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Gessl I, Sakellariou G, Wildner B, Filippou G, Mandl P, D'Agostino MA, Navarro-Compán V. Systematic literature review to inform the EULAR recommendations for the use of imaging in crystal-induced arthropathies in clinical practice. Ann Rheum Dis 2024:ard-2023-225247. [PMID: 38702175 DOI: 10.1136/ard-2023-225247] [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: 11/08/2023] [Accepted: 04/02/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE To summarise current data regarding the use of imaging in crystal-induced arthropathies (CiAs) informing a European Alliance of Associations for Rheumatology task force. METHODS We performed four systematic searches in Embase, Medline and Central on imaging for diagnosis, monitoring, prediction of disease severity/treatment response, guiding procedures and patient education in gout, calcium pyrophosphate dihydrate deposition (CPPD) and basic calcium phosphate deposition (BCPD). Records were screened, manuscripts reviewed and data of the included studies extracted. The risk of bias was assessed by validated instruments. RESULTS For gout, 88 studies were included. Diagnostic studies reported good to excellent sensitivity and specificity of dual-energy CT (DECT) and ultrasound (US), high specificity and lower sensitivity for conventional radiographs (CR) and CT. Longitudinal studies demonstrated sensitivity to change with regard to crystal deposition by US and DECT and inflammation by US and structural progression by CR and CT. For CPPD, 50 studies were included. Diagnostic studies on CR and US showed high specificity and variable sensitivity. There was a single study on monitoring, while nine assessed the prediction in CPPD. For BCPD, 56 studies were included. There were two diagnostic studies, while monitoring by CR and US was assessed in 43 studies, showing a reduction in crystal deposition. A total of 12 studies with inconsistent results assessed the prediction of treatment response. The search on patient education retrieved two studies, suggesting a potential role of DECT. CONCLUSION This SLR confirmed a relevant and increasing role of imaging in the field of CiAs.
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Affiliation(s)
- Irina Gessl
- Division of Rheumatology, Internal Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Garifallia Sakellariou
- Department of Internal Medicine and Therapeutics, Università di Pavia, Pavia, Italy
- Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy
| | | | - Georgios Filippou
- Rheumatology, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Peter Mandl
- Division of Rheumatology, Internal Medicine 3, Medical University of Vienna, Vienna, Austria
| | - Maria Antonietta D'Agostino
- Rheumatology Department, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, IRCSS, Rome, Italy
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Avendano JP, Pereira D. Treatment of Calcific Tendonitis of the Rotator Cuff: An Updated Review. Orthopedics 2023; 46:e326-e332. [PMID: 37672776 DOI: 10.3928/01477447-20230901-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Rotator cuff calcific tendonitis (RCCT) is a disorder that can greatly impair patients' quality of life. A literature review was conducted to find the most effective and newest treatments for RCCT. PubMed and Cochrane Review databases were searched, without strict inclusion/exclusion criteria, for peer-reviewed articles between 1941 and 2021 that discussed RCCT etiology and treatments. If nonoperative measures (non-steroidal anti-inflammatory drugs, physical therapy, and corticosteroids) are unsuccessful, other options include extracorporeal shockwave therapy, ultrasound-guided injection techniques, and minimally invasive surgery. Because RCCT can resolve spontaneously, patients should progress to invasive options only if conservative first-line treatments have failed. [Orthopedics. 2023;46(6):e326-e332.].
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Notarnicola A, Ladisa I, Lanzilotta P, Bizzoca D, Covelli I, Bianchi FP, Maccagnano G, Farì G, Moretti B. Shock Waves and Therapeutic Exercise in Greater Trochanteric Pain Syndrome: A Prospective Randomized Clinical Trial with Cross-Over. J Pers Med 2023; 13:976. [PMID: 37373965 DOI: 10.3390/jpm13060976] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
This study aimed to verify the comparative effectiveness of shock wave therapy versus therapeutic exercise, including the possibility of combining both therapies, in patients who did not respond to the first treatment. A prospective randomized clinical trial was carried out, predicting the possibility of a cross-over between the two treatment options, with patients who did not respond to either treatment. Treatments were, respectively, eccentric therapeutic exercise consisting of 30 min sessions of stretching and strengthening exercises, 5 days a week for 4 weeks (Groups A and D) and Extracorporeal Shock Waves Therapy (ESWT) according to a protocol of three sessions, one per week, each of 2000 pulses at a 4 Hz frequency and administering an energy flux density (EFD) varying between 0.03 mJ/mm2 and 0.17 mJ/mm2 (Groups B and C). Patients were evaluated at baseline (T0), 2 (T1), 4 (T2) and 6 months (T3) after the last session, using the Numeric Rating Scale (NRS), Low Extremity Functional Scale (LEFS) and Roles and Maudsley Scale (RMS). The whole study population demonstrated a progressive clinical reduction in pain according to NRS, a recovery from disability according to LEFS and a perception of recovery according to RMS within 6 months, with no significant differences between the four protocols (exercise; ESWT; exercise + ESWT; and ESWT + exercise). Both therapies are therefore valid options in patients with trochanteritis; the combination of the two therapies could be evaluated for those patients who do not respond to the single treatment.
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Affiliation(s)
- Angela Notarnicola
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience "DiBraiN", School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy
- Course of Motor and Sports Science, Department of Precision, Regenerative and Ionian Area Medicine, School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy
| | - Ilaria Ladisa
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience "DiBraiN", School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy
| | - Paola Lanzilotta
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience "DiBraiN", School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy
| | - Davide Bizzoca
- UOSD Vertebral Surgery, AOU Consorziale Policlinico di Bari, 70124 Bari, Italy
- PhD Course in Public Health, Clinical Medicine and Oncology, Department DiMePre-J, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Ilaria Covelli
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience "DiBraiN", School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy
- Course of Motor and Sports Science, Department of Precision, Regenerative and Ionian Area Medicine, School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy
| | - Francesco Paolo Bianchi
- Department of Interdisciplinary Medicine, School of Medicine and Surgery, University of Bari, 70124 Bari, Italy
| | - Giuseppe Maccagnano
- Orthopaedics Unit, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Foggia, General Hospital, 71122 Foggia, Italy
| | - Giacomo Farì
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy
| | - Biagio Moretti
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience "DiBraiN", School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy
- Course of Motor and Sports Science, Department of Precision, Regenerative and Ionian Area Medicine, School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy
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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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Lee JH, Kim EJ. A Comprehensive Review of the Effects of Extracorporeal Shock Wave Therapy on Stroke Patients: Balance, Pain, Spasticity. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050857. [PMID: 37241089 DOI: 10.3390/medicina59050857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023]
Abstract
Stroke remains a leading cause of disability worldwide, with survivors often experiencing impairments in balance, pain, spasticity, and control that limit their ability to perform daily living activities. Extracorporeal shock wave therapy (ESWT) has emerged as a potential treatment modality to improve these outcomes in stroke patients. This review aims to provide a comprehensive examination of the effects of ESWT on stroke patients, focusing on the theoretical background, balance, pain reduction, muscle spasticity and control, and upper and lower extremities. This study reviewed the use of ESWT in treating balance, pain, and spasticity in stroke patients, focusing on articles published in PubMed between January 2003 and January 2023. Systematic reviews related to stroke were used to provide an overview of stroke, and a total of 33 articles related to balance, pain, and spasticity were selected. ESWT has several shock wave generation methods and application methods, and it has been shown to have positive therapeutic effects on various aspects of rehabilitation for stroke patients, such as improving balance, reducing pain, decreasing muscle spasticity and increasing control, and enhancing functional activities of the upper and lower extremities. The efficacy of ESWT may vary depending on the patient's condition, application method, and treatment area. Therefore, it is important to apply ESWT according to the individual characteristics of each patient in clinical practice to maximize its potential benefits.
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Affiliation(s)
- Jung-Ho Lee
- Department of Physical Therapy, Kyungdong University, 815, Gyeonhwon-ro, Munmak-eup, Wonju-si 26495, Gang-won-do, Republic of Korea
| | - Eun-Ja Kim
- Department of Physical Therapy, Kyungdong University, 815, Gyeonhwon-ro, Munmak-eup, Wonju-si 26495, Gang-won-do, Republic of Korea
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Liang H, Chen K, Xie J, Yao L, Liu Y, Hu F, Li H, Lei Y, Wang Y, Lv L, Chen Z, Liu S, Liu Q, Wang Z, Li J, Chang YN, Li J, Yuan H, Xing G, Xing G. A Bone-Penetrating Precise Controllable Drug Release System Enables Localized Treatment of Osteoporotic Fracture Prevention via Modulating Osteoblast-Osteoclast Communication. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023:e2207195. [PMID: 36971278 DOI: 10.1002/smll.202207195] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Improving local bone mineral density (BMD) at fracture-prone sites of bone is a clinical concern for osteoporotic fracture prevention. In this study, a featured radial extracorporeal shock wave (rESW) responsive nano-drug delivery system (NDDS) is developed for local treatment. Based on a mechanic simulation, a sequence of hollow zoledronic acid (ZOL)-contained nanoparticles (HZNs) with controllable shell thickness that predicts various mechanical responsive properties is constructed by controlling the deposition time of ZOL and Ca2+ on liposome templates. Attributed to the controllable shell thickness, the fragmentation of HZNs and the release of ZOL and Ca2+ can be precisely controlled with the intervention of rESW. Furthermore, the distinct effect of HZNs with different shell thicknesses on bone metabolism after fragmentation is verified. In vitro co-culture experiments demonstrate that although HZN2 does not have the strongest osteoclasts inhibitory effect, the best pro-osteoblasts mineralization results are achieved via maintaining osteoblast-osteoclast (OB-OC) communication. In vivo, the HZN2 group also shows the strongest local BMD enhancement after rESW intervention and significantly improves bone-related parameters and mechanical properties in the ovariectomy (OVX)-induced osteoporosis (OP) rats. These findings suggest that an adjustable and precise rESW-responsive NDDS can effectively improve local BMD in OP therapy.
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Affiliation(s)
- Haojun Liang
- Department of Orthopedic, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, P. R. China
| | - Kui Chen
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Jing Xie
- State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing, 100081, P. R. China
| | - Lei Yao
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Yunpeng Liu
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Fan Hu
- Department of Orthopedic, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, P. R. China
| | - Hao Li
- Department of Orthopedic, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, P. R. China
| | - Yinze Lei
- State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing, 100081, P. R. China
| | - Yujiao Wang
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Linwen Lv
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Ziteng Chen
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Sen Liu
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Qiuyang Liu
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Zhijie Wang
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Jiacheng Li
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Ya-Nan Chang
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Juan Li
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Hui Yuan
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Gengyan Xing
- Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100043, P. R. China
| | - Gengmei Xing
- Department of Orthopedic, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, P. R. China
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Şah V, Elasan S, Kaplan Ş. Comparative effects of radial and focused extracorporeal shock wave therapies in coccydynia. Turk J Phys Med Rehabil 2023; 69:97-104. [PMID: 37201007 PMCID: PMC10186009 DOI: 10.5606/tftrd.2023.10371] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 10/18/2022] [Indexed: 05/20/2023] Open
Abstract
Objectives This study was conducted to compare the effects of radial and focused extracorporeal shock wave therapy (ESWT) in patients with coccydynia. Patients and methods In this prospective randomized double-blind study conducted between March 2021 and October 2021, 60 patients with coccydynia (50 males, 10 females; mean age: 35.9±12.0 years, range 18 to 65 years) were randomized into three groups (n=20) according to different wave types of ESWT: focused, radial, and sham. The Visual Analog Scale (VAS) was used for pain assessment, and the Oswestry Disability Index (ODI) was used for functional assessment in all patients before the treatment (baseline), after the completion of four sessions of treatment (fourth week), one month after the end of the treatment (eighth week), and three months after the end of the treatment (16th week). Results The mean body mass index of the participants was 26.2±3.0. Compared to baseline, the VAS scores at four weeks were reduced only in the radial ESWT group (p<0.05). Compared to baseline, the VAS and ODI scores at eight and 16 weeks were significantly reduced in both the focused and radial ESWT groups (p<0.05 for all). The radial ESWT group was significantly superior to the focused ESWT group in the comparisons between the groups at four weeks in the VAS values and at 16 weeks in the ODI scores (p<0.05 for all). Conclusion Radial and focused ESWT are both effective in treating coccydynia compared to sham ESWT. However, radial ESWT may be more effective in the treatment of coccydynia.
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Affiliation(s)
- Volkan Şah
- Department of Sports Medicine, Yüzüncü Yıl University School of Medicine, Van, Türkiye
| | - Sadi Elasan
- Department of Biostatistics, Yüzüncü Yıl University School of Medicine, Van, Türkiye
| | - Şeyhmus Kaplan
- Department of Sports Medicine, Yüzüncü Yıl University School of Medicine, Van, Türkiye
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The Efficacy of Focused Extracorporeal Shock Wave Therapy and Ultrasound Therapy in the Treatment of Calcar Calcanei: A Randomized Study. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8855687. [PMID: 36860813 PMCID: PMC9970705 DOI: 10.1155/2023/8855687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/22/2023]
Abstract
The prospective, simple randomized study assesses the effect of focused extracorporeal shock wave therapy (f-ESWT) on pain intensity and calcification size compared to the application of ultrasound physical therapy in treating patients with calcar calcanei. A total of 124 patients diagnosed with calcar calcanei were consecutively included in the study. The patients were divided into two groups: the experimental group (n = 62), which included the patients treated with f-ECWT, and the control group (n = 62), consisting of patients treated with the standard ultrasound therapy method. The experimental group's patients received ten therapy applications spaced seven days apart. The patients in the control group had ten ultrasound treatments on ten consecutive days over two weeks. All patients in both groups were tested using the Visual Analog Scale (VAS) to measure pain intensity before the beginning and at the end of treatment. The size of the calcification was assessed in all patients. The study hypothesizes that f-ESWT reduces the pain and the size of the calcification. Pain intensity reduction was registered in all patients. The calcification size in patients in the experimental group was reduced from the initial range of 2 mm-15 mm, to a content of 0.0 mm-6.2 mm. The calcification size in the control group ranged from 1.2 to 7.5 mm, without any change. None of the patients experienced any adverse reactions to the therapy. Patients treated with standard ultrasound therapy did not have a statistically significant reduction in the calcification size. In contrast, the patients in the experimental group treated with f-ESWT showed a substantial decrease in the calcification size.
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Guo J, Hai H, Ma Y. Application of extracorporeal shock wave therapy in nervous system diseases: A review. Front Neurol 2022; 13:963849. [PMID: 36062022 PMCID: PMC9428455 DOI: 10.3389/fneur.2022.963849] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/21/2022] [Indexed: 11/29/2022] Open
Abstract
Neurological disorders are one of the leading causes of morbidity and mortality worldwide, and their therapeutic options remain limited. Recent animal and clinical studies have shown the potential of extracorporeal shock wave therapy (ESWT) as an innovative, safe, and cost-effective option to treat neurological disorders. Moreover, the cellular and molecular mechanism of ESWT has been proposed to better understand the regeneration and repairment of neurological disorders by ESWT. In this review, we discuss the principles of ESWT, the animal and clinical studies involving the use of ESWT to treat central and peripheral nervous system diseases, and the proposed cellular and molecular mechanism of ESWT. We also discuss the challenges encountered when applying ESWT to the human brain and spinal cord and the new potential applications of ESWT in treating neurological disorders.
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Saldiran TÇ, Yazgan P, Akgöl AC, Mutluay FK. Radial shock-wave therapy for frozen shoulder patients with type 2 diabetes mellitus: a pilot trial comparing two different energy levels. Eur J Phys Rehabil Med 2022; 58:412-422. [PMID: 35191654 PMCID: PMC9980541 DOI: 10.23736/s1973-9087.22.07087-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Extracorporeal shock-wave therapy (ESWT) is highly recommended for the management of orthopedic shoulder pathologies. Yet, the clinical relevance of the dose difference effect of radial ESWT approaches in the management of frozen shoulder patients with type 2 diabetes mellitus remains uncertain. AIM The aim was to examine the short-term effects of medium-and high-energy levels of radial ESWT (rESWT) in the treatment of frozen shoulder patients with type 2 diabetes mellitus. DESIGN Prospective clinical pilot study. SETTING This study was conducted in an outpatient clinic. POPULATION Thirty-nine patients who had frozen shoulder untreated for at least 3 months, diagnosed with type 2 diabetes mellitus for ≥3 years were included. METHODS The patients were randomly allocated to receive either high-energy rESWT (hrESWT), or medium-energy rESWT (mrESWT) or placebo at 8 Hz twice a week for six weeks. The primary outcome measure was pain, evaluated by the Visual Analog Scale (VAS) Score. Secondary outcome measures were function evaluated by the Shoulder Pain and Disability Index (SPADI) Score, and shoulder active range of motion (AROM). The mechanical properties of the deltoid and trapezius muscles were assessed using the MyotonPRO (Myoton AS, Tallinn, Estonia). RESULTS The mrESWT resulted in statistically significant reductions in night pain at 6 weeks (η<inf>p</inf>2=0.27, P=0.003). Significantly improved function (SPADI scores: -35.42±21.29 vs.-29.59±22.60; η<inf>p</inf>2=0.39, P˂0.001) was found in both hrESWT and mrESWT group by 6 weeks. Significantly higher mean shoulder AROM values were recorded for external rotation (η<inf>p</inf>2=0.53, P<0.001), and internal rotation (η<inf>p</inf>2=0.21, P=0.020), in the hrESWT group at the 6th week. A significantly improved resting tone (η<inf>p</inf>2=0.58) and stiffness of deltoid muscle (η<inf>p</inf>2=0.62) were found in the mrESWT group (P<0.001). The trapezius muscle resting tone reduced with hrESWT (η<inf>p</inf>2=0.17, P=0.033). CONCLUSIONS Regardless of the energy levels, rESWT appears to be an effective therapeutic intervention for frozen shoulder patients with type 2 diabetes mellitus in the short-term results. CLINICAL REHABILITATION IMPACT Our results suggest that this rESWT can be a useful strategy for the rehabilitation of frozen shoulder patients with type 2 diabetes mellitus. This is the first study on dose difference effectiveness in terms of the clinical significance of rESWT which is key to transfer research evidence into practice.
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Affiliation(s)
- Tülay Ç Saldiran
- School of Health Sciences, Department of Physiotherapy and Rehabilitation, Bitlis Eren University, Bitlis, Turkey -
| | - Pelin Yazgan
- Department of Physical Therapy and Medicine, Faculty of Medicine, Istanbul Okan University, Istanbul, Turkey
| | - Ahmet C Akgöl
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Okan University, Istanbul, Turkey
| | - Fatma K Mutluay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
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Catapano M, Robinson DM, Schowalter S, McInnis KC. Clinical evaluation and management of calcific tendinopathy: an evidence-based review. J Osteopath Med 2022; 122:141-151. [PMID: 35119231 DOI: 10.1515/jom-2021-0213] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/29/2021] [Indexed: 11/15/2022]
Abstract
Calcific tendinopathy (CT) is an important musculoskeletal condition most commonly seen in the shoulder girdle, accounting for 10-42% of all shoulder pain. Despite the high prevalence within the shoulder region, CT has been demonstrated in many tendons throughout the axial and appendicular skeleton. Unlike degenerative tendinopathies, CT appears to be a self-limiting condition that affects otherwise-healthy tendon with deposition of calcium hydroxyapatite crystals between healthy tenocytes. In patients with functionally limiting symptoms or pain, the clinical course may be accelerated through a multitude of treatments including physical therapy and pain management, extracorporeal shock wave therapy, ultrasound-guided percutaneous lavage (UGPL), and operative debridement. Currently, the most efficacious and frequently utilized treatment for shoulder CT is UGPL due to its ability to effectively reduce calcium burden and pain while limiting soft-tissue damage. However, more evidence regarding the treatment and course of CT is needed before determining the most appropriate treatment at all potential sites of CT.
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Affiliation(s)
- Michael Catapano
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA
| | - David M Robinson
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Sean Schowalter
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA
| | - Kelly C McInnis
- Department of Physical Medicine and Rehabilitation and Division of Sports Medicine, Massachusetts General Hospital and Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA
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Robinson DM, Schowalter S, McInnis KC. Update on Evaluation and Management of Calcific Tendinopathy. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00317-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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