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Zhang T, Wang Y, Ding L, Ma C. Efficacy of hypertonic dextrose proliferation therapy in the treatment of rotator cuff lesions: a meta-analysis. J Orthop Surg Res 2024; 19:297. [PMID: 38750541 PMCID: PMC11094990 DOI: 10.1186/s13018-024-04754-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 04/20/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND One of the most prevalent illnesses of the shoulder is rotator cuff tendinosis, which is also a major contributor to shoulder discomfort and shoulder joint dysfunction. According to statistics, rotator cuff tendinosis occurs in 0.3-5.5% of cases and affects 0.5-7.4% of people annually. It will be necessary to conduct a meta-analysis to evaluate the efficacy of hypertonic glucose proliferation therapy in the treatment of rotator cuff problems. METHODS The databases Cochrane PubMed, Library, Web of Science and EMbase, are retrieved by the computer. Individuals with rotator cuff lesions in the intervention group were treated with hypertonic dextrose proliferation therapy, whereas individuals in the control condition were treated with a placebo. Outcome markers for rotator cuff lesions patients; Pursuant to studies, the visual analogue scale (VAS) score, the shoulder pain & disability index (SPADI), & other metrics are used to evaluate the effects of hypertonic dextrose proliferation treatment on individuals with rotator cuff diseases. After carefully evaluating the calibre of the literature, data analysis was performed utilising the RevMan 5.3 programme. RESULTS Meta-analysis finally contained 6 papers. In six investigations, the test & control group's VAS scores improved, with the test team's score considerably outperforming the control team [standardized mean difference (SMD): 1.10; 95% Cl: 0.37,1.83; P < 0.01], shoulder pain and disability index (SPADI) score (SMD:8.13; 95% Cl: 5.34,10.91; P < 0.01), Flexion (SMD:5.73; 95% Cl: 0.99,10.47; P < 0.05), Abduction (SMD:6.49; 95% Cl: 0.66,12.31; P < 0.05), Internal rotation (SMD:-1.74; 95% Cl: -4.25,0.78; P = 0.176) and External rotation (SMD:2.78; 95% Cl: -0.13,5.69; P = 0.062). CONCLUSION The findings of this study suggest that individuals with rotator cuff injuries may benefit from hypertonic dextrose proliferation treatment based on the visual analogue scale (VAS) score, the Shoulder Pain and Disability Index (SPADI) score, Flexion, & Abduction. These results must, nevertheless, be supported by high-caliber follow-up research.
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Affiliation(s)
- Ting Zhang
- Department of Rehabilitation Medicine, Central Hospital of Wuhan, Hubei Province, China
| | - YanFu Wang
- Department of Rehabilitation Medicine, Central Hospital of Wuhan, Hubei Province, China
| | - Lin Ding
- Department of Rehabilitation Medicine, Central Hospital of Wuhan, Hubei Province, China.
| | - ChaoYang Ma
- Department of Rehabilitation Medicine, Central Hospital of Wuhan, Hubei Province, China.
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Avendano JP, Pereira D. Treatment of Calcific Tendonitis of the Rotator Cuff: An Updated Review. Orthopedics 2023; 46:e326-e332. [PMID: 37672776 DOI: 10.3928/01477447-20230901-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Rotator cuff calcific tendonitis (RCCT) is a disorder that can greatly impair patients' quality of life. A literature review was conducted to find the most effective and newest treatments for RCCT. PubMed and Cochrane Review databases were searched, without strict inclusion/exclusion criteria, for peer-reviewed articles between 1941 and 2021 that discussed RCCT etiology and treatments. If nonoperative measures (non-steroidal anti-inflammatory drugs, physical therapy, and corticosteroids) are unsuccessful, other options include extracorporeal shockwave therapy, ultrasound-guided injection techniques, and minimally invasive surgery. Because RCCT can resolve spontaneously, patients should progress to invasive options only if conservative first-line treatments have failed. [Orthopedics. 2023;46(6):e326-e332.].
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ElGendy MH, Mazen MM, Saied AM, ElMeligie MM, Aneis Y. Extracorporeal Shock Wave Therapy vs. Corticosteroid Local Injection in Shoulder Impingement Syndrome : A Three-Arm Randomized Controlled Trial. Am J Phys Med Rehabil 2023; 102:533-540. [PMID: 36730000 DOI: 10.1097/phm.0000000000002158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to examine the effects of combining extracorporeal shock wave therapy or local corticosteroid injections with a conventional physical therapy (CPT) program for patients with shoulder impingement syndrome. DESIGN This was a prospective single-blinded, randomized controlled study. METHODS Sixty patients with unilateral shoulder impingement syndrome >3 mos were allocated to group A (a 4-wk program of CPT plus a single local corticosteroid injection of 40 mg triamcinolone acetonide mixed with 1% xylocaine, n = 20), group B (CPT only, n = 20), and group C (CPT plus extracorporeal shock wave therapy, 2000 impulses, 0.2-0.3 mJ/mm 2 , one session per week for 3 wks, n = 20). Subacromial space, shoulder pain and disability index, and shoulder range of motion were assessed at baseline and 4 and 12 wks posttreatment. RESULTS There were no between-group differences at 4 wks. At the 12-wk follow-up, no significant differences were found between groups A and B. There was a significant difference in favor of group C compared with group A with the expectation of shoulder internal rotation and subacromial space. Group C was also superior to group B in all outcomes except for subacromial space. CONCLUSION The addition of extracorporeal shock wave therapy to CPT induced more noticeable intermediate-term effects than CPT plus local corticosteroid injection or CPT alone.
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Affiliation(s)
- Mohamed H ElGendy
- From the Basic Sciences Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt (MHE, YA); Department of Basic Sciences, Faculty of Physical Therapy, Delta University for Science and Technology, Belqas City, Dakahlia Governorate, Egypt (MMM); Faculty of Medicine, Mansoura University, Mansoura City, Dakahlia Governorate, Egypt (AMS); and Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Ahram Canadian University, Giza, Egypt (MME)
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Low-intensity extracorporeal shock wave therapy promotes recovery of sciatic nerve injury and the role of mechanical sensitive YAP/TAZ signaling pathway for nerve regeneration. Chin Med J (Engl) 2021; 134:2710-2720. [PMID: 34845995 PMCID: PMC8631414 DOI: 10.1097/cm9.0000000000001431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: Histological and functional recovery after peripheral nerve injury (PNI) is of significant clinical value as delayed surgical repair and longer distances to innervate terminal organs may account for poor outcomes. Low-intensity extracorporeal shock wave therapy (LiESWT) has already been proven to be beneficial for injured tissue recovery on various pathological conditions. The objective of this study was to explore the potential effect and mechanism of LiESWT on PNI recovery. Methods: In this project, we explored LiESWT's role using an animal model of sciatic nerve injury (SNI). Shockwave was delivered to the region of the SNI site with a special probe at 3 Hz, 500 shocks each time, and 3 times a week for 3 weeks. Rat Schwann cells (SCs) and rat perineurial fibroblasts (PNFs) cells, the two main compositional cell types in peripheral nerve tissue, were cultured in vitro, and LiESWT was applied through the cultured dish to the adherent cells. Tissues and cell cultures were harvested at corresponding time points for a reverse transcription-polymerase chain reaction, Western blotting, and immunofluorescence staining. Multiple groups were compared by using one-way analysis of variance followed by the Tukey-Kramer test for post hoc comparisons. Results: LiESWT treatment promoted the functional recovery of lower extremities with SNI. More nerve fibers and myelin sheath were found after LiESWT treatment associated with local upregulation of mechanical sensitive yes-associated protein (YAP)/transcriptional co-activator with a PDZ-binding domain (TAZ) signaling pathway. In vitro results showed that SCs were more sensitive to LiESWT than PNFs. LiESWT promoted SCs activation with more expression of p75 (a SCs dedifferentiation marker) and Ki67 (a SCs proliferation marker). The SCs activation process was dependent on the intact YAP/TAZ signaling pathway as knockdown of TAZ by TAZ small interfering RNA significantly attenuated this process. Conclusion: The LiESWT mechanical signal perception and YAP/TAZ upregulation in SCs might be one of the underlying mechanisms for SCs activation and injured nerve axon regeneration.
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Moya D, Ramón S, Guiloff L, Terán P, Eid J, Serrano E. [Poor results and complications in the use of focused shockwaves and radial pressure waves in musculoskeletal pathology]. Rehabilitacion (Madr) 2021; 56:64-73. [PMID: 33832759 DOI: 10.1016/j.rh.2021.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/22/2021] [Accepted: 02/28/2021] [Indexed: 11/15/2022]
Abstract
The application of focused shockwaves and radial pressure waves in musculoskeletal pathology has had a great development in the last decade. Although most of the publications have highlighted their safety and efficacy, poor results and complications can occur. This review analyzes the main causes of its poor results, adverse effects, and complications, emphasizing their prevention.
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Affiliation(s)
- D Moya
- Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - S Ramón
- Servicio de Medicina Física y Rehabilitación, Hospital Quirónsalud Barcelona, Barcelona, España
| | - L Guiloff
- Clínica Dávila, Santiago de Chile, Chile
| | - P Terán
- Centro de Especialidades Ortopédicas CEO, Quito, Ecuador
| | - J Eid
- Cuerpo Clínico del Hospital HCor, San Pablo, Brasil
| | - E Serrano
- Centro Médico Especializado Neomedica, Lima, Perú
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Ramon S, Español A, Yebra M, Morillas JM, Unzurrunzaga R, Freitag K, Gómez S, Aranzabal JR. [Current evidences in shockwave treatment. SETOC (Spanish Society of Shockwave Treatment) recommendations]. Rehabilitacion (Madr) 2021; 55:291-300. [PMID: 33743978 DOI: 10.1016/j.rh.2021.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 01/11/2023]
Abstract
This SETOC consensus document shows the scientific evidence of the technology in shockwaves (SW) and radial pressure waves (RPW) in a variety of spasticity disorders, musculoskeletal, skin, urological diseases, etc. SW and RPW, without anesthesia, are an effective, safe, non-invasive, cost-effective treatment, which reduces the need for surgery, lower risk of complications, faster recovery and greater acceptability to patients than surgery. Consequently, SW and RPW should be the first therapeutic option in the aforementioned chronic pathologies, when conservative alternatives have failed. SETOC advises to follow the recommendations given in this article, including the ones given by SW scientific societies and best evidence for each technology as well.
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Affiliation(s)
- S Ramon
- Servicio de Medicina Física y Rehabilitación, Hospital Quirónsalud, Barcelona, España.
| | - A Español
- Hospital Universitario Dexeus Quirónsalud, Barcelona, España
| | - M Yebra
- Complejo Hospitalario Universitario de Ourense, Ourense, España
| | - J M Morillas
- Clínica de Medicina del Deporte, Lorca, Murcia, España
| | - R Unzurrunzaga
- MFR Clínicas MC-Mutual, Hospital Quirónsalud, Barcelona, España
| | - K Freitag
- Clínica DKF. Vocal SETOC y Onlat, Madrid, España
| | - S Gómez
- Unidad Médica de la Dirección Provincial del INSS, A Coruña, España
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Alian SM, Zaghlol RS, Khalil SS. Platelet rich plasma versus extracorporeal shock wave therapy in patients with non-calcific supraspinatous tears. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2020. [DOI: 10.1186/s43166-020-00020-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To compare the clinical efficacy of platelet rich plasma (PRP) subacromial injection and extracorporeal shock wave therapy (ESWT) on refractory non-calcific partial thickness supraspinatous tendon tear.
Results
Significant improvement in all outcome measures achieved in both groups at 4 weeks follow-up period (the end of treatment course) (P< 0.05). At 12 weeks follow-up period, group I, showed significant improvement in all outcome measures compared to baseline and group II; however, in group II, there was no significant difference compared to baseline; moreover, deterioration in the previous improvement was noticed.
Conclusion
Both PRP (group I) and ESWT (group II) are effective therapeutic methods in the management of refractory non-calcific partial thickness supraspinatous tendon tear; however, PRP (group I) has better long-term effects on both pain and function.
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8
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Acupuncture may anticipate the antalgic effects of focused shockwave therapy to rotator cuff tendinopathy: A retrospective clinical study 针刺和聚焦冲击波疗法对肩袖肌腱病的止痛作用:一项回顾性临床研究. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2020. [DOI: 10.1016/j.wjam.2020.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Muthukrishnan R, Rashid AA, Al-Alkharji F. The effectiveness of extracorporeal shockwave therapy for frozen shoulder in patients with diabetes: randomized control trial. J Phys Ther Sci 2019; 31:493-497. [PMID: 31417208 PMCID: PMC6642889 DOI: 10.1589/jpts.31.493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/01/2019] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study examined the effectiveness of extracorporeal shock wave therapy
versus ultrasound therapy, combined with the mobilization and therapeutic exercise in both
groups, in participants with diabetic frozen shoulder. [Participants and Methods] Twenty
participants with diabetic frozen shoulder were divided into an experimental group who
received extracorporeal shock wave therapy, mobilization and exercises (n=10, Mean: 43.70)
and the control group who received ultrasound, mobilization and exercises (n=10 Mean:
45.50). The clinical outcomes, i.e., a) pain b) active range of motions of the shoulder,
c) disability scores by Disabilities of the Arm, Shoulder and Hand scale and d) global
rating of change was measured weekly for four weeks. [Results] Significant improvements in
pain, all active range of motions and disability scores were observed at the end of the
4th week in both groups. Additionally, the experimental group benefitted significant pain
reduction (median difference: 7 in experimental versus 6 in control group), reduced number
of therapy sessions and thus the costs of treatment compared to the control group.
[Conclusion] Extracorporeal shock wave therapy significantly reduced pain in people with
diabetic frozen shoulder with a reduction of treatment cost compared to the control
group.
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Affiliation(s)
- Ramprasad Muthukrishnan
- Physiotherapy Division, College of Health Sciences, Gulf Medical University: Ajman, Ajman, UAE
| | - Ayesha Abdul Rashid
- Physiotherapy Division, College of Health Sciences, Gulf Medical University: Ajman, Ajman, UAE
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Klüter T, Krath A, Stukenberg M, Gollwitzer H, Harrasser N, Knobloch K, Maffulli N, Hausdorf J, Gerdesmeyer L. Electromagnetic transduction therapy and shockwave therapy in 86 patients with rotator cuff tendinopathy: A prospective randomized controlled trial. Electromagn Biol Med 2018; 37:175-183. [DOI: 10.1080/15368378.2018.1499030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Tim Klüter
- Department of Orthopaedic Surgery and Traumatology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - André Krath
- Department of Orthopaedic Surgery and Traumatology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Martin Stukenberg
- Department of Orthopaedic Surgery and Traumatology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Hans Gollwitzer
- Excellent Center of Medicine and ATOS-Clinic, München, Germany
| | - Norbert Harrasser
- Department of Orthopaedic Surgery, Klinikum rechts der Isar, München, Germany
| | | | | | - Jörg Hausdorf
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), München, Germany
| | - Ludger Gerdesmeyer
- Department of Orthopaedic Surgery and Traumatology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
- Department of Orthopaedic Surgery, Klinikum rechts der Isar, München, Germany
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Analgesic Effect of Extracorporeal Shock Wave Treatment Combined with Fascial Manipulation Theory for Adhesive Capsulitis of the Shoulder: A Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3450940. [PMID: 29581969 PMCID: PMC5822906 DOI: 10.1155/2018/3450940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 12/02/2017] [Accepted: 12/19/2017] [Indexed: 11/17/2022]
Abstract
Objectives This study aims to explore whether extracorporeal shockwave treatment (ESWT) based on the theory of fascial manipulation (FM) at select treatment points is superior to traditional local ESWT for pain relief in adhesive capsulitis of the shoulder. Methods Data from patients with adhesive capsulitis of the shoulder who received weekly ESWT according to fascial manipulation theory (ESWT-FM) or local extracorporeal shockwave treatment (L-ESWT) during a 5-week treatment period were evaluated. Pain-on-movement numeric rating scale (p-NRS) and range of motion (ROM) testing were performed before the treatment period, after the first treatment, and after the fifth treatment. Results There were significant reductions in pain scores in the ESWT-FM group (p < 0.05) after the first treatment, and after the fifth treatment, both groups had marked, significant improvement (p < 0.05), with a significantly greater reduction in pain (p-NRS) in the ESWT-FM group compared to the L-ESWT group (p < 0.05). There was no significant difference in terms of ROM in the L-ESWT group, while there was slight improvement of forward flexion in the ESWT-FM group after the fifth treatment. Conclusions ESWT-FM provided faster pain relief and slightly more notable improvement of function compared with L-ESWT for the patients with adhesive capsulitis of shoulder.
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Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The Role of Extracorporeal Shockwave Treatment in Musculoskeletal Disorders. J Bone Joint Surg Am 2018; 100:251-263. [PMID: 29406349 DOI: 10.2106/jbjs.17.00661] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Daniel Moya
- Buenos Aires British Hospital, Buenos Aires, Argentina
| | - Silvia Ramón
- Hospital Quirón, Barcelona, Fundación García Cugat, Spain
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Tan L, Zhao B, Ge FT, Sun DH, Yu T. Shockwaves Inhibit Chondrogenic Differentiation of Human Mesenchymal Stem Cells in Association with Adenosine and A2B Receptors. Sci Rep 2017; 7:14377. [PMID: 29085053 PMCID: PMC5662611 DOI: 10.1038/s41598-017-14875-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 09/12/2017] [Indexed: 11/09/2022] Open
Abstract
Extracorporeal shockwave therapy (ESWT) has emerged as the important choice for the treatment of many orthopedic disorders. Our previous mechanistic studies suggest that ESWT promoted osteogenesis of human mesenchymal stem cells (hMSCs) through mechanisms that involve adenosine 5'-triphosphate (ATP) release. In this study, we investigated the effect of ESWT on chondrogenesis of hMSCs. We demonstrate that ESWT treatment caused a significant release of adenosine from hMSCs; ESWT treatment increased the levels of A2B receptor (A2BR) in hMSCs under 3-D culture conditions. ESWT, exogenous adenosine and specialized A2BR agonist suppressed hMSC chondrogenic differentiation through downregulating the expressions of aggrecan (ACAN), Collagen Type I alpha 2(COL1A2), Collagen Type II alpha 1(COL2A1), Sex-Determining Region YBox 9 (SOX9) and Sex-Determining Region YBox 6 (SOX6). Selective A2BR antagonists induced chondrogenic differentiation of hMSCs. This study indicated that shockwave therapy inhibits hMSC chondrogenic differentiation through or partially through regulation of adenosine release and activation of A2B receptor under 3-D culture conditions.
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Affiliation(s)
- Lei Tan
- Department of Orthopedic Trauma, The first Hospital of Jilin University, Changchun, 130021, China
| | - Bin Zhao
- Department of Orthopedics, The Bin Zhou People's Hospital, Bin Zhou, 256600, China
| | - Fu-Tao Ge
- Department of Shockwave, The First Hospital of Jilin University, Changchun, 130021, China
| | - Da-Hui Sun
- Department of Orthopedic Trauma, The first Hospital of Jilin University, Changchun, 130021, China.
| | - Tiecheng Yu
- Department of Orthopedic Trauma, The first Hospital of Jilin University, Changchun, 130021, China.
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Radial shockwave therapy for a painful bone spur in an above-knee amputee. Ann Phys Rehabil Med 2017; 60:357-359. [DOI: 10.1016/j.rehab.2017.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 02/22/2017] [Indexed: 11/24/2022]
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Kvalvaag E, Brox JI, Engebretsen KB, Soberg HL, Juel NG, Bautz-Holter E, Sandvik L, Roe C. 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. Am J Sports Med 2017; 45:2547-2554. [PMID: 28586628 DOI: 10.1177/0363546517707505] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
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).
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Affiliation(s)
- Elisabeth Kvalvaag
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway.,University of Oslo, Medical Faculty, Oslo, Norway
| | - Jens Ivar Brox
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway
| | - Kaia Beck Engebretsen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway
| | - Helene Lundgaard Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway
| | - Niels Gunnar Juel
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway
| | - Erik Bautz-Holter
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway
| | - Leiv Sandvik
- University of Oslo, Faculty of Dentistry, Oslo, Norway
| | - Cecilie Roe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway.,University of Oslo, Medical Faculty, Oslo, Norway
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Comparative Effectiveness of Nonoperative Treatments for Chronic Calcific Tendinitis of the Shoulder: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2017; 98:1678-1692.e6. [DOI: 10.1016/j.apmr.2017.02.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/24/2017] [Accepted: 02/10/2017] [Indexed: 11/22/2022]
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Su X, Li Z, Liu Z, Shi T, Xue C. Effects of high- and low-energy radial shock waves therapy combined with physiotherapy in the treatment of rotator cuff tendinopathy: a retrospective study. Disabil Rehabil 2017; 40:2488-2494. [PMID: 28597729 DOI: 10.1080/09638288.2017.1336650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was to investigate the efficacy of high- and low-energy radial shock waves combined with physiotherapy for rotator cuff tendinopathy patients. METHODS Data from rotator cuff tendinopathy patients received high- or low-energy radial shock waves combined with physiotherapy or physiotherapy alone were collected. The Constant and Murley score and visual analog scale score were collected to assess the effectiveness of treatment in three groups at 4, 8, 12, and 24 weeks. RESULTS In total, 94 patients were involved for our retrospective study. All groups showed remarkable improvement in the visual analog scale and Constant and Murley score compared to baseline at 24 weeks. The high-energy radial shock waves group had more marked improvement in the Constant and Murley score compared to the physiotherapy group at 4 and 8 weeks and at 4 weeks when compared with low-energy group. Furthermore, high-energy radial shock waves group had superior results on the visual analog scale at 4, 8, and 12 weeks compared to low-energy and physiotherapy groups. CONCLUSIONS This retrospective study supported the usage of high-energy radial shock waves as a supplementary therapy over physiotherapy alone for rotator cuff tendinopathy by relieving the symptoms rapidly and maintaining symptoms at a satisfactory level for 24 weeks. Implications for Rehabilitation High-energy radial shock waves can be a supplemental therapy to physiotherapy for rotator cuff tendinopathy. We recommend the usage of high-energy radial shock waves during the first 5 weeks, at an interval of 7 days, of physiotherapy treatment. High-energy radial shock waves treatment combined with physiotherapy can benefit rotator cuff tendinopathy by relieving symptoms rapidly and maintain these improvements at a satisfactory level for quite a long time.
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Affiliation(s)
- Xiangzheng Su
- a Department of Sport Medical , Chinese PLA General hospital , Beijing , China
| | - Zhongli Li
- a Department of Sport Medical , Chinese PLA General hospital , Beijing , China
| | - Zhengsheng Liu
- a Department of Sport Medical , Chinese PLA General hospital , Beijing , China
| | - Teng Shi
- a Department of Sport Medical , Chinese PLA General hospital , Beijing , China
| | - Chao Xue
- a Department of Sport Medical , Chinese PLA General hospital , Beijing , China
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Incorrect methodology may favor ultrasound-guided needling over shock wave treatment in calcific tendinopathy of the shoulder. J Shoulder Elbow Surg 2016; 25:e241-3. [PMID: 27422464 DOI: 10.1016/j.jse.2016.04.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 04/25/2016] [Indexed: 02/01/2023]
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