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Xue X, Song Q, Yang X, Kuati A, Fu H, Cui G. Effect of extracorporeal shock wave therapy for rotator cuff injury: Protocol for a systematic review and meta-analysis. PLoS One 2024; 19:e0301820. [PMID: 38718071 PMCID: PMC11078342 DOI: 10.1371/journal.pone.0301820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/19/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Rotator cuff injury (RCI) is a common musculoskeletal ailment and a major cause of shoulder pain and limited functionality. The ensuing pain and restricted movement significantly impact overall quality of life. This study aims to systematically review the effects of extracorporeal shock wave therapy (ESWT) on RCI. METHODS This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. A literature search, spanning inception to November 1, 2023, will include databases such as PubMed, Web of Science, the Cochrane Library, Scopus, MEDLINE, EMBASE, EBSCO, and China National Knowledge Infrastructure (CNKI) to identify ESWT studies for RCI treatment. Excluding retrospectives, bias risk will be assessed with the Cochrane tool. Two researchers will independently screen, extract data, and evaluate bias risk. Revman 5.3 software will be used for data analysis. RESULTS This study aims to objectively and comprehensively evaluate the effectiveness and safety of randomized controlled trials of ESWT in the treatment of RCI, and analyze in detail the effect of ESWT in the treatment of RCI. Results will be analyzed using the Pain Visual Analogue Scale (VAS), Constant-Murley score, University of California Los Angeles score (UCLA), and American Shoulder and Elbow Surgeons form (ASES). If applicable, subgroup analysis will also be performed to divide patients into groups according to the energy level of ESWT, the time of intervention, and the degree of tearing of RCI. Finally, the results are submitted for publication in a peer-reviewed journal. DISCUSSION AND CONCLUSION There is existing evidence suggesting that ESWT may contribute to the amelioration of pain and functional limitations associated with Rotator Cuff Injury (RCI). This systematic review aims to update, consolidate, and critically evaluate relevant evidence on the effects of ESWT for RCI. The anticipated outcomes may serve as a valuable reference for clinical ESWT practices, covering treatment methods, timing, and intensity. Moreover, this review aspires to provide high-quality evidence addressing the impact of ESWT on RCI-related pain. Simultaneously, the findings of this systematic review are poised to offer guidance to clinicians and rehabilitation therapists. This guidance is intended to enhance the management of pain and functional impairments experienced by individuals with RCI, ultimately leading to improvements in their physical well-being. TRIAL REGISTRATION Protocol registration number CRD42023441407. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023441407.
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Affiliation(s)
- Xiali Xue
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan Province, China
| | - Qingfa Song
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
| | - Xinwei Yang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Amila Kuati
- Department of Rehabilitation, Peking University Third Hospital, Beijing, China
| | - Hao Fu
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
| | - Guoqing Cui
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan Province, China
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
- Department of Rehabilitation, Peking University Third Hospital, Beijing, China
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Xue X, Song Q, Yang X, Kuati A, Fu H, Liu Y, Cui G. Effect of extracorporeal shockwave therapy for rotator cuff tendinopathy: a systematic review and meta-analysis. BMC Musculoskelet Disord 2024; 25:357. [PMID: 38704572 PMCID: PMC11069249 DOI: 10.1186/s12891-024-07445-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/15/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Rotator cuff tendinopathy (RCT) is a widespread musculoskeletal disorder and a primary cause of shoulder pain and limited function. The resulting pain and limited functionality have a detrimental impact on the overall quality of life. The purpose of this study was to perform a systematic review of the effects of extracorporeal shock wave therapy (ESWT) for RCT. METHODS The literature search was conducted on the following databases from inception to February 20, 2024: PubMed, Web of Science, the Cochrane Library, Scopus, MEDLINE, EMBASE, EBSCO, and China National Knowledge Infrastructure (CNKI) were checked to identify the potential studies exploring the effect of ESWT for the treatment of Rotator cuff tendinopathy (Calcification or non-calcification), control group for sham, other treatments (including placebo), without restriction of date, language. Two researchers independently screened literature, extracted data, evaluated the risk of bias in the included studies, and performed meta-analysis using RevMan 5.3 software. RESULTS A total of 16 RCTs with 1093 patients were included. The results showed that compared with the control group, ESWT for pain score Visual Analogue Scale/Score (VAS) (SMD = -1.95, 95% CI -2.47, -1.41, P < 0.00001), function score Constant-Murley score (CMS) (SMD = 1.30, 95% CI 0.67, 1.92, P < 0.00001), University of California Los Angeles score (UCLA) (SMD = 2.69, 95% CI 1.64, 3.74, P < 0.00001), American Shoulder and Elbow Surgeons form (ASES) (SMD = 1.29, 95% CI 0.93, 1.65, P < 0.00001), Range of motion (ROM) External rotation (SMD = 1.00, 95% CI 0.29, 1.72, P = 0.02), Total effective rate (TER) (OR = 3.64, 95% CI 1.85, 7.14, P = 0.0002), the differences in the above results were statistically significant. But ROM-Abduction (SMD = 0.72, 95% CI -0.22, 1.66, P = 0.13), the difference was not statistically significant. CONCLUSION Currently limited evidence suggests that, compared with the control group, ESWT can provide better pain relief, functional recovery, and maintenance of function in patients with RCT.
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Affiliation(s)
- Xiali Xue
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Qingfa Song
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Xinwei Yang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Amila Kuati
- Department of Rehabilitation, Peking University Third Hospital, Beijing, 100191, China
| | - Hao Fu
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China
| | - Yulei Liu
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China.
| | - Guoqing Cui
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China.
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China.
- Department of Rehabilitation, Peking University Third Hospital, Beijing, 100191, China.
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Leeman JJ, Shaw KK, Mison MB, Perry JA, Carr A, Shultz R. Extracorporeal shockwave therapy and therapeutic exercise for supraspinatus and biceps tendinopathies in 29 dogs. Vet Rec 2016; 179:385. [DOI: 10.1136/vr.103487] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2016] [Indexed: 12/20/2022]
Affiliation(s)
- J. J. Leeman
- Department of Surgery; Seattle Veterinary Specialists; Kirkland Washington USA
| | - K. K. Shaw
- Department of Surgery; Animal Surgical Clinic of Seattle; Shoreline Washington USA
| | - M. B. Mison
- Department of Clinical Studies; School of Veterinary Medicine, University of Pennsylvania; Philadelphia Pennsylvania USA
| | - J. A. Perry
- Department of Surgery; Seattle Veterinary Specialists; Kirkland Washington USA
| | - A. Carr
- Department of Surgery; Seattle Veterinary Specialists; Kirkland Washington USA
| | - R. Shultz
- Vision Pet Imaging; Seattle Washington USA
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Kim SH, Ha KW, Kim YH, Seol PH, Kwak HJ, Park SW, Ryu BJ. Effect of Radial Extracorporeal Shock Wave Therapy on Hemiplegic Shoulder Pain Syndrome. Ann Rehabil Med 2016; 40:509-19. [PMID: 27446789 PMCID: PMC4951371 DOI: 10.5535/arm.2016.40.3.509] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 10/20/2015] [Indexed: 01/18/2023] Open
Abstract
Objective To investigate the effect of radial extracorporeal shock wave therapy (rESWT) on hemiplegic shoulder pain (HSP) syndrome. Methods In this monocentric, randomized, patient-assessor blinded, placebo-controlled trial, patients with HSP were randomly divided into the rESWT (n=17) and control (n=17) groups. Treatment was administered four times a week for 2 weeks. The visual analogue scale (VAS) score and Constant-Murley score (CS) were assessed before and after treatment, and at 2 and 4 weeks. The Modified Ashworth Scale and Fugl-Meyer Assessment scores and range of motion of the shoulder were also assessed. Results VAS scores improved post-intervention and at the 2-week and 4-week follow-up in the intervention group (p<0.05). Respective differences in VAS scores between baseline and post-intervention in the intervention and control groups were –1.69±1.90 and –0.45±0.79, respectively (p<0.05), between baseline and 2-week follow-up in the intervention and control groups were –1.60±1.74 and –0.34±0.70, respectively (p<0.05), and between baseline and 4-week follow-up in the intervention and control groups were –1.61±1.73 and –0.33±0.71, respectively (p<0.05). Baseline CS improved from 19.12±11.02 to 20.88±10.37 post-intervention and to 20.41±10.82 at the 2-week follow-up only in the intervention group (p<0.05). Conclusion rESWT consisting of eight sessions could be one of the effective and safe modalities for pain management in people with HSP. Further studies are needed to generalize and support these results in patients with HSP and a variety conditions, and to understand the mechanism of rESWT for treating HSP.
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Affiliation(s)
- Sung Hwan Kim
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul, Korea
| | - Kang Wook Ha
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul, Korea
| | - Yun Hee Kim
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul, Korea
| | - Pyong-Hwa Seol
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul, Korea
| | - Ho-Jun Kwak
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul, Korea
| | - Seung-Wan Park
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul, Korea
| | - Byung-Ju Ryu
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul, Korea
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Craig K, d'Agostino C, Poratt D, Walker M. Original hypothesis: Extracorporeal shockwaves as a homeostatic autoimmune restorative treatment (HART) for Type 1 diabetes mellitus. Med Hypotheses 2014; 83:250-3. [PMID: 24947195 DOI: 10.1016/j.mehy.2014.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 04/07/2014] [Accepted: 05/03/2014] [Indexed: 10/25/2022]
Abstract
Mononuclear invasion of Langerhans islet and the ensuing insulitis triggers signal-transduction for the autoimmune mediated pancreatic beta-cell (β-cell) apoptosis that severely disrupts insulin production resulting in hyperglycemia associated with Type-1 diabetes (T1DM). Today extensive global research is being conducted to eliminate the need for insulin, and even prevent or find a cure for T1DM. The multifactorial combination of autoimmune dysfunction, Langerhans islet hypoxia, and bio-chemical disruption are seen to be contributory factors for β-cell destruction and the consequential disruption to insulin production. Regeneration of β-cells back to physiological levels may restore homeostatic insulin levels, reversing T1DM. Evidence suggests that there are still functioning pancreatic β-cells even in long standing T1DM providing the potential for their regeneration. Although the exact mechanism of extracorporeal shockwaves (ESW) is yet to be fully elucidated, it is seen to influence a complex spectrum of bio-chemical, cellular and neuronal functions (i.e. suppression of pro-inflammatory immune response, improved tissue hemodynamics, anti-microbial properties, and the induction of progenitor cell expression including proangiogenic factors and nitric oxide syntheses). The rationale for the use of ESW as a therapeutic modality in this instance is attributed to its restorative properties and safety profile demonstrated in urology, cardiology, chronic wounds, osteogenesis, complex pain syndromes, and tendinopathies. ESW may restore autoimmune homeostasis creating a suitable environment for pancreatic β-cell proliferation which in-turn may significantly increase or normalize endogenous insulin secretion reducing or totally eliminating dependency of exogenous insulin. The devastating complications, morbidity and mortality associated with T1DM warrants the exploration of homeostatic autoimmune restorative treatment (HART) modalities that may partially or fully reverse this disease condition. We present our hypothesis discussing ESW as a potential homeostatic autoimmune restorative treatment (HART) option for T1DM.
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Affiliation(s)
| | - Cristina d'Agostino
- Shock Wave Therapy Research Unit, Rehabilitation Department, Instituto Clinico Humanitas, Milan, Italy. cristina.d'
| | - Daniel Poratt
- Auckland University of Technology, Auckland, New Zealand.
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van Bussel C, Stronks D, Huygen F. Complex regional pain syndrome type I of the knee: A systematic literature review. Eur J Pain 2013; 18:766-73. [DOI: 10.1002/j.1532-2149.2013.00434.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2013] [Indexed: 11/09/2022]
Affiliation(s)
- C.M. van Bussel
- Center for Pain Medicine; Erasmus MC; University Medical Center Rotterdam; The Netherlands
| | - D.L. Stronks
- Center for Pain Medicine; Erasmus MC; University Medical Center Rotterdam; The Netherlands
| | - F.J.P.M. Huygen
- Center for Pain Medicine; Erasmus MC; University Medical Center Rotterdam; The Netherlands
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Santamato A, Notarnicola A, Panza F, Ranieri M, Micello MF, Manganotti P, Moretti B, Fortunato F, Filoni S, Fiore P. SBOTE study: extracorporeal shock wave therapy versus electrical stimulation after botulinum toxin type a injection for post-stroke spasticity-a prospective randomized trial. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:283-291. [PMID: 23245824 DOI: 10.1016/j.ultrasmedbio.2012.09.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 09/15/2012] [Accepted: 09/22/2012] [Indexed: 06/01/2023]
Abstract
Research is on-going to identify new methods of biostimulation to increase the effect of botulinum toxin type A (BTX-A) in the treatment of spasticity. The Spasticity treated by Botulinum Toxin and ESWT (SBOTE) study is a prospective, randomized controlled trial assessing the effectiveness of extracorporeal shock wave therapy (ESWT) given immediately after BTX-A injections compared with electrical stimulation (ES) given immediately after BTX-A therapy for the management of focal upper limb spasticity in stroke patients. ES was given for 30 min twice a day for 5 days starting at 5 Hz; ESWT was given once a day for 5 days. At study follow-up, patients treated with BTX-A injections and ESWT showed a statistically greater significance and continuous decrease of spasticity measure (modified Ashworth scale [MAS]: 1.37, 1.75 and 1.58 at 15, 30 and 90 days post-treatment, respectively), of spasms (spasm frequency scale [SFS]: 0.8 and 0.25 at 30 and 90 days post-treatment, respectively) and of pain (visual analogue scale [VAS]: 1.94 and 1.87 at 30 and 90 days, respectively) compared with patients treated with BTX-A injections and ES (MAS: 2.37, 2.18 and 2.18, respectively) (p < 0.05) (SFS: 1.5 and 1.06, respectively) (p < 0.05) (VAS: 2.44 and 2.69 respectively) (p < 0.05). ESWT enhances the effect of BTX-A to a greater extent than ES, probably by modulating rheology of the muscle and neurotransmission at the neuromuscular junction.
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Affiliation(s)
- Andrea Santamato
- Department of Physical Medicine and Rehabilitation, University of Foggia, Foggia, Italy
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Wang CJ. Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res 2012; 7:11. [PMID: 22433113 PMCID: PMC3342893 DOI: 10.1186/1749-799x-7-11] [Citation(s) in RCA: 272] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 03/20/2012] [Indexed: 12/23/2022] Open
Abstract
The sources of shockwave generation include electrohydraulic, electromagnetic and piezoelectric principles. Electrohydraulic shockwaves are high-energy acoustic waves generated under water explosion with high voltage electrode. Shockwave in urology (lithotripsy) is primarily used to disintegrate urolithiasis, whereas shockwave in orthopedics (orthotripsy) is not used to disintegrate tissues, rather to induce tissue repair and regeneration. The application of extracorporeal shockwave therapy (ESWT) in musculoskeletal disorders has been around for more than a decade and is primarily used in the treatment of sports related over-use tendinopathies such as proximal plantar fasciitis of the heel, lateral epicondylitis of the elbow, calcific or non-calcific tendonitis of the shoulder and patellar tendinopathy etc. The success rate ranged from 65% to 91%, and the complications were low and negligible. ESWT is also utilized in the treatment of non-union of long bone fracture, avascular necrosis of femoral head, chronic diabetic and non-diabetic ulcers and ischemic heart disease. The vast majority of the published papers showed positive and beneficial effects. FDA (USA) first approved ESWT for the treatment of proximal plantar fasciitis in 2000 and lateral epicondylitis in 2002. ESWT is a novel non-invasive therapeutic modality without surgery or surgical risks, and the clinical application of ESWT steadily increases over the years. This article reviews the current status of ESWT in musculoskeletal disorders.
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Affiliation(s)
- Ching-Jen Wang
- Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan.
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Notarnicola A, Moretti L, Tafuri S, Forcignanò M, Pesce V, Moretti B. Reduced local perfusion after shock wave treatment of rotator cuff tendinopathy. ULTRASOUND IN MEDICINE & BIOLOGY 2011; 37:417-425. [PMID: 21316560 DOI: 10.1016/j.ultrasmedbio.2010.11.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 10/10/2010] [Accepted: 11/30/2010] [Indexed: 05/30/2023]
Abstract
A marked neovascularity has been demonstrated in tendinopathies, due to the inflammatory-degenerative process. The aim of this study was to assess the effect of extracorporeal shock wave therapy (ESWT) on tissue perfusion in the treatment of tendinopathy. An observational clinical study was made of 30 patients undergoing ESWT for tendinopathy of the rotator cuff. A clinical improvement was obtained in 65.6% of patients at 2 and 6 months. This was associated with a statistically significant reduction in the oxygen tissue saturation, measured by oxymetry that was apparent already during treatment, as well as at subsequent follow-up visits. The reduced perfusion achieved with ESWT supports the hypothesis that this treatment can regulate the inflammatory process and offset increased vascularization, restoring physiologic tendon conditions.
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Affiliation(s)
- Angela Notarnicola
- Department of Clinical Methodology and Surgical Techniques, Orthopedics Section, Faculty of Medicine and Surgery of University of Bari, General Hospital, Bari, Italy.
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