scholarly journals The Effectiveness of Combined Extracorporeal Shockwave Therapy and Exercise for Plantar Heel Pain: A Systematic Review

2022 ◽  
Vol 000 (000) ◽  
pp. 000-000
Author(s):  
Ian Burton ◽  
Aisling McCormack
Keyword(s):  
Systematic Review ◽  
Heel Pain ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Plantar Heel Pain

scholarly journals Combined extracorporeal shockwave therapy and exercise for the treatment of tendinopathy: A Narrative review

2020 ◽  
Author(s):  
Ian Burton
Keyword(s):  
Rotator Cuff ◽  
Combined Treatment ◽  
Tendon Healing ◽  
Heel Pain ◽  
Patellar Tendinopathy ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Plantar Heel Pain ◽  
Lateral Elbow

Tendinopathy is a chronic degenerative musculoskeletal disorder that is common in both athletes and the general population. Exercise and extracorporeal shockwave therapy (ESWT) are among the most common treatments used to mediate tendon healing and regeneration. The review presents current understanding of mechanisms of action of ESWT and exercise in isolation and briefly synthesises evidence of their effectiveness for various tendinopathies. The central purpose of the review is to synthesise research findings investigating the combination of ESWT and exercise for five common tendinopathies (plantar heel pain, rotator cuff, lateral elbow, Achilles, and patellar tendinopathy) and provide recommendations on clinical applicability. Collectively, the available evidence indicates that ESWT combined with exercise in the form of eccentric training, tissue specific stretching or heavy slow resistance training are effective for specific tendinopathies and can therefore be recommended in treatment. Whilst there are at present a limited number of studies investigating combined EWST and exercise approaches, there is evidence to suggest that the combination improves outcomes in treatment of plantar heel pain, Achilles, lateral elbow, and rotator cuff tendinopathy. However, despite overall positive outcomes in patellar tendinopathy, the combined treatment has not been shown at present to offer additional benefit over eccentric exercise alone.

scholarly journals The effectiveness of combined extracorporeal shockwave therapy and exercise for plantar heel pain: A systematic review

2020 ◽  
Author(s):  
Ian Burton
Keyword(s):  
Systematic Review ◽  
Laser Therapy ◽  
Heel Pain ◽  
High Quality ◽  
Extracorporeal Shockwave Therapy ◽  
Shockwave Therapy ◽  
Plantar Heel Pain ◽  
Moderate Quality ◽  
High Quality Evidence ◽  
Quality Evidence

Background: Plantar heel pain (PHP) is a common musculoskeletal disorder, with both extracorporeal shockwave therapy (ESWT) and specific exercise such as plantar fascia specific stretching shown to be effective treatments. This review aimed to evaluate the effectiveness of combined ESWT and exercise interventions versus other interventions in treating PHP. Methods: A systematic review of effectiveness was conducted, adhering to the PRISMA guidelines. Five databases were searched for studies published between January 2000 and March 2020, with 12 studies meeting the inclusion criteria. The Grading of Recommendations Assessment Development and Evaluation (GRADE) framework was used to determine quality of recommendations. Results: The 12 included studies (n = 861) compared ESWT and stretching with various other treatments. Due to clinical and methodological heterogeneity, pooling of data was not possible, and a narrative synthesis of findings was provided. There was high quality evidence that combined ESWT and stretching interventions are more effective than those using either alone or botulinum toxin injections, and low-quality evidence of superiority versus ultrasound and stretching. There was moderate quality evidence that combined ESWT and stretching is no more effective than corticosteroid injection (CSI), and high quality evidence that the combination is no more effective than blood-derived injection therapies, custom orthotics or low-level laser therapy (LLLT) combined with stretching. There is high quality evidence that the use of topical corticosteroid or laser therapy in combination with ESWT and stretching increases effectiveness compared to ESWT and stretching alone, and moderate quality evidence for the additive effective of dry needling. Conclusions: Combined ESWT and stretching treatments are effective and may be recommended where they are available and practical to implement. Further high-quality studies with larger sample sizes and longer follow-up durations comparing combined interventions for PHP, including different exercise types such as resistance training are required.

scholarly journals Extracorporeal Shockwave Therapy Treatment in Upper Limb Diseases: A Systematic Review

2020 ◽  
Vol 9 (2) ◽  
pp. 453 ◽  
Author(s):  
Gianluca Testa ◽  
Andrea Vescio ◽  
Stefano Perez ◽  
Alberto Consoli ◽  
Luciano Costarella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Upper Limb ◽  
Full Text ◽  
High Energy ◽  
Reference List ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Text Reading

Background: Rotator cuff tendinopathy (RCT), subacromial impingement (SAIS), and medial (MEP) and lateral (LEP) epicondylitis are the most common causes of upper limb pain caused by microtrauma and degeneration. There are several therapeutic choices to manage these disorders: extracorporeal shockwave therapy (ESWT) has become a valuable option. Methods: A systematic review of two electronic medical databases was performed by two independent authors, using the following inclusion criteria: RCT, SAIS, MEP, and LEP, ESWT therapy without surgical treatment, with symptoms duration more than 2 months, and at least 6 months of follow-up. Studies of any level of evidence, reporting clinical results, and dealing with ESWT therapy and RCT, SAIS, MEP, and LEP were included. Results: A total of 822 articles were found. At the end of the first screening, following the previously described selection criteria, we selected 186 articles eligible for full-text reading. Ultimately, after full-text reading, and reference list check, we selected 26 articles following previously written criteria. Conclusions: ESWT is a safe and effective treatment of soft tissue diseases of the upper limbs. Even in the minority cases when unsatisfied results were recorded, high energy shockwaves were nevertheless suggested in prevision of surgical treatment.

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