scholarly journals Efficacy of Extracorporeal Shock Wave Therapy for Achilles Tendinopathy: A Meta-analysis

2020 ◽  
Vol 8 (2) ◽  
pp. 232596712090343
Author(s):  
Yifei Fan ◽  
Ziyan Feng ◽  
Jun Cao ◽  
Weili Fu
Keyword(s):  
Shock Wave ◽  
Energy Level ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Extracorporeal Shock Wave Therapy ◽  
Achilles Tendinopathy ◽  
Shock Wave Therapy ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Extracorporeal Shock Wave

Background: Achilles tendinopathy is a frequent sports injury, and extracorporeal shock wave therapy (ESWT) has been proposed as a treatment. Purpose: To compare outcomes between ESWT and other nonsurgical intervention (including sham shock wave therapy) in Achilles tendinopathy patients. Study Design: Systematic review; Level of evidence, 2. Methods: We included 5 randomized controlled trials and 3 case-control studies published between 2005 and 2018. We analyzed pain scores and other outcomes that were reported in more than 3 of the 8 studies. Results: ESWT was associated with significantly better scores than comparison therapy on the visual analog scale for pain ( P < .01), American Orthopaedic Foot & Ankle Society scale ( P = .01), Likert scale for satisfaction ( P = .03), Roles and Maudsley scale ( P < .01), Victorian Institute of Sports Assessment–Achilles questionnaire ( P < .01), and numerical rating scale ( P = .02). The 2 patient groups did not differ significantly in tenderness ( P = .34) or pain threshold ( P = .24). Subgroup analysis showed that ESWT led to better VAS pain scores than comparison treatments at both low-energy level (0.06-0.11 mJ/mm2) and medium-energy level (0.12-0.25 mJ/mm2) and at both shorter (<6 months) and longer (≥6 months) follow-up. Conclusion: ESWT improves pain and functional outcomes in patients with Achilles tendinopathy. Further research is needed to determine the optimal energy level.

scholarly journals Efficacy and safety of treating chronic nonspecific low back pain with radial extracorporeal shock wave therapy (rESWT), rESWT combined with celecoxib and eperisone (C+E) or C+E alone: a prospective, randomized trial

2020 ◽  
Author(s):  
Xuejiao Guo ◽  
Lin Li ◽  
Zhe Yan ◽  
Yunze Li ◽  
Zhiyou Peng ◽  
...  
Keyword(s):  
Shock Wave ◽  
Low Back Pain ◽  
Back Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Low Back ◽  
Shock Wave Therapy ◽  
Level Of Evidence ◽  
Extracorporeal Shock Wave

AbstractBackgroundTo investigate whether respectively radial extracoporeal shock wave therapy (rESWT) or a combination of rESWT, Celecoxib and Eperisone (rESWT+C+E) are superior in reducing pain in subjects with chronic nonspecific low back pain (cnsLBP) compared to C+E alone (a standard treatment of this condition in China).Methods140 subjects with cnsLBP were randomly allocated to rESWT (n=47), rESWT+C+E (n=45) or C+E alone (n=48) for four weeks. Outcome was evaluated using the Pain Self-Efficacy Questionnaire (PSEQ), Numerical Rating Scale (NRS), Oswestry Low Back Pain Disability Questionnaire and Patient Health Questionnaire 9, collected at one week (W1), W2, W3, W4 and W12 after beginning of the therapy.ResultsAll scores showed a statistically significant improvement over time. The PSEQ and NRS scores showed a significant Time × Treatment effect. Subjects treated with rESWT had significantly lower mean NRS values than subjects treated with rESWT+C+E at W1 and W3, as well as than subjects treated with C+E alone at W3 and W4. No severe adverse events were observed.ConclusionrESWT may be superior to respectively rESWT+C+E or C+E alone in reducing pain in subjects with cnsLBP. Level of Evidence: Level I, prospective, randomized, active-controlled trial.

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.

Effectiveness of Radial Extracorporeal Shock Wave Therapy (rESWT) When Combined With Supervised Exercises in Patients With Subacromial Shoulder Pain: A Double-Masked, Randomized, Sham-Controlled Trial

2017 ◽  
Vol 45 (11) ◽  
pp. 2547-2554 ◽  
Author(s):  
Elisabeth Kvalvaag ◽  
Jens Ivar Brox ◽  
Kaia Beck Engebretsen ◽  
Helene Lundgaard Soberg ◽  
Niels Gunnar Juel ◽  
...  
Keyword(s):  
Shock Wave ◽  
Rotator Cuff ◽  
Shoulder Pain ◽  
Controlled Trial ◽  
Extracorporeal Shock Wave Therapy ◽  
Mean Difference ◽  
Shock Wave Therapy ◽  
Level Of Evidence ◽  
Group Assignment ◽  
Extracorporeal Shock Wave

Background: Subacromial shoulder pain is a common complaint, and radial extracorporeal shock wave therapy (rESWT) is increasingly used to treat this condition. Although many therapists use rESWT in combination with supervised exercises, no studies have evaluated the additional effect of rESWT with supervised exercises for subacromial shoulder pain. Purpose: To assess whether rESWT is more effective than sham rESWT when combined with supervised exercises for improving pain and function in patients with subacromial shoulder pain. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients between 25 and 70 years of age with subacromial shoulder pain with and without calcification in the rotator cuff lasting at least 3 months were assessed for eligibility; 143 patients were recruited. Participants were allocated (1:1) by computer-generated randomization in blocks of 20 to receive either rESWT or sham rESWT in addition to supervised exercises. The rESWT and sham rESWT were performed once a week with additional supervised exercises once a week for the first 4 weeks. The following 8 weeks, the patients received supervised exercises twice a week. The primary outcome was change in the Shoulder Pain and Disability Index (SPADI) after 24 weeks. Patients and outcome assessors were masked to group assignment. Results: At 24 weeks, participants in both the sham group and the rESWT group had improved ( P < .001) in SPADI score compared with baseline (−23.9 points [SD, 23.8 points] and −23.3 points [SD, 25.0 points], respectively), but there were no differences between the groups (mean difference 0.7; 95% CI, −6.9 to 8.3; P = .76). Prespecified subgroup analysis of patients with calcification in rotator cuff showed that the rESWT group had a greater improvement in SPADI score after 24 weeks (mean difference −12.8; 95% CI, −24.8 to −0.8; P = .018). Conclusion: Radial ESWT offered no additional benefit to supervised exercises in the treatment of subacromial shoulder pain after 24 weeks, except in the subgroup of patients with calcification in the rotator cuff. Registration: NCT01441830 ( ClinicalTrials.gov identifier).

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
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