[Current evidences in shockwave treatment. SETOC (Spanish Society of Shockwave Treatment) recommendations]

Calcifying Tendinopathy of the Rotator Cuff: Barbotage vs. Shock Waves: Controlled Clinical Trial Protocol (BOTCH)

Background: Shoulder pain is a very common health issue among adults, being 8% due to calcifying tendinopathies (CT) of the shoulder. The evolutionary process of this lesion can be classified according to Bianchi Martinoli, depending on the ultrasound appearance. In 50% of cases, with first-line treatments, they resolve spontaneously. However, in the remaining 50%, they become chronic, requiring other lines of treatment, such as shock waves (ESWT) or ultrasound-guided barbotage (US-PICT). Objectives: The objective focuses on comparing the improvement in pain using the visual analgesic scale (VAS) and shoulder joint balance (ROM) in patients with CT based on the treatment received, stratifying according to the characteristics of the injury, with the aim of protocolizing said treatment. Methods: Randomized analytical controlled clinical trial in blocks with two arms according to the Bianchi Martinolli classification (I or II/III) in 56 patients affected by chronic pain by CT. The decision to treat will be made randomly 1:1, based on the treatment assigned to the previous patient. Results will be evaluated in three moments (1, 3, and 6 months). The following variables will be collected: VAS, Lattinen test, ROM (flexion, abduction, external and internal rotation), patient global improvement impression scale (PGI-I), global improvement impression scale (CGI-C). Discussion: The use of ESWT or US-PICT as treatments is a widely used practice in the daily life of this pathology. However, despite knowing that both treatments are useful in chronic CT, there are no known data or protocols by which one therapy is chosen over another, much less the influence that the evolutionary stage can have of the injury in the results obtained.

Extracorporeal Shock Wave Therapy (eSWT) in Spinal Cord Injury-A Narrative Review

BACKGROUND

Injury of the spinal cord causes motor and sensory dysfunction as well as pathological reflexes, leading to paraplegia or tetraplegia. The sequelae of traumatic spinal cord injury (SCI) are a significant burden and impact on healthcare systems. Despite constant progress in medicine, traumatic SCI still remains irreversible. To date, no satisfying treatment that can enable neuronal regeneration and recovery of function at the damaged level has been found. Hundreds of experiments have been conducted on various possibilities of influencing spinal regeneration; some of them have yielded promising results, but unfortunately, the successes obtained in experimental animals have not translated into humans.

METHODS

This narrative review article presents the application of extracorporeal shock wave therapy (eSWT) in patients with SCI. The article has been divided into parts: 1) use of extracorporeal shock wave therapy for regeneration of the spinal cord after traumatic spinal cord injury; 2) application of extracorporeal shock wave therapy in spasticity after spinal cord injury. In both cases, the hypotheses of possible mechanisms of action will be described.

RESULTS AND CONCLUSIONS

A small number of clinical trials have demonstrated the potential of eSWT to influence the regeneration of the spine, as an innovative, safe, and cost-effective treatment option for patients with SCI. Some reports have shown that eSWT can improve spasticity, walking ability, urological function, quality of life, and independence in daily life.

Regenerative therapies as a potential treatment of erectile dysfunction

Erectile dysfunction (ED) is the most common sexual dysfunction disease in adult males. ED can be caused by many factors, such as vascular disease, neuropathy, metabolic disturbances, psychosocial causes, and side effects of medications. Although current oral phosphodiesterase type 5 inhibitors can achieve a certain effect, they cause temporary dilatation of blood vessels with no curative treatment effects. Emerging targeted technologies, such as stem cell therapy, protein therapy, and low-intensity extracorporeal shock wave therapy (Li-ESWT), are being used to achieve more natural and long-lasting effects in treating ED. However, the development and application of these therapeutic methods are still in their infancy, and their pharmacological pathways and specific mechanisms have not been fully discovered. This article reviews the preclinical basic research progress of stem cells, proteins, and Li-ESWT therapy, as well as the current status of clinical application of Li-ESWT therapy.

Application of extracorporeal shock wave therapy in nervous system diseases: A review

Neurological disorders are one of the leading causes of morbidity and mortality worldwide, and their therapeutic options remain limited. Recent animal and clinical studies have shown the potential of extracorporeal shock wave therapy (ESWT) as an innovative, safe, and cost-effective option to treat neurological disorders. Moreover, the cellular and molecular mechanism of ESWT has been proposed to better understand the regeneration and repairment of neurological disorders by ESWT. In this review, we discuss the principles of ESWT, the animal and clinical studies involving the use of ESWT to treat central and peripheral nervous system diseases, and the proposed cellular and molecular mechanism of ESWT. We also discuss the challenges encountered when applying ESWT to the human brain and spinal cord and the new potential applications of ESWT in treating neurological disorders.