The Musculoskeletal Applications of Extracorporeal Shockwave Therapy for Foot and Ankle Disorders: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Tengku Nazim B. Tengku Yusof ◽  
Dexter Seow ◽  
Khushdeep S. Vig
Keyword(s):  
Musculoskeletal Disorders ◽  
Clinical Studies ◽  
Treatment Protocol ◽  
Case Series ◽  
Treatment Modalities ◽  
Cochrane Library ◽  
Foot And Ankle ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy

BACKGROUND: Extracorporeal Shockwave Therapy (ESWT) was first introduced into clinical practice in 1982 and has proved to be a beneficial adjuvant in the non-invasive treatment of numerous orthopaedic pathologies. However, clinical evidence reporting the use of ESWT in treating musculoskeletal disorders of the foot and ankle remain limited and a general consensus on its efficacy has not been achieved. Therefore, we reviewed the available literature and analysed any reported evidence in order to determine the benefits of ESWT in this cohort. METHODS: PubMed, EMBASE and Cochrane Library databases were systematically reviewed for any clinical studies that reported the treatment of foot and ankle disorders with ESWT. RESULTS: A total of 24 clinical studies, including 12 randomised control trials and 12 case series, were identified and included into this study. Analysis of the reported evidence indicate that ESWT can be beneficial in the symptomatic management of plantar fasciitis, calcaneal spur, Achilles tendinopathy and Morton's neuroma. However, differences in ESWT protocols used limit the generalizability of these findings and prevented an optimum treatment protocol from being determined. CONCLUSIONS: Evidence from the articles analysed in this review suggest a beneficial healing effect of ESWT in treating musculoskeletal disorders affecting the foot and ankle, with minimal side effects being reported. Thus, ESWT can be used safely in combination with other treatment modalities in order to achieve the best patient outcomes. Future studies should attempt to optimize the treatment protocols of ESWT to confirm these findings.

scholarly journals EXTRACORPOREAL SHOCKWAVE THERAPY IN SHOULDER INJURIES: PROSPECTIVE STUDY

2021 ◽  
Vol 29 (5) ◽  
pp. 268-273
Author(s):  
VICTOR OTAVIO MORAES DE OLIVEIRA ◽  
JULIANA MUNHOZ VERGARA ◽  
VICENTE FURQUIM DE OLIVEIRA ◽  
PAULO HENRIQUE SCHMIDT LARA ◽  
LUIZ CARLOS NOGUEIRA JÚNIOR ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Case Series ◽  
Post Treatment ◽  
Dash Score ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Significant Difference ◽  
Functional Scores

ABSTRACT Objective: To evaluate the functional results after the use of extracorporeal shockwave therapy (ESWT) in four groups of patients: tendinopathy, partial rotator cuff injury, adhesive capsulitis and calcareous tendinopathy of the rotator cuff at one month and three months after the end of treatment. Methods: Case series in which patients were evaluated according to the VAS of pain, range of motion of the shoulder, and functional questionnaires DASH and modified UCLA. Results: There was a significant increase in the measure of flexion, lateral rotation and shoulder abduction in the evaluations after treatment in relation to the baseline measurement (p < 0.001) and no evidence of significant difference was found between the post-treatment evaluations at one month and three months follow-up (p > 0.05). There was a significant reduction in the VAS score, increase in the UCLA score and a significant reduction in the DASH score in the post-treatment evaluations in relation to the baseline score (p < 0.001) and a significant improvement in the three-month evaluation in relation to one month (p < 0.05). Conclusion: Extracorporeal shockwave therapy proved to be efficient and safe in the treatment of shoulder pathologies, improving pain, range of motion and functional scores in all groups of patients evaluated in the study. Level of Evidence IV, Case series.

scholarly journals Comparison of the effect of hyaluronic acid injection versus extracorporeal shockwave therapy on chronic plantar fasciitis: Protocol for a randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0250768
Author(s):  
Gabriel Ferraz Ferreira ◽  
Davy Sevilla ◽  
Carolinne Nascimento Oliveira ◽  
Luiz Carlos Nogueira Junior ◽  
Gustavo Gonçalves Arliani ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Statistical Analysis ◽  
Repeated Measures ◽  
Plantar Fasciitis ◽  
Foot And Ankle ◽  
Ultrasound Guided ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Significant Difference

Background Plantar fasciitis is the most common cause of pain in the plantar region of the heel, and extracorporeal shockwave therapy (ESWT) is an option used in cases where conservative treatment fails. Hyaluronic acid (HA), initially used for osteoarthrosis, is a treatment option because it has been applied to extra-articular regions, such as tendons, ligaments, and fascia. The aim of the present study will be to evaluate the outcomes of pain, function, and personal satisfaction after a single injection of HA and to compare the results with those of ESWT in patients with chronic plantar fasciitis. Methods The study will include 80 patients who will be randomized to receive three sessions of ESWT (n = 40) or a single ultrasound-guided HA injection in the plantar fascia (n = 40). The outcomes will include the visual analog pain scale score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Foot and Ankle Outcome Score (FAOS). All of the assessments will be performed at baseline and 3, 6, and 12 months after treatment. Statistical analysis will be performed using the repeated measures ANOVA (analysis of variance test) for primary and secondary outcomes and also Fisher’s Least Significant Difference, a Post-Hoc test. We will use R software for statistical analysis, randomization, and sample size calculation. Results Recruitment and data collection will begin in November 2020, with completion scheduled for November 2022 and final publication available in March 2023. Conclusion This trial will evaluate the effects of a single ultrasound-guided HA injection for the treatment of chronic plantar fasciitis. Trial registration Brazilian Clinical Trials Registry (Register Number: RBR-97vkx4) http://www.ensaiosclinicos.gov.br/rg/RBR-97vkx4/.

Assessment of the Efficacy of Extracorporeal Shockwave Therapy for Plantar Fasciitis with Magnetic Resonance Imaging Findings

2018 ◽  
Vol 108 (2) ◽  
pp. 100-105 ◽  
Author(s):  
Mualla Bicer ◽  
Elif Hocaoglu ◽  
Sema Aksoy ◽  
Ercan İnci ◽  
İlknur Aktaş
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Plantar Fasciitis ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Analog Scale ◽  
Mri Findings ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy

Background:Extracorporeal shockwave therapy (ESWT) has recently been used as a new treatment modality for plantar fasciitis. We aimed to determine the efficacy of ESWT by magnetic resonance imaging (MRI) findings.Methods:Thirty patients with plantar fasciitis who had received no treatment for 6 months were included. Extracorporeal shockwave therapy was applied once a week for a total of three sessions (frequency of 12–15 Hz, 2–3 bars, and 2,500 pulses). All of the patients were assessed with the visual analog scale, a 6-point evaluation scale, the Foot and Ankle Outcome Score (FAOS), and MRI findings before and 3 months after ESWT. Visual analog scale scores were used in determining the pain level of patients in the morning, during activity, and at rest. Foot and ankle–related problems were evaluated with the FAOS.Results:The duration of painless walking according to the 6-point rating scale, the FAOS, and pain showed significant improvements after ESWT (P &lt; .05). Significant decreases in MRI findings, including thickening of the plantar fascia, soft-tissue edema, and bone marrow edema, were observed after treatment (P &lt; .05).Conclusions:Extracorporeal shockwave therapy is a safe and effective treatment that yields favorable results in improvement of pain and function for plantar fasciitis. An MRI is useful for determining response to ESWT for these patients.

A review of the cellular and molecular effects of extracorporeal shockwave therapy

2016 ◽  
Vol 29 (02) ◽  
pp. 99-107 ◽  
Author(s):  
Georgina Chamberlain ◽  
Robert Colborne
Keyword(s):  
Analgesic Effect ◽  
Tissue Repair ◽  
Treatment Protocol ◽  
Therapeutic Modality ◽  
Promising Alternative ◽  
Extracorporeal Shockwave Therapy ◽  
Surgical Interventions ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Tissue Repair And Regeneration

SummaryExtracorporeal shockwave therapy (ESWT) is a novel therapeutic modality and its use in promoting connective tissue repair and analgesic effect has been advocated in the literature. It is convenient, cost-effective, and has negligible complications; it therefore bypasses many of the problems associated with surgical interventions. This paper reviews the proposed mechanisms of action in promoting tissue repair and regeneration as well as analysing its efficacy providing an analgesic effect in clinical applications. Further research will be required to not only identify the underlying mechanisms more precisely, but will also be critical for ensuring consistency across the literature so that the most beneficial treatment protocol can be developed. Extracorporeal shockwave therapy stands as a promising alternative modality in promoting tissue repair.

scholarly journals Functional Outcome at Short and Middle Term of the Extracorporeal Shockwave Therapy Treatment in Lateral Epicondylitis: A Case-Series Study

2020 ◽  
Vol 9 (3) ◽  
pp. 633
Author(s):  
Gianluca Testa ◽  
Andrea Vescio ◽  
Stefano Perez ◽  
Vincenzo Petrantoni ◽  
Giulio Mazzarella ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Low Dose ◽  
Case Series ◽  
Lateral Epicondylitis ◽  
Elderly Subjects ◽  
Extracorporeal Shockwave Therapy ◽  
Middle Term ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Case Series Study

Lateral epicondylitis (LE) of the humerus is a chronic degeneration of wrist extensor tendons at their attachments to the lateral epicondyle of the humerus. There is not a common consensus on a specific therapeutic algorithm, but Extracorporeal Shockwave Therapy (ESWT) is widely used. The purpose of this study is to evaluate the clinical benefits of low dose ESWT in LE-affected patients in short and medium follow-up. Between January 2015 and December 2017, 60 patients (38 male, mean age 52.2 ± 10.1 years, the duration of the disease was 3.6 ± 1.3 months) were clinically evaluated using visual analog scale (VAS) and Patient Rated Tennis Elbow Evaluation Test (PRTEE-I) scores before treatment, at one, three, six and 12 months after treatment. According to the VAS and PRTEE-I scoring systems, all patients achieved an improvement of pain and functional outcome comparing the baseline results with one, six and 12 months values. Low dose ESWT is a safe and effective treatment of LE in the short and middle term. In elderly subjects, patients with a long disease history, or those with occupational and sportive risk factors, a longer persistence of the symptomatology could be observed.

The Basic Science Behind Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction: A Systematic Scoping Review of Pre-Clinical Studies

2019 ◽  
Vol 16 (2) ◽  
pp. 168-194 ◽  
Author(s):  
Ioannis Sokolakis ◽  
Fotios Dimitriadis ◽  
Pearline Teo ◽  
Georgios Hatzichristodoulou ◽  
Dimitrios Hatzichristou ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Scoping Review ◽  
Clinical Studies ◽  
Basic Science ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Low Intensity

scholarly journals COMPARATIVE EFFICACY OF COMBINED LOW-INTENSITY EXTRACORPOREAL SHOCKWAVE THERAPY AND ORAL THERAPY VS ORAL THERAPY ALONE FOR CHRONIC PELVIC PAIN SYNDROME: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIAL

2021 ◽  
Vol 28 (2) ◽  
pp. 172-178
Author(s):  
Rocky Nurakbariansyah ◽  
Doddy M. Soebadi ◽  
Wahjoe Djatisoesanto ◽  
Johan Renaldo
Keyword(s):  
Oral Therapy ◽  
Controlled Trial ◽  
Chronic Pelvic Pain Syndrome ◽  
Urinary Symptoms ◽  
Cochrane Library ◽  
Pelvic Pain Syndrome ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Low Intensity

Objective: This study aimed to compare the efficacy of Low-Intensity Extracorporeal Shockwave Therapy (Li-ESWT) and oral therapy combination compared to sole oral therapy for reducing symptoms in CP/CPPS patients. Material & Methods: A systematic search was conducted from the electronic database including PubMed, Clinicaltrial.gov, and Cochrane Library, published up to July 2020 following the PRISMA guideline. We screened RCTs with the inclusion criteria and assessed the quality with the Cochrane Risk of Bias tool. The primary outcome was the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and subgroup analysis for triple therapy users was conducted to improve interpretability. The analysis was performed using Review Manager 5.3. Results: A total of 2 RCTs consisted of 91 CP/CPPS patients were analyzed. Pooled analysis showed that compared to the oral therapy only group, combination therapy had a significant lower NIH-CPSI total score at the endpoint of the treatment (MD -7.46, 95% CI -9.85 to -5.07, p<0.001) and NIH-CPSI component pain score (MD -3.48, 95% CI -5.04 to -1.93, p<0.0001), urinary symptoms score (MD -0.96, 95% CI -1.47 to -0.45, p<0.001), and quality of life (QoL) impact score (MD -2.94; 95% CI -3.68 to -2.20, p=<0.001). Conclusion: This review revealed that patients undergoing combination Li-ESWT therapy have lower total NIH-CPSI scores than patients receiving oral therapy alone, this finding is consistent with each component of the score: pain, urinary symptoms, and impact on QoL.

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