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Sánchez AG, Andrade EL, Marsal JV, Tauste LA, Mingot CG, Monge JL, Puértolas MC, Calero NS, Argemí AS, Badia BG, Moncusí SP, Benito HG, Peñabad LN, Pujol ML, Nieves I Collado M, Ruiz LB. A study to evaluate the effect of ultrasound treatment on nodules in multiple sclerosis patients. Int J Neurosci 2016; 127:404-411. [PMID: 27144498 DOI: 10.1080/00207454.2016.1186025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose/aim: Ultrasound has demonstrated anti-inflammatory and pain-relief benefits in several conditions such as cellulite or trauma events. We assessed the efficacy of ultrasound therapy on nodules associated with first-line treatments in multiple sclerosis patients. MATERIALS AND METHODS Twenty-two multiple sclerosis patients were enrolled during 2013 and randomized to two groups: in the control group patients were treated only with a conventional gel prescribed for cellulite and nodules, while in the experimental group the gel was combined with ultrasound therapy. Patients were treated during 10 weeks and followed up for 10 additional weeks. Three nodules were assessed for each patient, measuring size, pain and redness at 0, 10 and 20 weeks. RESULTS We found a significant decrease in both groups in size, pain and redness across the three visits (p < 0.0001 for size, p = 0.01 and p < 0.0001 for pain, and p = 0.0002 and p < 0.0001 for redness, respectively for the difference at visit 2 and 3 with respect to visit 1). More interestingly, we observed a greater reduction in pain and redness in the ultrasound-treated group, but the difference was only statistically significant at 10 weeks (p = 0.01 for both pain and redness). On the third visit, no differences between control and experimental groups were detected, both achieving the same levels in measured variables. CONCLUSIONS Both treatments are useful to improve skin reaction after first-line treatments, but ultrasound in combination with gel achieves a faster reduction in pain and redness, suggesting that ultrasound treatment might be a good analgesic for nodule management in multiple sclerosis patients.
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Affiliation(s)
- Anna Gil Sánchez
- a a Neurology Department-Multiple Sclerosis Unit, Hospital Universitario Arnau de Vilanova and Institut de Recerca Biomèdica Lleida , Lleida , Spain
| | - Eugenia Lacasa Andrade
- b b Multiple Sclerosis Unit, Hospital de Día Miquel Martí i Pol, Fundación Esclerosis Múltiple (FEM) , Lleida , Spain
| | - Joan Valls Marsal
- c c Biostatistics Unit, Institut de Recerca Biomèdica Lleida , Lleida , Spain
| | - Lourdes Assens Tauste
- b b Multiple Sclerosis Unit, Hospital de Día Miquel Martí i Pol, Fundación Esclerosis Múltiple (FEM) , Lleida , Spain
| | - Cristina González Mingot
- a a Neurology Department-Multiple Sclerosis Unit, Hospital Universitario Arnau de Vilanova and Institut de Recerca Biomèdica Lleida , Lleida , Spain
| | - Jorge Lecina Monge
- a a Neurology Department-Multiple Sclerosis Unit, Hospital Universitario Arnau de Vilanova and Institut de Recerca Biomèdica Lleida , Lleida , Spain
| | - Margarita Casalilla Puértolas
- b b Multiple Sclerosis Unit, Hospital de Día Miquel Martí i Pol, Fundación Esclerosis Múltiple (FEM) , Lleida , Spain
| | - Nuria Sáez Calero
- b b Multiple Sclerosis Unit, Hospital de Día Miquel Martí i Pol, Fundación Esclerosis Múltiple (FEM) , Lleida , Spain
| | - Albert Sacristán Argemí
- b b Multiple Sclerosis Unit, Hospital de Día Miquel Martí i Pol, Fundación Esclerosis Múltiple (FEM) , Lleida , Spain
| | - Blanca Guiu Badia
- a a Neurology Department-Multiple Sclerosis Unit, Hospital Universitario Arnau de Vilanova and Institut de Recerca Biomèdica Lleida , Lleida , Spain
| | - Silvia Peralta Moncusí
- b b Multiple Sclerosis Unit, Hospital de Día Miquel Martí i Pol, Fundación Esclerosis Múltiple (FEM) , Lleida , Spain
| | - Hugo Gonzalo Benito
- a a Neurology Department-Multiple Sclerosis Unit, Hospital Universitario Arnau de Vilanova and Institut de Recerca Biomèdica Lleida , Lleida , Spain
| | - Lara Nogueras Peñabad
- a a Neurology Department-Multiple Sclerosis Unit, Hospital Universitario Arnau de Vilanova and Institut de Recerca Biomèdica Lleida , Lleida , Spain
| | - Marta Lordan Pujol
- b b Multiple Sclerosis Unit, Hospital de Día Miquel Martí i Pol, Fundación Esclerosis Múltiple (FEM) , Lleida , Spain
| | - Mónica Nieves I Collado
- b b Multiple Sclerosis Unit, Hospital de Día Miquel Martí i Pol, Fundación Esclerosis Múltiple (FEM) , Lleida , Spain
| | - Luis Brieva Ruiz
- a a Neurology Department-Multiple Sclerosis Unit, Hospital Universitario Arnau de Vilanova and Institut de Recerca Biomèdica Lleida , Lleida , Spain
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Stieger M, Schmid JP, Yawalkar N, Hunziker T. Extracorporeal Shock Wave Therapy for Injection Site Panniculitis in Multiple Sclerosis Patients. Dermatology 2014; 230:82-6. [DOI: 10.1159/000368351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 09/10/2014] [Indexed: 11/19/2022] Open
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Márquez-Rebollo C, Vergara-Carrasco L, Díaz-Navarro R, Rubio-Fernández D, Francoli-Martínez P, Sánchez-De la Rosa R. Benefit of endermology on indurations and panniculitis/lipoatrophy during relapsing-remitting multiple sclerosis long-term treatment with glatiramer acetate. Adv Ther 2014; 31:904-14. [PMID: 25047757 DOI: 10.1007/s12325-014-0137-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Use of endermology (Endermologie®), which consists of a deep mechanical massage, in patients with multiple sclerosis receiving glatiramer acetate suggested improvements in injection-site indurations and panniculitis/lipoatrophy in our previous pilot experience. We aimed to assess the effect of endermology in a larger population of patients with multiple sclerosis receiving glatiramer acetate in clinical practice. METHODS This was the extension phase of our pilot experience, carried out in patients with relapsing-remitting multiple sclerosis (RRMS) and indurations and/or panniculitis/lipoatrophy associated with long-term glatiramer acetate administration. Patients underwent endermology sessions twice per week, for 6 weeks, according to clinical practice. RESULTS Seventy evaluable patients were included (mean age, 42.7±9.3 years; female, 95.7%; mean multiple sclerosis duration, 9.2±8.6 years; mean glatiramer acetate duration, 46.7±29.9 months). Fifty (71.4%) patients showed indurations and 58 (82.9%) panniculitis/lipoatrophy. After 12 endermology sessions, the number of patients with indurations significantly decreased (71.4% vs. 28.6%; p<0.001), as did the number of their indurations (4.2±3.6 vs. 3.7±3.4; p<0.001). Although the number of patients with panniculitis/lipoatrophy did not significantly decrease, there was a significant reduction in the number of areas of panniculitis/lipoatrophy (4.3±2.6 vs. 3.9±2.2; p<0.05). Forty-nine (98.0%) patients with indurations and 57 (98.3%) patients with panniculitis/lipoatrophy felt satisfied/very satisfied with treatment and considered endermology useful/very useful. Endermology was well tolerated, as some pain was reported in eight (11.4%) patients, discomfort in three (4.3%) patients, and local blotch/swelling and transient bruise in one (1.4%) patient each. Endermology enabled glatiramer acetate tolerance to be enhanced in 42 (60.0%) patients. CONCLUSION This project represents the largest experience available supporting the benefit of endermology in the reduction/disappearance of indurations and improvement in panniculitis/lipoatrophy in patients with RRMS receiving long-term glatiramer acetate treatment. Moreover, these benefits also contributed to enhancing glatiramer acetate tolerance.
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Affiliation(s)
- Carmen Márquez-Rebollo
- Multiple Sclerosis Unit, Hospital Clínico Universitario Virgen de la Arrixaca, Carretera Madrid-Cartagena, S/N, 30120, El Palmar, Spain
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Rubio Fernández D, Rodríguez Del Canto C, Marcos Galán V, Falcón N, Edreira H, Sevane Fernández L, Francoli Martínez P, Sánchez-De la Rosa R. Contribution of endermology to improving indurations and panniculitis/lipoatrophy at glatiramer acetate injection site. Adv Ther 2012; 29:267-75. [PMID: 22382874 DOI: 10.1007/s12325-012-0005-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Endermology is a mechanical massage therapy that enables fat mobilization and body contouring. The authors' aim was to assess the effect of endermology on indurations and panniculitis/lipoatrophy associated with subcutaneous administration of glatiramer acetate in patients with multiple sclerosis (MS). METHODS This was a multicenter pilot experience carried out in patients with MS treated with glatiramer acetate who showed indurations and/ or panniculitis/lipoatrophy at the injection site. Patients underwent endermology and glatiramer acetate treatment according to clinical practice. The primary endpoint was the change in indurations and/or panniculitis/lipoatrophy after 12 endermology sessions. RESULTS Between April and July 2011, a total of 13 evaluable patients were included (mean age, 40.7±3.1 years; female, 100%; white, 100%; mean MS duration, 10.1±2.3 years; previous MS treatment, 46.2%; mean glatiramer acetate treatment duration, 27.3±9.5 months). Eleven patients (84.6%) showed local indurations (mean diameter, 3.4±0.5 cm; mean number, 9.0±1.0) and six patients (46.2%) areas of panniculitis/ lipoatrophy (mean number, 5.0±1.1). After 12 endermology sessions, patients with indurations reported having experienced a reduction in size (10 patients [90.9%]; mean diameter, 0.1±0.05 cm; P<0.001) and number of indurations (nine patients [81.8%]; mean number, 2.3±1.1; P<0.005). These indurations completely disappeared from arms, thighs, buttocks, and abdomen in six (75.0%), six (75.0%), two (50.0%), and three (42.9%) patients, respectively. Three of these patients (27.3%) recovered from all indurations. Although panniculitis/lipoatrophy did not completely disappear, all patients reported improvements. Most patients with indurations (63.6%) felt very satisfied and considered endermology very useful for reducing indurations. All patients with panniculitis/lipoatrophy were satisfied and considered to be endermology useful in improving it. In addition, endermology enabled glatiramer acetate tolerance to be improved in most patients (60.0%). CONCLUSION Endermology may contribute to improving indurations and panniculitis/ lipoatrophy at the site of subcutaneous injection of glatiramer acetate in patients with MS, enabling areas of injection to recover, and treatment tolerance to increase.
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