizations of calcific deposits in the shoulder. Int J Surg Case Rep 2015; 10:206-10. [PMID: 25884610 PMCID: PMC4430114 DOI: 10.1016/j.ijscr.2015.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 03/20/2015] [Accepted: 04/03/2015] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Calcific tendinopathies of the shoulder are due to inflammation around deposits of calcium within periarticular tendineal structures. PRESENTATION OF CASES We present three cases of atypical localization of calcium deposits in the shoulder. All of the cases have been treated with arthroscopic excision, followed by post-operative rehabilitation, regaining excellent results. Patients were evaluated 6 months after surgery using the Visual Analogue Scale (VAS), the Simple Shoulder Test (SST) and the UCLA modified shoulder rating. DISCUSSION Calcific tendinopathy is a self-limiting condition or is successfully treated with conservative therapy especially during the early phases of the pathology. If conservative measures fail, removal of calcium deposits is recommended. Arthroscopic management showed good results in our three cases. CONCLUSION We suggest that arthroscopic treatment of calcific tendonitis guarantees good results even when calcium deposits are in atypical locations.
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Affiliation(s)
- G B Vinanti
- Saint Rocco Clinic, via dei Sabbioni 24, 25050 Ome, Brescia, Italy.
| | - D Pavan
- Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, via Giustiniani 2, 35128 Padova, Italy.
| | - A Rossato
- Saint Rocco Clinic, via dei Sabbioni 24, 25050 Ome, Brescia, Italy.
| | - Carlo Biz
- Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, via Giustiniani 2, 35128 Padova, Italy.
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Effect of taping on spinal pain and disability: systematic review and meta-analysis of randomized trials. Phys Ther 2015; 95:493-506. [PMID: 25413622 DOI: 10.2522/ptj.20130619] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 11/13/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Taping is a widely used therapeutic tool for the treatment of musculoskeletal disorders, nevertheless its effectiveness is still uncertain. PURPOSE The purpose of this study was to conduct a current review of randomized controlled trials (RCTs) concerning the effects of elastic and nonelastic taping on spinal pain and disability. DATA SOURCES MEDLINE, CINAHL, EMBASE, PEDro, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, ISI Web of Knowledge, and SPORTDiscus databases were searched. STUDY SELECTION All published RCTs on symptomatic adults with a diagnosis of specific or nonspecific spinal pain, myofascial pain syndrome, or whiplash-associated disorders (WAD) were considered. DATA EXTRACTION Two reviewers independently selected the studies and extracted the results. The quality of individual studies was assessed using the PEDro scale, and the evidence was assessed using GRADE criteria. DATA SYNTHESIS Eight RCTs were included. Meta-analysis of 4 RCTs on low back pain demonstrated that elastic taping does not significantly reduce pain or disability immediately posttreatment, with a standardized mean difference of -0.31 (95% confidence interval=-0.64, 0.02) and -0.23 (95% confidence interval=-0.49, 0.03), respectively. Results from single trials indicated that both elastic and nonelastic taping are not better than placebo or no treatment on spinal disability. Positive results were found only for elastic taping and only for short-term pain reduction in WAD or specific neck pain. Generally, the effect sizes were very small or not clinically relevant, and all results were supported by low-quality evidence. LIMITATIONS The paucity of studies does not permit us to draw any final conclusions. CONCLUSION Although different types of taping were investigated, the results of this systematic review did not show any firm support for their effectiveness.
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Effectiveness of passive physical modalities for shoulder pain: systematic review by the Ontario protocol for traffic injury management collaboration. Phys Ther 2015; 95:306-18. [PMID: 25394425 DOI: 10.2522/ptj.20140361] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Shoulder pain is a common musculoskeletal condition in the general population. Passive physical modalities are commonly used to treat shoulder pain. However, previous systematic reviews reported conflicting results. PURPOSE The aim of this study was to evaluate the effectiveness of passive physical modalities for the management of soft tissue injuries of the shoulder. DATA SOURCES MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials were searched from January 1, 1990, to April 18, 2013. STUDY SELECTION Randomized controlled trials (RCTs) and cohort and case-control studies were eligible. Random pairs of independent reviewers screened 1,470 of 1,760 retrieved articles after removing 290 duplicates. Twenty-two articles were eligible for critical appraisal. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. Of those, 11 studies had a low risk of bias. DATA EXTRACTION The lead author extracted data from low risk of bias studies and built evidence tables. A second reviewer independently checked the extracted data. DATA SYNTHESIS The findings of studies with a low risk of bias were synthesized according to principles of best evidence synthesis. Pretensioned tape, ultrasound, and interferential current were found to be noneffective for managing shoulder pain. However, diathermy and corticosteroid injections led to similar outcomes. Low-level laser therapy provided short-term pain reduction for subacromial impingement syndrome. Extracorporeal shock-wave therapy was not effective for subacromial impingement syndrome but provided benefits for persistent shoulder calcific tendinitis. LIMITATIONS Non-English studies were excluded. CONCLUSIONS Most passive physical modalities do not benefit patients with subacromial impingement syndrome. However, low-level laser therapy is more effective than placebo or ultrasound for subacromial impingement syndrome. Similarly, shock-wave therapy is more effective than sham therapy for persistent shoulder calcific tendinitis.
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