scholarly journals The Impact of Extracorporeal Shockwave Therapy on the Reported Pain Levels of Chronic Patients in a Clinical Setting

2020 ◽  
Author(s):  
Edward J. Cremata ◽  
Edward E Cremata ◽  
Ulyss Bidkaram ◽  
Bryce Brown ◽  
Allan Radman
Keyword(s):  
Linear Relationship ◽  
The Body ◽  
Pain Level ◽  
Medium Energy ◽  
Point Scale ◽  
Extracorporeal Shockwave Therapy ◽  
Shockwave Therapy ◽  
Point Reduction ◽  
Final Treatment ◽  
Treatment Number

AbstractBackgroundA review of literature for in-office, low to medium energy (.04mj/mm2 to .4mj/mm2) Extracorporeal Shockwave Therapy (ESWT) shows a substantial body of evidence suggesting strong efficacy and safety for the use of this form of Acoustic Compression Therapy. Much of this evidence is focused on the treatment of a specific region of the body, such as lateral epicondylitis, plantar fasciitis, and shoulder tendinopathies. This evaluation is designed to address the clinical utility of low to medium energy ESWT in an outpatient health care office setting, including delivery to multiple regions of the body, and for patients considered good candidates based on the failure of at least six months of prior conservative care.MethodsOrdinary least squares (OLS) models with errors clustered at the patient level estimate the association between shockwave treatments and patient-reported pain levels. Additional models utilizing polynomial treatment indicators test for a non-linear relationship between treatment number and reported pain level.ResultsFor the sixty-one patients represented in this analysis, the mean reduction in pain was 2.3 points on a 10 point scale, representing a 47% reduction in average reported pain levels. Results suggest that each treatment is associated with a 0.33 point reduction in reported pain levels (on a 10 point scale), controlling for patient demographics and treatment intensity. Additional models utilizing polynomial treatment indicators suggest a non-linear relationship between treatment number and reported pain level, indicating that the initial benefit of treatment is a 0.67 point reduction in pain for the first treatment, and falling slightly with each subsequent treatment. A subset of patients responded to follow up requests to ascertain reported pain levels at least three months after the final treatment. All patients were contacted, out of which 24 responded, reporting average pain levels of 2.9 out of 10, a substantial improvement from initial reported pain levels following final treatment (4.0), representing a decrease of 28%.ConclusionThe results suggest the use of Acoustic Compression at these doses on properly selected cases can improve clinical outcomes for conservatively treated patients who may otherwise end up requiring more aggressive measures in the absence of ESWT. Evidence reviewed suggests that continued healing time leads to further improvement.

Extracorporeal Shockwave Therapy for Shoulder Lameness in Dogs

2015 ◽  
Vol 51 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Willem Becker ◽  
Michael P. Kowaleski ◽  
Robert J. McCarthy ◽  
Cara A. Blake
Keyword(s):  
Medical Records ◽  
Short Term ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Inflammatory Conditions ◽  
Final Treatment ◽  
Negative Side Effects ◽  
Improved Function

The purpose of this article was to describe the outcome of dogs with instability, calcifying, and inflammatory conditions of the shoulder treated with extracorporeal shockwave therapy (ESWT). Medical records for 15 dogs with lameness attributable to the shoulder that failed previous conservative management were retrospectively reviewed. ESWT was delivered to those dogs q 3–4 wk for a total of three treatments. Short-term, in-hospital subjective lameness evaluation revealed resolution of lameness in three of nine dogs and improved lameness in six of nine dogs available for evaluation 3–4 wk following the final treatment. Long-term lameness score via telephone interview was either improved or normal in 7 of 11 dogs (64%). ESWT may result in improved function based on subjective patient evaluation and did not have any negative side effects in dogs with lameness attributable to instability, calcifying, and inflammatory conditions of the shoulder.

scholarly journals Efficacy of Different Energy Levels Used in Focused and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Meta-Analysis of Randomized Placebo-Controlled Trials

2019 ◽  
Vol 8 (9) ◽  
pp. 1497 ◽  
Author(s):  
Wang ◽  
Chen ◽  
Huang ◽  
Huang ◽  
Cheng ◽  
...  
Keyword(s):  
Plantar Fasciitis ◽  
Meta Analysis ◽  
Energy Levels ◽  
High Energy ◽  
Control Group ◽  
Medium Energy ◽  
Extracorporeal Shockwave Therapy ◽  
Shockwave Therapy ◽  
Vas Scores

The objective of this study was to assess the efficacy of different energy levels used in extracorporeal shockwave therapy (ESWT) in the treatment of plantar fasciitis using a systematic review and meta-analysis. We searched PubMed, Embase, and Cochrane library, from inception to March 2019 for randomized controlled trials that compared ESWT with placebo in patients with plantar fasciitis. The risk of bias for selected articles was assessed based on the Cochrane Handbook Systematic Review of Interventions. The pooled data were estimated by the mean difference or odds ratio. The meta-analysis showed that the high-energy ESWT group had a better success rate than the control group only at a three-month follow-up, but no significant difference between groups was observed for the other follow-up visits (1 and 12 months). In addition, no significant differences in visual analog scale (VAS) scores between groups were observed for all the follow-up visits (one-month and three-month). On the contrary, the medium-energy ESWT group had significantly better success rates than the control group for all the follow-up visits (3, 6, and 12 months). In addition, the medium-energy ESWT group had significant improvement in VAS scores compared with the control group for all the follow-up visits (1, 3, 6, and 12 months) after removing the extreme values. The low-energy ESWT group had significant improvement in VAS scores compared with the control group for all the follow-up visits (3 and 12 months). Otherwise, focused ESWT seems to be more effective than radial ESWT when compared with the control group. Use of local anesthesia can reduce the efficacy of low- and high-energy ESWTs. Our meta-analysis suggested that medium-energy ESWT in the treatment of plantar fasciitis was more effective than the control group. A limited number of trials related to low- and high-energy ESWTs were included in our meta-analysis. More research is required to confirm the efficacy of low- and high-energy ESWTs in future studies.

Men’s Hunger, Food Consumption, and Preferences for Female Body Types

2014 ◽  
Vol 45 (6) ◽  
pp. 495-497 ◽  
Author(s):  
Nicolas Guéguen
Keyword(s):  
Food Consumption ◽  
Female Body ◽  
The Body ◽  
Slender Body ◽  
Mediation Effect ◽  
Point Scale ◽  
Body Type ◽  
Experimental Conditions

Nelson and Morrison (2005 , study 3) reported that men who feel hungry preferred heavier women. The present study replicates these results by using real photographs of women and examines the mediation effect of hunger scores. Men were solicited while entering or leaving a restaurant and asked to report their hunger on a 10-point scale. Afterwards, they were presented with three photographs of a woman in a bikini: One with a slim body type, one with a slender body type, and one with a slightly chubby body. The participants were asked to indicate their preference. Results showed that the participants entering the restaurant preferred the chubby body type more while satiated men preferred the thinner or slender body types. It was also found that the relation between experimental conditions and the choices of the body type was mediated by men’s hunger scores.

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.

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