Power Doppler Ultrasound Findings before and after Focused Extracorporeal Shock Wave Therapy for Achilles Tendinopathy: A Pilot Study on Pain Reduction and Neovascularization Effect

2019 ◽  
Vol 45 (5) ◽  
pp. 1316-1323 ◽  
Author(s):  
Andrea Santamato ◽  
Raffaele Beatrice ◽  
Maria Francesca Micello ◽  
Francesca Fortunato ◽  
Francesco Panza ◽  
...  
Keyword(s):  
Shock Wave ◽  
Pilot Study ◽  
Power Doppler ◽  
Extracorporeal Shock Wave Therapy ◽  
Achilles Tendinopathy ◽  
Power Doppler Ultrasound ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave ◽  
Ultrasound Findings ◽  
Before And After

scholarly journals Line- and Point-Focused Extracorporeal Shock Wave Therapy for Achilles Tendinopathy: A Placebo-Controlled RCT Study

2021 ◽  
pp. 194173812199179
Author(s):  
Matthias Gatz ◽  
Sebastian Schweda ◽  
Marcel Betsch ◽  
Timm Dirrichs ◽  
Matias de la Fuente ◽  
...  
Keyword(s):  
Shock Wave ◽  
Power Doppler ◽  
Extracorporeal Shock Wave Therapy ◽  
Achilles Tendinopathy ◽  
Shock Wave Therapy ◽  
Ultrasound Tissue Characterization ◽  
Score Improvement ◽  
Extracorporeal Shock Wave ◽  
Tendon Adaptation ◽  
Over Time

Background: Extracorporeal shock wave therapy (ESWT) is a widely considered treatment option for Achilles tendinopathy. Line-focused ESWT is a novel technique treating a larger tendon area than point-focused ESWT. Monitoring capacities of clinical symptoms with ultrasound under ESWT treatment are unknown. Hypothesis: Point- and line-focused ESWT have a superior outcome than placebo ESWT. ESWT leads to morphological tendon changes detectable with ultrasound. Study Design: Single-blinded placebo-controlled randomized contolled trial. Level of Evidence: Level 1. Methods: The study was conducted in 3 cohorts, namely ESWT point (n = 21), ESWT line (n = 24), and ESWT placebo (n = 21). Victorian Institute of Sports Assessment–Achilles (VISA-A) score was measured before the intervention (T0), after 6 weeks (T1), and after 24 weeks (T2). All cohorts performed daily physiotherapy for 24 weeks and received 4 sessions of point-focused, line-focused, or placebo ESWT in the first 6 weeks. Ultrasound was performed with B-mode, power Doppler, shear wave elastography (SWE) at T0 and T2 and with ultrasound tissue characterization (UTC) at T0, T1, and T2. Data were analyzed with a mixed analysis of variance and t test. Results: There was a significant VISA-A improvement over time for all groups ( P < 0.001). ESWT point had the strongest VISA-A score improvement +23 (ESWT line: +18; ESWT placebo: +15), but there was no significant interaction between time and any of the groups: F(4, 116) = 1.393; P = 0.24. UTC, power Doppler, and B-mode could not show significant alterations over time. SWE revealed a significant increase of elastic properties for ESWT point in the insertion ( t = −3.113, P = 0.03) and midportion ( t = −2.627, P = 0.02) over time. Conclusion: There is a significant VISA-A score improvement for all study groups without a statistically significant benefit for ESWT point or ESWT line compared with ESWT placebo. Tendon adaptation could only be detected with SWE for ESWT point. Clinical Relevance: The present study could not detect any statistically relevant effect of ESWT compared to placebo. SWE is able to demonstrate tendon adaptation.

scholarly journals Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy

2015 ◽  
Vol 24 ◽  
pp. 154-159 ◽  
Author(s):  
Ludger Gerdesmeyer ◽  
Rainer Mittermayr ◽  
Martin Fuerst ◽  
Munjed Al Muderis ◽  
Richard Thiele ◽  
...  
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Therapy ◽  
Achilles Tendinopathy ◽  
Current Evidence ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave ◽  
Chronic Achilles Tendinopathy

scholarly journals The Effectiveness Of Radial Extracorporeal Shock Wave Therapy In Patients With Chronic Low Back Pain: A Prospective, Randomized, Single-Blinded Pilot Study

2019 ◽  
Vol Volume 14 ◽  
pp. 1859-1869 ◽  
Author(s):  
Karolina Walewicz ◽  
Jakub Taradaj ◽  
Katarzyna Rajfur ◽  
Kuba Ptaszkowski ◽  
Michał Tomasz Kuszewski ◽  
...  
Keyword(s):  
Shock Wave ◽  
Low Back Pain ◽  
Back Pain ◽  
Pilot Study ◽  
Chronic Low Back Pain ◽  
Extracorporeal Shock Wave Therapy ◽  
Low Back ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave

The Clinical Value of Extracorporeal Shock Wave Therapy Evaluated by Contrast-Enhanced Ultrasound for Noninfectious Nonunion

2021 ◽  
Vol 11 (8) ◽  
pp. 2080-2085
Author(s):  
Yinfeng Hu ◽  
Xuewen Jia ◽  
Yingchun Zhu ◽  
Youfeng Xu ◽  
Minhua Guo ◽  
...  
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Therapy ◽  
Healing Time ◽  
Contrast Enhanced Ultrasound ◽  
Shock Wave Therapy ◽  
Clinical Value ◽  
Extracorporeal Shock Wave ◽  
Contrast Enhanced ◽  
Before And After ◽  
Bone Nonunion

Objectives: The aim of this study was to investigate the clinical value of Contrast-enhanced ultrasound (CEUS) in evaluating Extracorporeal shock wave therapy (ESWT) for noninfectious nonunion. Methods: Thirty-eight patients with long bone nonunion fractures whose were treated in our hospital from October 2016 to October 2019 were included (20 males and 18 females). The patients received ESWT once a week for 12 consecutive weeks. CEUS was performed before and after the first ESWT session. According to the ratio of the perfusion area to the callus area, neovascular blood flow observed in CEUS was divided into 4 grades: grade 0 = 0%, grade 1 = 0–30%, grade 2 = 30–70% and grade 3 = 70–100%. The peak values of microbubbles perfusion in the callus area were recorded before and after ESWT. Each patient was followed up for 12 months to record the healing time. Nonunion over 12 months was considered a nonhealing fracture. To compare the ultrasonic data before and after ESWT, paired T test was used and the correlation between the ultrasonic data and the nonunion healing time, the pearson analysis was used. Results: Of the 38 patients, 35 patients achieved nonunion healing. The healing time ranged from 5 months to 12 months. Among the 38 patients, 24 patients had a microvascular health score of 0 points and 14 patients had a score of 1 point before treatment. After therapy, the neovascular health score was 0, 1, 2 and 3 in 5, 10, 15 and 8 patients, respectively. There was a statistically significant difference before and after treatment (P < 0.05). The peak value of microbubbles perfusion in the fracture site after ESWT was significantly higher than that before ESWT (P < 0.05). The greater of difference, the shorter of healing time. Conclusion: Under the supervision of CEUS, the changes in microvascular perfusion of noninfectious nonunion patients before and after ESWT effectively reflected the therapeutic effect. CEUS could predict the ESWT on bone nonunion at an early stage. Level of evidence: Level III.

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