scholarly journals Extracorporeal Shockwave Therapy for the Treatment of Tendinopathies: Current Evidence on Effectiveness, Mechanisms, Limitations and Future Directions

2021 ◽  
Author(s):  
Ian Burton
Keyword(s):  
Current Evidence ◽  
Future Directions ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy

scholarly journals Extracorporeal Shockwave Therapy for the Treatment of Tendinopathies: Current Evidence on Effectiveness, Mechanisms, Limitations, and Future Directions

2020 ◽  
Author(s):  
Ian Burton
Keyword(s):  
Tendon Healing ◽  
Patellar Tendinopathy ◽  
Current Evidence ◽  
Future Research ◽  
Future Directions ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Research Findings ◽  
And Performance

Tendinopathy is a chronic degenerative tendon disorder which is characterised by pain, swelling and impaired physical function and performance, presenting in both athletes and the general population. Extracorporeal shockwave therapy (ESWT) is an increasingly common treatment for tendinopathy, which can initiate tendon healing and regeneration. The review presents current understanding of mechanisms of action of ESWT and provides a brief overview of its history and development. The central purpose of the review is to synthesise research findings investigating the effectiveness of ESWT for seven common tendinopathies (plantar heel pain, rotator cuff, lateral elbow, Achilles, gluteal, hamstring and patellar tendinopathy) and provide recommendations on clinical applicability. Collectively, the available evidence indicates that ESWT is effective and can be recommended in treatment for the seven tendinopathies. However, the evidence is stronger for certain tendinopathies compared to others and uncertainties remain regarding the optimal ESWT treatment parameters. The consensus from recent literature is that although ESWT can be effective in isolation it should be combined with other treatments in tendinopathy, which needs to be addressed in future research.

Role of extracorporeal shockwave therapy in patients with rotator cuff tendinopathy: synthetic analysis of last two decades

2021 ◽  
pp. 1-16
Author(s):  
Arooj Fatima ◽  
Haider Darain ◽  
Syed Amir Gilani ◽  
Ashfaq Ahmad ◽  
Asif Hanif ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Grey Literature ◽  
Functional Mobility ◽  
Current Evidence ◽  
Eligibility Criteria ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Rotator Cuff Tendinopathy

Abstract Objective: The study is designed explore the current evidence on effectiveness of shockwave therapy in patients with rotator cuff tendinopathy from 2000-2019. Methodology: Data bases were searched including Cochrane, Medline, Embase and PEDro from 2000 to latest. A thorough search was performed to retrieve articles missed through databases as well as unpublished grey literature. Methodological quality assessment was performed using Cochrane risk of bias tool and included studies were critically appraised using PEDro scale. Results: In current review, 11 articles were finally included based on eligibility criteria. However data was not extractable from 2 studies due to which 9 studies were finally reviewed as shown in figure I. There were 8 Randomized trials and 1 randomized pilot study. The summary of critical appraisal of included studies through PEDro scale was done which showed that 4 studies had high quality and 5 studies fall under the category of fair. Conclusion: Extracorporeal shockwave therapy showed significant improvement in terms of reducing pain and improving functional mobility as compared to traditional rehabilitation in patients with rotator cuff tendinopathy in some studies however in others results were not found to be significant. This systematic review has established that there is no consensus between both interventions however; extracorporeal shockwave therapy is an acceptable practical alternative among patients having tendinopathy. Keywords: Extracorporeal shockwave therapy, Rotator cuff tendinopathy, Systematic review, Continuous...

scholarly journals Focused Extracorporeal Shockwave Therapy in Physical Medicine and Rehabilitation

2020 ◽  
Author(s):  
Richard Crevenna ◽  
Michael Mickel ◽  
Othmar Schuhfried ◽  
Christina Gesslbauer ◽  
Andrej Zdravkovic ◽  
...  
Keyword(s):  
Pain Syndrome ◽  
Surrounding Tissue ◽  
Patellar Tendinopathy ◽  
Physical Medicine ◽  
Physical Treatment ◽  
Extracorporeal Shockwave Therapy ◽  
Non Union ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Physical Medicine And Rehabilitation

Abstract Purpose of Review Focused extracorporeal shockwave therapy (fESWT) is a physical treatment modality developed over the last 25 years for musculoskeletal indications. It has many indications in the field of physical medicine and rehabilitation (PM&R) and is effective, time-efficient, and cost-efficient. This review focuses on basics and on clinical indications as well as on significant trends in fESWT. Recent Findings In PM&R, stimulation of healing processes in tendons, surrounding tissue, and bones via mechanotransduction seems to be a relevant biological effect. The International Society for Medical Shockwave Treatment (ISMST) describes different types of indications (such as approved standard indications—in accordance with most scientific evidence—like calcifying tendinopathy of the shoulder, plantar fasciitis lateral epicondylopathy of the elbow, greater trochanter pain syndrome, patellar tendinopathy, Achilles tendinopathy and bone non-union, common empirically tested clinical uses, exceptional or expert indications, and experimental indications). Summary fESWT is a relevant treatment option in PM&R and regenerative medicine. In recent years, historical paradigms (for example, application in cancer patients) have changed and new indications (such as nerve regeneration, myofascial trapezius syndrome, low back pain, dermatosclerosis, and lymphedema) are supported. Future translational research should focus on establishing actual exceptional indications and experimental indications for clinical routine.

scholarly journals Extracorporeal shockwave therapy versus musculoskeletal mesotherapy for Achilles tendinopathy in athlete

2020 ◽  
Vol 47 (1) ◽  
Author(s):  
Reem EL-Mallah ◽  
Enas A. Elattar
Keyword(s):  
Treatment Options ◽  
Visual Analogue Score ◽  
Achilles Tendinopathy ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Tendon Thickness ◽  
Vas Scores ◽  
Tendon Pathology

Abstract Background Achilles tendinopathy (AT) is considered the commonest tendon pathology, occurring mainly in athletes. Different conservative treatment options have been introduced but with short-term effects; however, extracorporeal shockwave therapy (ESWT) and mesotherapy (MT) injections were claimed to provide longer effects and could be used in cases failure of response to conservative treatments. The objective of our prospective 12-week study was to compare the effect of ESWT and MT on chronic Achilles tendinopathy in athletes by both clinical and ultrasonographical assessment. Results Forty patients with chronic AT diagnosed clinically and with high-resolution ultrasound (US) randomly allocated in two groups first received weekly ESWT session, and the other group underwent weekly MT sessions for 4 consecutive weeks. Both groups improved during the treatment and follow-up period. The mean visual analogue score (VAS) decreased in both the ESWT group and the MT group. Mean American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score and VAS scores were not significantly different between ESWT and MT groups at the 4th and the 12th week of follow-up. However, US assessment significantly improved after 12 weeks in the ESWT group (as regards tendon thickness, calcifications, and Doppler signal), and for the mesotherapy group, there was the only improvement of tendon thickness. Conclusion ESWT showed improvement of pain and inflammation and calcifications of AT than MT injections, which was documented by US improved findings at week 12 follow up.

Extracorporeal shockwave therapy in spinal cord injury, early to advance to clinical trials? A systematic review and meta-analysis on animal studies

2021 ◽  
pp. 197140092110268
Author(s):  
Seyedeh Niloufar Rafiei Alavi ◽  
Arian Madani Neishaboori ◽  
Mahmoud Yousefifard
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Trials ◽  
Animal Models ◽  
Meta Analysis ◽  
Mean Difference ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Cord Injury

Background As there is no consensus over the efficacy of extracorporeal shockwave therapy in the management of spinal cord injury complications, the current meta-analysis aims to investigate preclinical evidence on the matter. Methods The search strategy was developed based on keywords related to ‘spinal cord injury’ and ‘extracorporeal shockwave therapy’. A primary search was conducted in Medline, Embase, Scopus and Web of Science until the end of 2020. Studies which administered extracorporeal shockwave therapy on spinal cord injury animal models and evaluated motor function and/or histological findings were included. The standardised mean difference with a 95% confidence interval (CI) were calculated. Results Seven articles were included. Locomotion was significantly improved in the extracorporeal shockwave therapy treated group (standardised mean difference 1.68, 95% CI 1.05–2.31, P=0.032). It seems that the efficacy of extracorporeal shockwave therapy with an energy flux density of 0.1 mJ/mm2 is higher than 0.04 mJ/mm2 ( P=0.044). Shockwave therapy was found to increase axonal sprouting (standardised mean difference 1.31, 95% CI 0.65, 1.96), vascular endothelial growth factor tissue levels (standardised mean difference 1.36, 95% CI 0.54, 2.18) and cell survival (standardised mean difference 2.49, 95% CI 0.93, 4.04). It also significantly prevents axonal degeneration (standardised mean difference 2.25, 95% CI 1.47, 3.02). Conclusion Extracorporeal shockwave therapy significantly improves locomotor recovery in spinal cord injury animal models through neural tissue regeneration. Nonetheless, in spite of the promising results and clinical application of extracorporeal shockwave therapy in various conditions, current evidence implies that designing clinical trials on extracorporeal shockwave therapy in the management of spinal cord injury may not be soon. Hence, further preclinical studies with the effort to reach the safest and the most efficient treatment protocol are needed.

scholarly journals Extracorporeal shockwave therapy in diabetic foot ulcers

2015 ◽  
Vol 24 ◽  
pp. 207-209 ◽  
Author(s):  
Ching-Jen Wang ◽  
Jai-Hong Cheng ◽  
Yur-Ren Kuo ◽  
Wolfgang Schaden ◽  
Rainer Mittermayr
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy
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