scholarly journals The Effectiveness of Radial Extracorporeal Shock Wave Therapy for Chronic Achilles Tendinopathy: A Case Report with 18 Months Follow-Up

2018 ◽  
Vol 6 (3) ◽  
pp. 523-527
Author(s):  
Erieta Dimitrije Nikolikj-Dimitrova ◽  
Cvetanka Gjerakaroska-Savevska ◽  
Valentina Koevska ◽  
Biljana Mitrevska ◽  
Marija Gocevska ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Extracorporeal Shock Wave Therapy ◽  
Numeric Rating Scale ◽  
Achilles Tendinopathy ◽  
Pathological State ◽  
Extracorporeal Shock Wave ◽  
Insertional Achilles Tendinopathy

BACKGROUND: Achilles tendinopathy (AT) is a pathological state resulting from repetitive loading or stress on the tendon. The article aims to evaluate the effects of the low - energy radial extracorporeal shockwave therapy (RESWT) in the treatment of the adult with chronic insertional Achilles tendinopathy (AT) after the unsuccessful conservative treatment, with 18 months follow - up evaluation.CASE REPORT: We report the case of a 55 years - old male suffering from severe right posterior heel pain for 4 months. For his chronic insertional Achilles tendinopathy on the right heel, he received conservative treatment in the Institute of Physical Medicine and Rehabilitation. For outcome assessment, Numerical Rating Scale (NRS) for pain, the range of motion in the ankle, and Roles-Maudsley Score (RMS) for assessment of function were used. At the baseline the pain was severe, and he received physical therapy treatment. After unsuccessful conservative treatment, he underwent RESWT treatment. Numeric Rating Scale was significantly decreased at immediate, short-term and long-term follow-up. After the last treatment, the patient had no pain, and function assessed by Roles-Maudsley Score was excellent. At the follow-up check-up at 3, 6, 12 and 18 months the patient had no pain and excellent functional results.CONCLUSION: Radial ESWT is a safe and effective treatment even for a longer period for patients with chronic insertional Achilles tendinopathy.

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 Outcome of Extracorporeal Shock Wave Therapy for Insertional Achilles Tendinopathy with and without Haglund’s Deformity

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ziying Wu ◽  
Wei Yao ◽  
Shiyi Chen ◽  
Yunxia Li
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Therapy ◽  
Likert Scale ◽  
Achilles Tendinopathy ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave ◽  
Haglund’S Deformity ◽  
Insertional Achilles Tendinopathy ◽  
Time Point

Purpose.To compare the results of extracorporeal shock wave therapy (ESWT) for insertional Achilles tendinopathy (IAT) with or without Haglund’s deformity.Methods.Between September 2014 and May 2015, all patients who underwent ESWT were retrospectively enrolled in this study. A total of 67 patients were available for follow-up and assigned into nondeformtiy group (n=37) and deformtiy group (n=30). Clinical outcomes were evaluated by VISA-A Score and 6-point Likert scale.Results.The VISA-A score increased in both groups, from49.57±9.98at baseline to83.86±8.59at14.5±7.2months after treatment in nondeformity group (P<0.001) and from48.70±9.38at baseline to67.78±11.35at15.3±6.7months after treatment in deformity group (P<0.001). However, there was a greater improvement in VISA-A Score for the nondeformity group compared with deformity group (P=0.005). For the 6-point Likert scale, there were decreases from3.92±0.80at baseline to1.57±0.73at the follow-up time point in nondeformity group (P<0.001) and from4.0±0.76at baseline to2.37±1.03at the follow-up time point in deformity group (P<0.001). There was no significant difference in improvement of the 6-point Likert scale between both groups (P=0.062).Conclusions.ESWT resulted in greater clinical outcomes in patients without Haglund’s deformity compared with patients with Haglund’s deformity.

scholarly journals Utility of Ultrasonography in Assessing the Effectiveness of Extracorporeal Shock Wave Therapy in Insertional Achilles Tendinopathy

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Yi Cheng ◽  
Jian Zhang ◽  
Yehua Cai
Keyword(s):  
Shock Wave ◽  
Achilles Tendon ◽  
Extracorporeal Shock Wave Therapy ◽  
Achilles Tendinopathy ◽  
Shock Wave Therapy ◽  
Cross Sectional ◽  
Extracorporeal Shock Wave ◽  
Calcific Plaque ◽  
Insertional Achilles Tendinopathy

Introduction. The aim of this study was to investigate the utility of ultrasonography (US) for predicting and assessing the effectiveness of extracorporeal shock wave therapy (ESWT) in insertional Achilles tendinopathy (IAT).Methods. A total of 42 patients with an established diagnosis of chronic IAT were examined by US before ESWT and at 4 weeks and 12 weeks after ESWT. The thickness and cross-sectional area (CSA) of the Achilles tendon, size of calcific plaques, tendon structure score, and neovascularization score were measured at each time point.Results. After therapy, Victorian Institute of Sport Assessment-Achilles (VISA-A) scores increased significantly, and the size of calcific plaques decreased (P<0.05). Neovascularization scores increased at the 4th week and then decreased at the 12th week (P<0.05). The thickness, CSA, and structure of the Achilles tendon did not change. Variables observed by US at baseline were not associated with changes in VISA-A scores at follow-up. However, the changes in calcific plaque size and neovascularization scores were related to the improvement of VISA-A scores between pre- and posttherapy (P<0.01).Conclusion. Ultrasonography can reveal some changes in the insertion of the Achilles tendon after ESWT, but the outcome of ESWT in IAT cannot be predicted by the variables observed by US.

A Treatment-Based Classification Algorithm to Treat Achilles Tendinopathy: An Exploratory Case Series

2017 ◽  
Vol 26 (3) ◽  
pp. 260-268
Author(s):  
Patti Syvertson ◽  
Emily Dietz ◽  
Monica Matocha ◽  
Janet McMurray ◽  
Russell Baker ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Rating Scale ◽  
Case Series ◽  
Numeric Rating Scale ◽  
Achilles Tendinopathy ◽  
Global Rating ◽  
Physically Active ◽  
Indirect Treatment

Context:Achilles tendinopathy is relatively common in both the general and athletic populations. The current gold standard for the treatment of Achilles tendinopathy is eccentric exercise, which can be painful and time consuming. While there is limited research on indirect treatment approaches, it has been proposed that tendinopathy patients do respond to indirect approaches in fewer treatments without provoking pain.Objective:To determine the effectiveness of using a treatment-based-classification (TBC) algorithm as a strategy for classifying and treating patients diagnosed with Achilles tendinopathy.Participants:11 subjects (mean age 28.0 ±15.37 y) diagnosed with Achilles tendinopathy.Design:Case series.Setting:Participants were evaluated, diagnosed, and treated at multiple clinics.Main Outcome Measures:Numeric Rating Scale (NRS), Disablement in the Physically Active Scale (DPA Scale), Victorian Institute of Sport Assessment–Achilles (VISA-A), Global Rating of Change (GRC), and Nirschl Phase Rating Scale were recorded to establish baseline scores and evaluate participant progress.Results:A repeated-measures ANOVA was conducted to analyze NRS scores from initial exam to discharge and at 1-mo follow-up. Paired t tests were analyzed to determine the effectiveness of using a TBC algorithm from initial exam to discharge on the DPA Scale and VISA-A. Descriptive statistics were evaluated to determine outcomes as reported on the GRC.Conclusion:The results of this case series provide evidence that using a TBC algorithm can improve function while decreasing pain and disability in Achilles tendinopathy participants.

scholarly journals The Efficacy of Unfocused Extracorporeal Shock Waves for the Treatment of Achilles Tendinopathy

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0020
Author(s):  
Ashraf M. Fansa ◽  
Martin J. O’Malley ◽  
Eoghan T. Hurley ◽  
John G. Kennedy
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Extracorporeal Shock Wave Therapy ◽  
Achilles Tendinopathy ◽  
Shock Wave Therapy ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Extracorporeal Shock Waves ◽  
Extracorporeal Shock Wave

Category: Sports Introduction/Purpose: Extracorporeal shock wave therapy (ESWT) may be a viable non-invasive treatment modality for patients suffering from Achilles Tendinopathy. There seems to be a relationship between the ESWT protocol and patient outcomes. Data suggest that higher energy levels of shock waves together with adequate treatment delivery to the affected area is necessary to achieve favorable outcomes. The aim of this study is present our experience with the use of electrohydraulically produced unfocused extracorporeal shock waves for the treatment of Achilles Tendinopathy. Methods: A retrospective analysis of prospectively collected data was performed, including all patients who had received ESWT for plantar fasciitis heel pain between January 2013 and September 2018. The primary outcomes included change in pain intensity on the visual analog pain scale and patient satisfaction at final follow-up. Pre and post-procedure Foot and Ankle Outcome Scores were also assessed for change. Results: A total of 158 patients (179 heels) were followed-up for a mean duration of 17 +- 6.8 months post ESWT. The mean pre-ESWT pain VAS improved from 7.2 +- 1.4 to 2.3 +- 2.1 (p< 0.001) at final follow-up. The FAOS Symptoms, Pain, Function of Daily Living, Function of Sports and Recreational activities and Quality of Life domains improved from 57.7 +- 12.7 to 79.7 +- 13.6 (p< 0.001), from 35 +- 15.8 to 72.6 +- 22 (p< 0.001), from 43.8 +- 15.3 to 81.4 +- 11 (p< 0.001), from 41.2 +- 21.3 to 66.4 +- 18.3 (p< 0.001) and from 33.9 +- 17.4 to 78 +- 24.4 (p< 0.001), respectively. Overall, 85.4% were satisfied with the procedure at final follow-up. Conclusion: For patients with Achilles tendinopathy, unfocussed extracorporeal shock wave therapy appears to be a safe and viable non-invasive treatment option with a patient satisfaction rate of 85.4% and a 68% reduction in patient reported pain intensity.

scholarly journals Effectiveness and tolerability of focal versus radial extracorporeal shock wave therapy in patients affected by plantar fascia enthesopathy

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Edoardo Pisani ◽  
Claudio Curci ◽  
Antimo Moretti ◽  
Anna Mazzola ◽  
Marco Paoletta ◽  
...  
Keyword(s):  
Shock Wave ◽  
Plantar Fasciitis ◽  
Rating Scale ◽  
Plantar Fascia ◽  
Extracorporeal Shock Wave Therapy ◽  
Brief Pain Inventory ◽  
Severity Index ◽  
Numeric Rating Scale ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave

Plantar fascia enthesopathy is the most common cause of heel pain. Extracorporeal shock wave therapy (ESWT) is widely used in patients affected by this condition. The aim of this study was to compare efficacy and tolerability of ESWT modalities in the treatment of plantar fasciitis. We included 42 patients receiving 1 session of focused ESWT (f-ESWT group) or radial ESWT (r-ESWT group) per week for 3 weeks. Pain assessment was performed at baseline, before each session, and 1 month after the last session using brief pain inventory (BPI) severity index, and interference index (II). Tolerability was defined in terms of patient discomfort after treatment assessed by numeric rating scale at baseline and after each session. Plantar fascia changes in ultrasonography were further investigated. A significant reduction of BPI-II (P<0.001) was reported in both groups, although no between-group differences were found. Plantar fascia thickness showed significant reduction only in the f- ESWT group (P=0.028). Patient’s tolerability was significantly better in the r-ESWT group (P<0.05). Our study confirms that ESWT is effective for reducing pain and disability in patients affected by plantar fasciitis, although r- ESWT seems to be better tolerated.

Sign in / Sign up

Export Citation Format

Share Document