1
|
Zhou Q, Chen J. A critical overview of systematic reviews and meta-analyses of extracorporeal shockwave therapy for knee osteoarthritis. Asian J Surg 2024; 47:2975-2984. [PMID: 38290944 DOI: 10.1016/j.asjsur.2024.01.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/20/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024] Open
Abstract
Knee Osteoarthritis (KOA) has become a serious health issue for elderly patients. Several systematic reviews (SRs) and Meta-Analyses (MAs) have reported extracorporeal shockwave therapy (ESWT) has widely been used in the treatment of KOA. This overview aims to summarize and evaluate the available evidence for the efficacy of ESWT for KOA. Eight databases were searched from inception to December 4, 2022. The methodological quality of the included SRs/MAs was assessed by Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to assess the quality of the included studies in terms of outcome indicators. Eight SRs/MAs were finally included in this study. The results of the methodological quality of the included SRs/MAs were generally unsatisfactory. The limitations were a lack of explaining the reasons for selection, a list of excluded literature, reporting bias assessment, and reporting the potential sources of conflict of interest. A total of 49 outcome indicators were assessed by using the GRADE tool. Only 3 items were assessed as moderate quality and the remaining indicators were rated as low and very low. Limitations were the most common downgraded factors. ESWT is regarded as a safe and therapeutically effective non-pharmacological method for the treatment of KOA. However, the reliability of the results is affected by the generally low methodological and evidential quality of the included SRs/MAs. Future researchers should improve the quality of original studies and SRs/MAs to provide a higher level of evidence-based medical evidence.
Collapse
Affiliation(s)
- Qinxin Zhou
- Department of Orthopaedic Surgery, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, 312000, People's Republic of China.
| | - Jixin Chen
- Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, People's Republic of China
| |
Collapse
|
2
|
Peña-Martínez VM, Acosta-Olivo C, Simental-Mendía LE, Sánchez-García A, Jamialahmadi T, Sahebkar A, Vilchez-Cavazos F, Simental-Mendía M. Effect of corticosteroids over plantar fascia thickness in plantar fasciitis: a systematic review and meta-analysis. PHYSICIAN SPORTSMED 2024; 52:217-228. [PMID: 37293970 DOI: 10.1080/00913847.2023.2223673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/03/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Corticosteroid injections have been typically used for the management of plantar fasciitis with apparently good clinical outcomes; however, there is no information of the effect of corticosteroids on the thickness of the plantar fascia which is typically altered in this pathology. We aimed determine whether treatment with corticosteroid injections induces plantar fascia thickness changes in plantar fasciitis. METHODS MEDLINE, Embase, Web of Science, and Scopus databases were searched for randomized controlled trials (RCT) reporting the use of corticosteroid injection to treat plantar fasciitis to July 2022. Studies must have reported plantar fascia thickness measurement. The risk of bias in all studies was assessed with the Cochrane Risk of Bias 2.0 tool. Meta-analysis was conducted using a random-effects model and the generic inverse variance method. RESULTS Data from 17 RCT (including 1109 subjects) were collected. The follow-up period ranged from one to six months. Most studies measured the thickness of the plantar fascia at the insertion into the calcaneus using ultrasound. Pooled analysis revealed that corticosteroid injections had no significant effect on plantar fascia thickness (weighted mean differences [WMD], 0.06 mm [95% CI: -0.17, 0.29]; p = 0.61) or pain relief (WMD, 0.12 cm [95% CI: -0.36, 0.61]; p = 0.62) above active controls. CONCLUSION Corticosteroid injections do not perform better than other common interventions in terms of a decrease of plantar fascia thickness and pain relief for plantar fasciitis.
Collapse
Affiliation(s)
- Víctor M Peña-Martínez
- Universidad Autonoma de Nuevo Leon, Orthopedic Trauma Service, University Hospital "Dr. José Eleuterio González", Monterrey, México
| | - Carlos Acosta-Olivo
- Universidad Autonoma de Nuevo Leon, Orthopedic Trauma Service, University Hospital "Dr. José Eleuterio González", Monterrey, México
| | | | - Adriana Sánchez-García
- Universidad Autonoma de Nuevo Leon, Endocrinology Division, University Hospital "Dr. José Eleuterio González", Monterrey, México
| | - Tannaz Jamialahmadi
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Félix Vilchez-Cavazos
- Universidad Autonoma de Nuevo Leon, Orthopedic Trauma Service, University Hospital "Dr. José Eleuterio González", Monterrey, México
| | - Mario Simental-Mendía
- Universidad Autonoma de Nuevo Leon, Orthopedic Trauma Service, University Hospital "Dr. José Eleuterio González", Monterrey, México
| |
Collapse
|
3
|
Orhan Ö, Ağır H, Sarıkaya B, Dolap MA, Akif Altay M. Pain relief and functional improvement provided by extracorporeal shock wave therapy in plantar fasciitis is better than corticosteroid injection and kinesio taping: A randomized trial. Turk J Phys Med Rehabil 2023; 69:469-478. [PMID: 38766588 PMCID: PMC11099853 DOI: 10.5606/tftrd.2023.12824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/16/2023] [Indexed: 05/22/2024] Open
Abstract
Objectives This study aimed to evaluate the results of extracorporeal shock wave therapy (ESWT), corticosteroid injection (CI), and kinesio taping (KT) in terms of pain and function in plantar fasciitis (PF). Patients and methods In this prospective study, 90 feet of 64 patients (11 males, 53 females; mean age: 38.3±10.4 years; range, 22 to 70 years) who presented with chronic PF between November 2021 and March 2022 were evaluated. The patients were randomized to three groups, with 30 feet in each group: the CI group, the ESWT group, and the KT group. Each group received only the respective treatment modalities assigned to their group. Pain assessment of the patients before the treatment and at six weeks, three months, and six months was evaluated with the Visual Analog Scale (VAS), and their functions were evaluated with the American Orthopedic Foot and Ankle Society (AOFAS) score. Results There was no statistical difference in the demographic data (age, body mass index, and VAS; all p>0.05). At six weeks, VAS was statistically significantly lower in the CI group compared to the other groups (p<0.001), but there was no difference in AOFAS between the groups (p=0.666). At three months, there was no statistical difference between the groups regarding VAS (p=0.311), while the AOFAS was higher in the ESWT group (p=0.006). At six months, VAS was lower (p<0.001) and AOFAS was higher (p=0.003) in the ESWT group. Conclusion All three commonly used treatment modalities, ESWT, CI, and KT, are effective in reducing pain and increasing function in chronic PF. However, while CIs can be more effective in relieving pain in the early period, the most significant improvement at the end of the sixth month was achieved by ESWT.
Collapse
Affiliation(s)
- Özlem Orhan
- Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye
| | - Hatice Ağır
- Department of Physical Medicine and Rehabilitation, Şanlıurfa Regional Training and Research Hospital, Şanlıurfa, Türkiye
| | - Baran Sarıkaya
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
| | - Mehmet Ali Dolap
- Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye
| | - Mehmet Akif Altay
- Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye
| |
Collapse
|
4
|
Wang H, Shi Y. Extracorporeal shock wave treatment for post‑surgical fracture nonunion: Insight into its mechanism, efficacy, safety and prognostic factors (Review). Exp Ther Med 2023; 26:332. [PMID: 37346403 PMCID: PMC10280326 DOI: 10.3892/etm.2023.12031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/21/2023] [Indexed: 06/23/2023] Open
Abstract
Post-surgical fracture nonunion (PSFN) represents the failure to achieve cortical continuity at radiological examination after an orthopedic operation, which causes a considerable disease burden in patients with fractures. As one of the traditional treatment modalities, surgical therapy is associated with a high fracture union rate; however, post-surgical complications are not negligible. Therefore, less invasive therapies are needed to improve the prognosis of patients with PSFN. Extracorporeal shock wave treatment (ESWT) is a noninvasive method that presents a similar efficacy profile and favorable safety profile compared with surgical treatment. However, the application and detailed mechanism of ESWT in patients with PSFN remain unclear. The present review focuses on the mechanism, efficacy, safety and prognostic factors of ESWT in patients with PSFN, aiming to provide a theoretical basis for its application and improve the prognosis of these patients.
Collapse
Affiliation(s)
- Haoyu Wang
- Department of Orthopaedics, Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region 010050, P.R. China
| | - Yaxuan Shi
- Department of Internal Medicine (Bone Oncology), Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region 010050, P.R. China
| |
Collapse
|
5
|
Gao Q, Zhang Y, Long J, Pan M, Wang J, Yang F. Effect of different constraint-induced movement therapy protocols on recovery of stroke survivors with upper extremity dysfunction: a systematic review and network meta-analysis. Int J Rehabil Res 2023; 46:133-150. [PMID: 37039604 DOI: 10.1097/mrr.0000000000000577] [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: 04/12/2023]
Abstract
We aimed to assess and rank comparative efficacy of different constraint-induced movement therapy (CIMT) protocols on motor function of upper extremity and activities of daily living (ADL) in stroke survivors. A comprehensive search was conducted in PubMed, EMBASE, Web of Science and Cochrane Library to identify randomized controlled trials on CIMT. Included studies were evaluated using the revised Cochrane risk of bias tool. Then a random-effects network meta-analysis was performed within a frequentist framework using Stata v16.0. Of the 1150 studies retrieved, 44 studies with 1779 participants were included. In terms of motor recovery of upper extremity, CIMT combined with trunk restraint, in which the less affected arm was constrained at least 4 h but no more than 6 h per day, ranked as the most effective intervention for the improvement of the Fugl-Meyer Assessment-Upper Extremity and the Action Research Arm Test score. In terms of ADL improvement, constraining the less affected arm for at least 4 h but no more than 6 h per day in CIMT combined with trunk restraint, was found to significantly improve the Motor Activity Log of quality of movement scale and amount of use scale score. The protocol of CIMT combined with trunk restraint, in which the less affected arm was constrained at least 4 h but no more than 6 h per day, ranked the highest in this analysis and might be considered in practice.
Collapse
Affiliation(s)
- Qian Gao
- School of Rehabilitation Medicine, Henan University of Chinese Medicine, Henan, China
| | | | | | | | | | | |
Collapse
|
6
|
Pandey S, Kumar N, Kumar A, Biswas A, Sinha U, Pandey J, Ghosh S, Das S, Johnson RA, Kumar R, E V A, Kumari K. Extracorporeal Shockwave Therapy Versus Platelet Rich Plasma Injection in Patients of Chronic Plantar Fasciitis: A Randomized Controlled Trial From a Tertiary Center of Eastern India. Cureus 2023; 15:e34430. [PMID: 36874677 PMCID: PMC9980840 DOI: 10.7759/cureus.34430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2023] [Indexed: 02/01/2023] Open
Abstract
Introduction Plantar fasciitis is a degenerative condition of the plantar fascia that leads to heel and sole pain. Physical modalities, physiotherapy, medication, and orthoses have been tried before as treatments. Extracorporeal shockwave therapy (ESWT) and the injection of autologous platelet-rich plasma (PRP) are generally effective in the treatment of plantar fasciitis, which might be resistant to other conservative measures. The present study compares the efficacy of ESWT and PRP injection in respect of symptomatic relief, functional improvement, and change in plantar fascia thickness (PFT). Methods Seventy-two patients were enrolled and randomized into two groups. Patients in the first group received ESWT, whereas patients in the second group received PRP injections. Patients were evaluated using the Visual Analog Scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) score, along with PFT measurement (using ultrasonography) before the treatment and at days 15, 30, and 90 after the treatment. The X2 test was used to compare qualitative variables, and the paired T-test was used to evaluate quantitative data. Quantitative variables had a normal distribution with a standard deviation, and the significance level was set at P-value=0.05. Results On day 0, the mean VAS of the ESWT and PRP groups were 6.44±1.11 and 6.78±1.17, respectively (p=0.237). On day 15, the mean VAS of the ESWT and PRP groups were 4.67±1.45 and 6.67±1.35, respectively (p<0.001). At day 30, the mean VAS of the ESWT and PRP groups were 4.97±1.46 and 4.69±1.39, respectively (p=0.391). On day 90, the mean VAS of the ESWT and PRP groups were 5.47±1.63 and 3.36±0.96 (p<0.001). On day 0, the mean PFTs of the ESWT and PRP groups were 4.73±0.40 and 5.19±0.51, respectively (p<0.001). At day 15, the mean PFT of the ESWT and PRP groups were 4.64±0.46 and 5.11±0.62, respectively (p<0.001) which changed to 4.52±0.53 and 4.40±0.58 at day 30 (p<0.001), and to 4.40±0.50 and 3.82±0.45 at day 90 (p<0.001). The mean AOFAS of the ESWT and PRP groups were 68.39±5.88 and 64.86±8.95 on day 0 (p=0.115), 72.58±6.26 and 67.22±10.47 on day 15 (p=0.115), 73.22±6.92 and 74.72±7.52 on day 30 (p=0.276), and 72.75±7.90 and 81.08±6.01 on day 90, respectively (p<0.001). Conclusion Both PRP injection and ESWT are very effective methods to improve pain and cause reduced plantar fascia thickness in patients with chronic plantar fasciitis non-responsive to other conservative measures. PRP injection is more effective at a longer duration as compared to ESWT.
Collapse
Affiliation(s)
- Sanjay Pandey
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Niraj Kumar
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Anjani Kumar
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Anurug Biswas
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Upasna Sinha
- Radiology, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Jyoti Pandey
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Srutarshi Ghosh
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Subha Das
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Renu A Johnson
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Ranjeet Kumar
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Anjusha E V
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Kalyani Kumari
- Paediatrics, Darbhanga Medical College and Hospital, Darbhanga, IND
| |
Collapse
|
7
|
Poenaru D, Sandulescu MI, Cinteza D. Biological effects of extracorporeal shockwave therapy in tendons: A systematic review. Biomed Rep 2022; 18:15. [PMID: 36684664 PMCID: PMC9845689 DOI: 10.3892/br.2022.1597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 11/30/2022] [Indexed: 12/30/2022] Open
Abstract
Extracorporeal shockwave therapy was initially used for kidney stone disintegration and its application was then extended to calcific tendinitis. The therapeutic field expanded and included numerous types of tendinopathies, from shoulder to plantar fascia. The clinical benefits were documented in trials and the effects and mechanisms were studied on models including animal and human tendons. The present systematic review outlines a large spectrum of biological effects. First, an optimal dose is adapted for each species and each tendon; exceeding the optimal dose may lead to structural injury. Furthermore, the biological effects may be grouped into neovascularization induction, cellularity and extracellular matrix changes, metalloprotease and cytokine modulation, as well as lubricin production. As a result, the remodeled tendon displays improved biomechanical properties to resist stress.
Collapse
Affiliation(s)
- Daniela Poenaru
- Department of Rehabilitation, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania,Correspondence to: Dr Daniela Poenaru, Department of Rehabilitation, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Miruna Ioana Sandulescu
- Doctoral School, Clinical Pharmacology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Delia Cinteza
- Department of Rehabilitation, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| |
Collapse
|
8
|
Wu WT, Chang KV, Özçakar L. Polydeoxyribonucleotide injection in muscle atrophy/immobilization: does that ring a bell? ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1046. [PMID: 36330411 PMCID: PMC9622503 DOI: 10.21037/atm-22-4035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 08/31/2022] [Indexed: 08/30/2023]
Affiliation(s)
- Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei
- Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| |
Collapse
|
9
|
Malahias MA, Roumeliotis L, Tyrpenou E, Kazas ST, Sourlas I, Kaseta MK. Ultrasound-Guided Partial Plantar Fascia Release with the Use of a Fine Cutting Device for the Treatment of Persistent Plantar Fasciitis: A Case Series. J Am Podiatr Med Assoc 2022; 112:20-244. [PMID: 36115031 DOI: 10.7547/20-244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Plantar fasciitis is a common cause of musculoskeletal discomfort. Minimally invasive interventions are preferred as second-line treatments following failure of conservative management. We report on a novel technique of ultrasound-guided percutaneous release of the medial third of the plantar fascia with the use of a fine cutting device for the treatment of persistent plantar fasciitis. METHODS This is a retrospective case series of all patients treated with the technique between 2013 and 2015. Patients had failed conservative management for a minimum of 6 months. The procedure was performed in an outpatient setting under local anesthesia. Under continuous ultrasound guidance, release of the medial third of the plantar fascia from the calcaneus was performed using an ophthalmic V-Lance knife through a medial stab wound entry point. RESULTS Fifteen patients (six men and nine women) with an average age of 54.7 years were included. The mean (standard deviation [SD]) visual analogue scale score for pain improved significantly, from 66.0 (SD, 18.8) preoperatively to each consecutive follow-up point: 29.3 (SD, 25.2) at 2 weeks, 30.0 (SD, 27.8) at 4 weeks, and 34.0 (SD, 26.1) at 12 weeks (P < .001). The mild increase in visual analogue scale score between 4 and 12 weeks was statistically significant (P = .018). Average duration of required analgesia was 5.5 days and average time required to return to usual activities was 5.7 days. Two patients suffered with refractory neuropathic pain over the lateral border of the foot without any obvious abnormality. CONCLUSIONS Ultrasound-guided percutaneous release with the use of a fine cutting device could be an alternative option for the treatment of persistent plantar fasciitis. The technique is not without complications, and a mild but statistically significant decline in pain levels from early to short term has been detected. Therefore, the long-term outcomes of this technique need to be investigated before we can advocate its routine use.
Collapse
Affiliation(s)
- Michael-Alexander Malahias
- *Stavros Niarchos Foundation, Hospital for Special Surgery, Complex Joint Reconstruction Center, New York, NY.,†Second Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Konstantopouleio General Hospital, Athens, Greece
| | - Leonidas Roumeliotis
- †Second Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Konstantopouleio General Hospital, Athens, Greece.,‡Department of Trauma and Orthopaedics, Basingstoke and North Hampshire Hospital, Basingstoke, Hampshire, United Kingdom
| | - Evangelos Tyrpenou
- †Second Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Konstantopouleio General Hospital, Athens, Greece.,§Department of Orthopaedic Surgery, McGill University, Jewish General Hospital, Montreal, Quebec, Canada
| | - Sotirios-Tsambikos Kazas
- †Second Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Konstantopouleio General Hospital, Athens, Greece
| | - Ioannis Sourlas
- †Second Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Konstantopouleio General Hospital, Athens, Greece
| | - Maria-Kyriaki Kaseta
- †Second Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Konstantopouleio General Hospital, Athens, Greece
| |
Collapse
|
10
|
Burton I, McCormack A. The Effectiveness of Combined Extracorporeal Shockwave Therapy and Exercise for Plantar Heel Pain: A Systematic Review. EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2022; 7:39-52. [DOI: 10.14218/erhm.2021.00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
11
|
The Efficacy of Instrumental Physical Therapy through Extracorporeal Shock Wave Therapy in the Treatment of Plantar Fasciitis: An Umbrella Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12062841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
(1) Background: Plantar fasciitis (PF) is the most common cause of heel pain in adults. Extracorporeal shockwave therapy (ESWT) is a minimally invasive treatments commonly used for treating PF. Our aim is to provide a complete overview of which treatments have been compared to ESWT, with a focus on the modalities that have been used. (2) Methods: A thorough search of the literature was performed on Medline via Pubmed, Cochrane Database of Systematic Reviews (CDSR) of the Cochrane Library and Physiotherapy Evidence Databases (PEDro) up to 18 November 2021. In the study were included only systematic reviews and meta-analysis in English language, published from 2010 to date. (3) Results: A total of 14 systematic reviews and meta-analysis were included in the umbrella review. A total of eight studies compared the efficacy of ESWT treatment with placebo, three studies compared ESWT with another therapy (two studies compared ESWT and corticosteroids, one study ESWT and ultrasound therapy), and three studies had more than one comparison. (4) Conclusions: When compared to placebo, ESWT demonstrated to be effective. More randomized trials with specific comparisons between different types and intensity of SW are needed to obtain more precise information on SW effectiveness.
Collapse
|
12
|
Rhim HC, Kwon J, Park J, Borg-Stein J, Tenforde AS. A Systematic Review of Systematic Reviews on the Epidemiology, Evaluation, and Treatment of Plantar Fasciitis. Life (Basel) 2021; 11:life11121287. [PMID: 34947818 PMCID: PMC8705263 DOI: 10.3390/life11121287] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 12/20/2022] Open
Abstract
The number of systematic review and meta-analyses on plantar fasciitis is expanding. The purpose of this review was to provide a comprehensive summary of reviews on the topic pertaining to plantar fasciitis, identify any conflicting and inconsistent results, and propose future research direction. A qualitative review of all systematic reviews and meta-analyses related to plantar fasciitis up to February 2021 was performed using PubMed, Embase, Web of Science, and the Cochrane Database. A total of 1052 articles were initially identified and 96 met the inclusion criteria. Included articles were summarized and divided into the following topics: epidemiology, diagnosis, and treatment. While the majority of reviews had high level of heterogeneity and included a small number of studies, there was general consensus on certain topics, such as BMI as a risk factor for plantar fasciitis and extracorporeal shockwave therapy as an effective mode of therapy. A qualitative summary of systematic reviews and meta-analyses published on plantar fasciitis provides a single source of updated information for clinicians. Evidence on topics such as the epidemiology, exercise therapy, or cost-effectiveness of treatment options for plantar fasciitis are lacking and warrant future research.
Collapse
Affiliation(s)
- Hye Chang Rhim
- MetroWest Medical Center, Tufts University School of Medicine, Framingham, MA 01702, USA;
| | - Jangwon Kwon
- Department of Physical Therapy, University of Delware, Newark, DE 19716, USA;
| | - Jewel Park
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA;
| | - Joanne Borg-Stein
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA;
- Spaulding Rehabilitation Hospital, Charlestown, MA 02129, USA
| | - Adam S. Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA;
- Spaulding Rehabilitation Hospital, Charlestown, MA 02129, USA
- Correspondence:
| |
Collapse
|
13
|
Fei X, Lang L, Lingjiao H, Wei C, Zhou X. Platelet-rich plasma has better mid-term clinical results than traditional steroid injection for plantar fasciitis: A systematic review and meta-analysis. Orthop Traumatol Surg Res 2021; 107:103007. [PMID: 34217867 DOI: 10.1016/j.otsr.2021.103007] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 08/18/2020] [Accepted: 09/14/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Recently, local platelet-rich plasma (PRP) injection has been gradually used in the treatment of plantar fasciitis (PF). However, compared with traditional steroid injection, the clinical results of local PRP injection for PF patients remain controversial. Therefore, we performed a systematic review to focus on two questions as follows: (1) is PRP more effective than steroid to relieve pain in PF patients? (2) is PRP more effective than steroid to improve the foot and ankle function of PF patients? HYPOTHESIS The PRP could be more effective to relieve pain and improve the foot and ankle function in PF patients. MATERIAL AND METHODS We systematically searched electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, Web of Science, and Embase) from inception to October 20, 2019. The data of clinical results, including visual analogue scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) scores, were extracted and analyzed. RESULTS Finally, twelve randomized controlled trials (RCT), involving 653 PF patients, were enrolled. All enrolled trials were considered to be of high quality. The results showed that the VAS of the PRP group was significantly lower than that of the steroid group at 6-month (p=0.02), 1-year (p=0.02), and 1.5-year (p<0.00001) follow-up. The AOFAS scores of the PRP group were significantly higher than that of the steroid group at 1-year (p=0.005) follow-up. DISCUSSION Compared to local steroid injection, local autologous PRP injection is more effective in relieving pain and improving the foot and ankle function at mid-term follow-up. LEVEL OF EVIDENCE II; Systematic review and Meta-analysis.
Collapse
Affiliation(s)
- Xing Fei
- Department of Orthopaedics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, 610041 Chengdu, Sichuan, People's Republic of China
| | - Li Lang
- Department of Orthopaedics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, 610041 Chengdu, Sichuan, People's Republic of China
| | - Hu Lingjiao
- Department of Gastroenterology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, No. 46 Chongxin Road, 541002 Guilin City, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Chen Wei
- Department of Orthopaedics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, 610041 Chengdu, Sichuan, People's Republic of China
| | - Xiang Zhou
- Department of Orthopaedics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, 610041 Chengdu, Sichuan, People's Republic of China.
| |
Collapse
|
14
|
Extracorporeal Shockwave Therapy for the Treatment of Tendinopathies: Current Evidence on Effectiveness, Mechanisms, Limitations and Future Directions. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00324-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
15
|
Dextrose prolotherapy versus radial extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: A randomized, controlled clinical trial. Foot Ankle Surg 2021; 27:643-649. [PMID: 32919897 DOI: 10.1016/j.fas.2020.08.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 02/04/2023]
Abstract
In the recent years, prolotherapy is increasingly being used in the field of musculoskeletal medicine. However, few studies have investigated its effectiveness in plantar fasciitis (PF). The purpose of this study was to compare the effectiveness of ultrasound-guided dextrose prolotherapy with radial extracorporeal shock wave therapy (ESWT) in the treatment of chronic PF. This randomized controlled trial was conducted on 59 patients with chronic PF. Patients were randomly assigned into two groups receiving three sessions of radial ESWT (29 patients) vs. two sessions of ultrasound-guided intrafascial 2 cc dextrose 20% injection (30 patients). The following outcome measures were assessed before and then six weeks and 12 weeks after the treatments: pain intensity by visual analog scale (VAS), daily life and exercise activities by Foot and Ankle Ability Measure (FAAM), and the plantar fascia thickness by ultrasonographic imaging. The VAS and FAAM scales showed significant improvements of pain and function in both study groups 6 weeks and 12 weeks after the treatments. A significant reduction was noted for plantar fascia thickness at these intervals (all p < .05). The inter-group comparison revealed that except for the FAAM-sport subscale which favored ESWT, the interaction effects of group and time were not significant for other outcome measures. Dextrose prolotherapy has comparable efficacy to radial ESWT in reducing pain, daily-life functional limitation, and plantar fascia thickness in patients with PF. No serious adverse effects were observed in either group. LEVEL OF EVIDENCE: Level I, randomized controlled trial.
Collapse
|
16
|
Yu T, Xia J, Li B, Zhou H, Yang Y, Yu G. Outcomes of platelet-rich plasma for plantar fasciopathy: a best-evidence synthesis. J Orthop Surg Res 2020; 15:432. [PMID: 32958046 PMCID: PMC7504858 DOI: 10.1186/s13018-020-01783-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 07/02/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Plantar fasciopathy (PF) is a very common disease, affecting about 1/10 people in their lifetime. Platelet-rich plasma (PRP) had been demonstrated to be useful in achieving helpful effects for plantar fasciopathy. The purpose of this study was to compare the pain and functional outcomes between PRP and corticosteroid (CS) or placebo for plantar fasciopathy through meta-analysis and provide the best evidence. METHODS Literature was searched systematically to explore related studies that were published in Cochrane Library, PubMed, Embase, Medline, SpringerLink, OVID, and ClinicalTrials.gov . Articles regarding comparative research about the outcomes of PRP therapy and CS or placebo injection were selected. Data of pain and functional outcomes was extracted and imported into Reviewer Manager 5.3 to analyze. RESULTS Thirteen RCTs were included and analyzed. Analysis results showed significant superiority of PRP in outcome scores when compared with CS (VAS: MD = - 0.85, P < 0.0001, I2 = 85%; AOFAS: MD = 10.05, P < 0.0001, I2 = 85%), whereas there is no statistical difference in well-designed double-blind trials (VAS: MD = 0.15, P = 0.72, I2 = 1%; AOFAS: MD = 2.71, P = 0.17, I2 = 0%). In the comparison of the PRP and the placebo, the pooled mean difference was - 3.76 (P < 0.0001, 95% CI = - 4.34 to - 3.18). CONCLUSIONS No superiority of PRP had been found in well-designed double-blind studies, whereas it is implied that the outcomes of PRP are better than placebo based on available evidence.
Collapse
Affiliation(s)
- Tao Yu
- Department of Orthopedic Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China
| | - Jiang Xia
- Department of Orthopedic Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China
| | - Bing Li
- Department of Orthopedic Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China.
| | - Haichao Zhou
- Department of Orthopedic Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China
| | - Yunfeng Yang
- Department of Orthopedic Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China.
| | - Guangrong Yu
- Department of Orthopedic Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China
| |
Collapse
|
17
|
Khurana A, Dhankhar V, Goel N, Gupta R, Goyal A. Comparison of midterm results of Platelet Rich Plasma (PRP) versus Steroid for plantar fasciitis: A randomized control trial of 118 patients. J Clin Orthop Trauma 2020; 13:9-14. [PMID: 33717869 PMCID: PMC7920137 DOI: 10.1016/j.jcot.2020.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/14/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Plantar fasciitis, which is a common cause of heel pain, often results in significant morbidity. In cases who are not responsive to initial conservative treatment, invasive procedures, often in the form of local infiltration of steroid are required. These procedures are associated with significant complications. Local Platelet Rich Plasma (PRP) infiltration is an emerging addition to these treatments. However, whether it is more effective in reducing pain and improving function than other treatments (such as steroid injections or whole blood) remains controversial. METHODS Skeletally mature patients with plantar fasciitis who had failed conservative therapy were randomized using envelope method into 2 groups: PRP and Steroid group. The participants were assessed for pain using Visual Analog Scale on the day of presentation, and then after therapy at 2 weeks, 4 weeks, 3 months, and 6 months. They were additionally assessed on final follow-up using AOFAS hind-foot Score. RESULTS 118 patients were randomized into 2 groups: 58 patients to the PRP group and 60 to the Steroid group. PRP was associated with greater improvement in VAS score and resulted in superior AOFAS score at 6 months as compared to steroid injection. The authors did not find any local or systemic complications in any of the groups. The result and difference were more pronounced as the time from injection increased and maximal benefit was observed at 6 months follow-up. None of the patients needed a repeat injection at 6 months. CONCLUSION Our study expands on the previous studies to provide a better evidence for superiority of PRP over local injection of steroid in plantar fasciitis, and the authors conclude that PRP provides better pain relief and function as compared to steroid injection. LEVEL OF EVIDENCE Level 1 Prospective Randomized Control Trial (RCT).
Collapse
Affiliation(s)
- Ankit Khurana
- Department of Orthopaedics, Dr BSA Medical College and Hospital, Delhi, India,Corresponding author. Department of Orthopaedics, Dr BSA Medical college and Hospital, Rohini Sector 6, Delhi, 110085, India.
| | - Vaneet Dhankhar
- Department of Orthopaedics, Dr BSA Medical College and Hospital, Delhi, India
| | - Navneet Goel
- Department of Orthopaedics, Dr BSA Medical College and Hospital, Delhi, India
| | - Rishi Gupta
- Department of Biostatistics, Manokalp Clinic, Delhi, India
| | - Ashish Goyal
- Department of Orthopaedics, Dr BSA Medical College and Hospital, Delhi, India
| |
Collapse
|
18
|
Zhang Q, Schwade M, Smith Y, Wood R, Young L. Exercise-based interventions for post-stroke social participation: A systematic review and network meta-analysis. Int J Nurs Stud 2020; 111:103738. [PMID: 32858433 DOI: 10.1016/j.ijnurstu.2020.103738] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/04/2020] [Accepted: 07/27/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Resuming participation in society is an important goal of post-stroke rehabilitation. Exercise-based interventions have been shown to be effective non-pharmacological methods for improving social participation in post-stroke survivors, however it is unclear what the most effective types of exercise interventions are. OBJECTIVE To assess the comparative effects and ranks of all exercise-based interventions in improving social participations in patients after a stroke. METHODS A random-effects network meta-analysis was performed to identify evidence from relevant randomized control trials. We searched MEDLINE, CINAHL, EMBASE, PsycINFO, CINHAL, Cochrane Library, AMED, SPORTDiscus, Web of Science and Clinical Trials.gov from their earliest records to January 2020. Included trials must include at least one types of exercise for patients with stroke. The primary e was social participation. Bias will be assessed according to the revised Cochrane risk of bias tool. Data were analysed using Stata v14.0. Registration number of this study is CRD42020152523. RESULTS A total of 16 randomized control trials involving 1704 patients and 12 intervention arms were included in our study. We performed three subgroup analyses divided based on follow up time (1 to <6 months post-treatment, and ≥6 months post-treatment), and intervention adherence. Based on the ranking probabilities, motor relearning programme was ranked as the most effective among all exercise interventions (surface under cumulative ranking curve values [SUCRCV]: 95.6%, standardized mean difference [SMD]: 2.72, 95% confidence interval [CI]: 1.76 to 3.69) in overall and short-term treatment efficacy. In the long-term subgroup, home-based combined exercise ranked the best for the efficacy of social participation improvements among stroke survivors (SUCRCV: 71.8%, SMD: -0.23, 95% CI: -0.61 to 0.15). In the analysis of all interventions with adherence of >90%, cognitive-based exercise ranked the best (SUCRCV: 100%, SMD: 2.64, 95% CI: 1.62 to 3.66). CONCLUSIONS Interventions that emerged with the highest ranks in our analysis might be considered in practice when resources allow. More large, well-designed multicentre trials are needed to support the conclusion of this study.
Collapse
Affiliation(s)
- Qi Zhang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Mark Schwade
- Medical College of Georgia, Augusta University, Augusta, USA
| | - Yvonne Smith
- Abraham Baldwin Agricultural College, Tifton, USA
| | - Racheal Wood
- College of Nursing, Augusta University, Augusta, USA
| | - Lufei Young
- College of Nursing, Augusta University, Augusta, USA
| |
Collapse
|
19
|
Huang K, Giddins G, Wu LD. Platelet-Rich Plasma Versus Corticosteroid Injections in the Management of Elbow Epicondylitis and Plantar Fasciitis: An Updated Systematic Review and Meta-analysis. Am J Sports Med 2020; 48:2572-2585. [PMID: 31821010 DOI: 10.1177/0363546519888450] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Platelet-rich plasma (PRP), as a promising alternative to traditional corticosteroid (CS), is now increasingly used in the treatment of elbow epicondylitis (EE) and plantar fasciitis (PF). To date, however, the synthesis of information on the clinical efficacy of PRP versus CS is limited with divergent conclusions. PURPOSE To compare the clinical efficacy of PRP and CS injections in reducing pain and improving function in EE and PF. STUDY DESIGN Systematic review and meta-analysis. METHODS Online databases were searched from inception to October 2018 for prospective studies evaluating PRP versus CS injections for EE or PF. Independent reviewers undertook searches, screening, and risk-of-bias appraisals. The primary outcomes of interest were pain and function in both the short term (1-3 months) and the long term (≥6 months). RESULTS Twenty trials with 1268 participants were included. For EE, PRP provides a statistically and clinically meaningful long-term improvement in pain, with a very large effect size of -1.3 (95% CI, -1.9 to -0.7) when compared with CS, but the evidence level was low. For EE, there was moderate evidence that CS provides a statistically meaningful improvement in pain in the short term, with a medium effect size of 0.56 (95% CI, 0.08-1.03) as compared with PRP; this improvement might not be clinically significant. For PF, there was low evidence that PRP provides a statistically and clinically meaningful long-term improvement in function (American Orthopedic Foot & Ankle Society score), with a very large effect size of 1.94 (95% CI, 0.61-3.28). There were no significant differences between the groups in improvement in function in EE and pain and short-term function in PF, but the quality of the evidence was low. CONCLUSION The use of PRP yields statistically and clinically better improvement in long-term pain than does CS in the treatment of EE. The use of PRP yields statistically and clinically better long-term functional improvement than that of CS in the treatment of PF.
Collapse
Affiliation(s)
- Kai Huang
- Department of Orthopaedic Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Grey Giddins
- Department of Orthopaedic Surgery, Royal United Hospital Bath, Bath, UK
| | - Li-Dong Wu
- Department of Orthopaedic Surgery, The Second Hospital of Medical College, Zhejiang University, Hangzhou, China
| |
Collapse
|
20
|
Tseng W, Uy J, Chiu Y, Chen W, Vora A. The Comparative Effectiveness of Autologous Blood‐derived Products Versus Steroid Injections in Plantar Fasciitis: A Systematic Review and Meta‐analysis of Randomized Controlled Trials. PM R 2020; 13:87-96. [DOI: 10.1002/pmrj.12373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 02/25/2020] [Accepted: 03/20/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Wen‐Che Tseng
- Department of Epidemiology, Harvard T.H. Chan School of Public Health Harvard University Boston MA USA
- Department of Physical Medicine and Rehabilitation National Taiwan University Hospital Taipei Taiwan
| | - Jhanna Uy
- Department of Epidemiology, Harvard T.H. Chan School of Public Health Harvard University Boston MA USA
| | - Yi‐Hsiang Chiu
- Department of Physical Medicine and Rehabilitation National Taiwan University Hospital Taipei Taiwan
| | - Wen‐Shiang Chen
- Department of Physical Medicine and Rehabilitation National Taiwan University Hospital Taipei Taiwan
| | - Ariana Vora
- Department of Physical Medicine Harvard Medical School, Harvard University Boston MA USA
| |
Collapse
|
21
|
Copenhagen Adduction Exercise to Increase Eccentric Strength: A Systematic Review and Meta-Analysis. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10082863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The purpose of this study was to systematically review the scientific literature about the benefits of using the Copenhagen Adductor (CA) exercise to improve eccentric hip adduction strength (EHAD), as well as to provide directions for training. Methods: A systematic search was conducted in three electronic databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The inclusion criteria were: (a) EHAD as outcome variable, with means and standard deviations before and after the intervention, (b) the study was a randomized controlled trial using the CA in the program intervention, (c) the article was written in English. The quality of evidence was evaluated according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. A mini meta-analysis was performed to determine the overall effect. Results: Three studies were selected and included in this systematic review and mini meta-analysis. All articles reported significant enhancement in EHAD in football (soccer) players. The overall effect for the EHAD test was significant in favor to CA group (mean difference = 0.61; 95% CI from 0.20 to 1.01; p = 0.003) with large heterogeneity. Conclusions: CA exercise performed 2–3 times for 8 weeks is useful for improving EHAD in football players.
Collapse
|
22
|
dos Santos IK, Ashe MC, Cobucci RN, Soares GM, de Oliveira Maranhão TM, Dantas PMS. The effect of exercise as an intervention for women with polycystic ovary syndrome: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e19644. [PMID: 32311937 PMCID: PMC7220722 DOI: 10.1097/md.0000000000019644] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) affects reproductive-aged women and is associated with increased prevalence of serious clinical problems including: reproductive implications, metabolic dysfunction, and cardiovascular risk. Physical activity offers several health benefits for women with PCOS. The aim of this systematic review was to synthesize evidence on the effect of different types of exercise on reproductive function and body composition for women with PCOS. METHODS This was a systematic review and meta-analysis of randomized controlled trials (RCTs) following recommended review methods. We searched 6 databases: Cumulative Index of Nursing and Allied Health Literature; Embase; MEDLINE (via Ovid); PubMed; Sport Discus; and Web of Science; and we developed search strategies using a combination of Medical Subject Headings terms and text words related to exercise interventions for women with PCOS. There was no restriction on language or publication year. The search was conducted on April 16, 2019 and updated on November 15, 2019. Two authors independently screened citations, determined risk of bias and quality of evidence with Grading of Recommendations Assessment, Development and Evaluation. We conducted meta-analyses following recommended guidelines, and report results using standardized mean difference (SMD). RESULTS Ten RCTs (n = 533) were included in this review. Studies tested the following interventions: aerobic, resistance, and combined (aerobic/resistance) training programs. Most studies were small (average 32, range 15-124 participants), and of relatively short duration (8-32 weeks). There was high heterogeneity for outcomes of reproductive function (menstrual cycle, ovulation, and fertility). We noted low certainty evidence for little to no effect of exercise on reproductive hormones and moderate certainty evidence that aerobic exercise reduced body mass index (BMI) in women with PCOS: BMI SMD -0.35, 95% confidence interval -0.56 to -0.14, P = .001. CONCLUSION For women with PCOS, evidence is limited to discern the effect of exercise on major health outcomes (e.g., reproductive function). There is moderate certainty evidence that aerobic exercise alone is beneficial for reducing BMI in women with PCOS. Future studies should be conducted with longer duration, larger sample sizes, and should provide detailed information on menstrual cycle and fertility outcomes.PROSPERO Systematic review registration: 2017 CRD42017058869.
Collapse
Affiliation(s)
- Isis Kelly dos Santos
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Maureen C. Ashe
- Department of Family Practice, The University of British Columbia
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Ricardo Ney Cobucci
- Biotechnology Postgraduate Program and Medicine School, Potiguar University of Rio Grande do Norte
| | | | | | | |
Collapse
|
23
|
Melo SNS, Ezekwesili A, Yurdi NA, Murrell WD, Maffulli N. Gold-Induced Cytokine (GOLDIC ®) Injection Therapy in Patient with Plantar Fasciosis: A Case Report. Indian J Orthop 2020; 54:348-351. [PMID: 32399155 PMCID: PMC7205939 DOI: 10.1007/s43465-020-00089-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/06/2020] [Indexed: 02/04/2023]
Abstract
A novel technique of cultivating autologous blood with gold particles; then separating the gold particles and cells from the serum and injecting the conditioned serum into affected plantar fascia. A first-time report of the safety and efficacy in treatment of recalcitrant plantar fasciosis in an Olympic equestrian. A single patient with clinical signs, symptoms and ultrasound evidence of plantar fasciosis was treated with four intra-ligamentous GOLDIC® injection therapy. The Olympic jumper was evaluated by Visual Analog Scale (VAS), Foot and Ankle Disability Index (FADI), and Global Rating of Change (GRoC) score(s) before injection and at 6-month follow-up. VAS, FADI, and GRoC scores showed substantial and marked improvement clinically. The subject was able to return to sport without limitations after 8 weeks. The initial result demonstrates that the treatment regimen is safe, and efficacious. The subject demonstrated reduction of pain, and improved function that allowed return to high level competition.
Collapse
Affiliation(s)
- Sergio Nicolas Sardon Melo
- Emirates Integra Medical and Emirates Integra Medical and Surgery and Surgery Centre, Department Orthopaedic Sports Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Agnes Ezekwesili
- grid.410711.20000 0001 1034 1720University of North Carolina, Chapel Hill, NC USA
| | - Nagib A. Yurdi
- grid.490175.e0000 0004 4668 2924Healthpoint Hospital, Abu Dhabi, United Arab Emirates
| | - William D. Murrell
- grid.490175.e0000 0004 4668 2924Healthpoint Hospital, Abu Dhabi, United Arab Emirates ,grid.415784.b0000 0004 0464 1526Division of Surgery, Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany
| | - Nicola Maffulli
- grid.11780.3f0000 0004 1937 0335Department of Musculoskeletal Disorders, School of Medicine and Dentistry, University of Salerno, Salerno, Italy ,grid.439227.90000 0000 8880 5954Queen Mary University of London, Barts and the London School of Medicine and Dentistry Centre for Sports and Exercise Medicine, Mile End Hospital, London, England, UK
| |
Collapse
|
24
|
Lin CP, Chang KV, Huang YK, Wu WT, Özçakar L. Regenerative Injections Including 5% Dextrose and Platelet-Rich Plasma for the Treatment of Carpal Tunnel Syndrome: A Systematic Review and Network Meta-Analysis. Pharmaceuticals (Basel) 2020; 13:ph13030049. [PMID: 32197544 PMCID: PMC7151714 DOI: 10.3390/ph13030049] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/13/2020] [Accepted: 03/14/2020] [Indexed: 02/07/2023] Open
Abstract
This network meta-analysis aimed to integrate the available direct and indirect evidence on regenerative injections—including 5% dextrose (D5W) and platelet-rich plasma (PRP)—for the treatment of carpal tunnel syndrome (CTS). Literature reports comparing D5W and PRP injections with non-surgical managements of CTS were systematically reviewed. The main outcome was the standardized mean difference (SMD) of the symptom severity and functional status scales of the Boston Carpal Tunnel Syndrome Questionnaire at three months after injections. Ranking probabilities of the SMD of each treatment were acquired by using simulation. Ten studies with 497 patients and comparing five treatments (D5W, PRP, splinting, corticosteroid, and normal saline) were included. The results of the simulation of rank probabilities showed that D5W injection was likely to be the best treatment, followed by PRP injection, in terms of clinical effectiveness in providing symptom relief. With respect to functional improvement, splinting ranked higher than PRP and D5W injections. Lastly, corticosteroid and saline injections were consistently ranked fourth and fifth in terms of therapeutic effects on symptom severity and functional status. D5W and PRP injections are more effective than splinting and corticosteroid or saline injection for relieving the symptoms of CTS. Compared with splinting, D5W and PRP injections do not provide better functional recovery. More studies investigating the long-term effectiveness of regenerative injections in CTS are needed in the future.
Collapse
Affiliation(s)
- Chih-Peng Lin
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10048, Taiwan;
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10048, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan;
- Correspondence: ; Tel.: +886-2-23717101-5309
| | - Yi-Kai Huang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan;
| | - Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan;
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey;
| |
Collapse
|
25
|
Chang KV, Wu WT, Özçakar L. Ultrasound imaging and guidance in peripheral nerve entrapment: hydrodissection highlighted. Pain Manag 2020; 10:97-106. [DOI: 10.2217/pmt-2019-0056] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Ultrasound (US) imaging has become one of the most useful modalities to assess peripheral nerve disorders. Nowadays, it is as important as nerve conduction studies and electromyography for peripheral nerve entrapment. Additionally, US is also helpful in guiding a possible intervention. As peripheral nerves are tiny, palpation-guided injections are really challenging for precisely targeting the nerves. By using US, perineural injections have significantly become safe and effective. Recently, US-guided hydrodissection has emerged as the mainstream for nerve entrapment. Accordingly, this review aims to summarize and update the mechanism and evidence regarding this imperative procedure for neuropathic pain management. Furthermore, the pathogenesis, anatomic features, US findings and histological correlations of nerve entrapment syndromes will also be discussed in this article.
Collapse
Affiliation(s)
- Ke-Vin Chang
- Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, 10845, Taiwan
- National Taiwan University College of Medicine, Taipei, 10051, Taiwan
| | - Wei-Ting Wu
- Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, 10845, Taiwan
- National Taiwan University College of Medicine, Taipei, 10051, Taiwan
| | - Levent Özçakar
- Department of Physical & Rehabilitation Medicine, Hacettepe University Medical School, Ankara, 06532, Turkey
| |
Collapse
|
26
|
Abstract
Foot and ankle injuries account for a significant volume of primary care office visits each year. Given the incidence of injury and concern for long-term sequelae, it is imperative that primary care physicians familiarize themselves with commonly encountered foot and ankle injuries. Coupling a sound understanding of key anatomic structures with an appropriately gathered history can help to quickly narrow the differential diagnosis in this clinical presentation. This article focuses on key elements from the history and physical examination as well as provides a concise review of imaging modalities and recommended treatment strategies.
Collapse
|
27
|
Raeissadat SA, Nouri F, Darvish M, Esmaily H, Ghazihosseini P. Ultrasound-Guided Injection of High Molecular Weight Hyaluronic Acid versus Corticosteroid in Management of Plantar Fasciitis: A 24-Week Randomized Clinical Trial. J Pain Res 2020; 13:109-121. [PMID: 32021400 PMCID: PMC6969680 DOI: 10.2147/jpr.s217419] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 12/24/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND AIMS Plantar fasciitis (PF) is the leading cause of heel pain in adults. This study was designed to evaluate the effect of hyaluronic acid (HA) injection in reducing the symptoms of PF, compared with corticosteroid (CS) injection as a conventional treatment. METHODS In this triple-blind, randomized, clinical trial, 75 patients who had the symptoms of PF for at least 3 months were randomly divided into two groups of 38 and 37 individuals. Then, each patient received either a single injection of high molecular weight (>2000 kDa) HA (1 mL HA 20 mg + 1 mL lidocaine 2%) or CS (1 mL methylprednisolone 40 mg + 1 mL lidocaine 2%) under the ultrasonography (US) guidance. Visual analog scale (VAS), foot ankle ability index (FAAI), pressure pain threshold (PPT), functional foot index (FFI), and plantar fascia thickness (PFT) were measured using US at baseline, 6 weeks and 24 weeks after the injection. Eventually, at the end of the treatment period, the patients' satisfaction was measured. Intention to treat analysis was used to assess the results. RESULTS After 24 weeks of follow-up, results from 60 subjects were fully obtained; however, results of 73 patients included into intention to treat analysis in the sixth-week follow-up. In both groups, VAS, PFT and FFI decreased, while FAAI and PPT increased significantly (P <0.001). At the baseline and at the 24th-week, no significant difference between the two groups was observed in any of the variables. However, a comparison between the baseline and the sixth-week results shows a prominent decrease in PPT and PFT in the CS group compared to the HA group (P = 0.004 and P = 0.011). Finally, there were no statistical differences between the two groups in treatment satisfaction (P = 0.618). CONCLUSION Both CS and HA were effective modalities for PF and can improve pain and function with no superiority in 24th-week follow-ups, although CS seems to have a faster trend of improvement in the short term.
Collapse
Affiliation(s)
- Seyed Ahmad Raeissadat
- Clinical Research Development Center, Shahid Modarres Hospital, Tehran, Iran
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farshad Nouri
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahtab Darvish
- Clinical Research Development Center, Shahid Modarres Hospital, Tehran, Iran
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadi Esmaily
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parsa Ghazihosseini
- Clinical Research Development Center, Shahid Modarres Hospital, Tehran, Iran
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
28
|
Johal H, Khan M, Yung SHP, Dhillon MS, Fu FH, Bedi A, Bhandari M. Impact of Platelet-Rich Plasma Use on Pain in Orthopaedic Surgery: A Systematic Review and Meta-analysis. Sports Health 2019; 11:355-366. [PMID: 31136726 DOI: 10.1177/1941738119834972] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
CONTEXT Amid extensive debate, evidence surrounding the use of platelet-rich plasma (PRP) for musculoskeletal injuries has rapidly proliferated, and an overall assessment of efficacy of PRP across orthopaedic indications is required. OBJECTIVES (1) Does PRP improve patient-reported pain in musculoskeletal conditions? and (2) Do PRP characteristics influence its treatment effect? DATA SOURCES MEDLINE, EMBASE, Cochrane, CINAHL, SPORTDiscus, and Web of Science libraries were searched through February 8, 2017. Additional studies were identified from reviews, trial registries, and recent conferences. STUDY SELECTION All English-language randomized trials comparing platelet-rich therapy with a control in patients 18 years or older with musculoskeletal bone, cartilage, or soft tissue injuries treated either conservatively or surgically were included. Substudies of previously reported trials or abstracts and conference proceedings that lacked sufficient information to generate estimates of effect for the primary outcome were excluded. STUDY DESIGN Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 1. DATA EXTRACTION All data were reviewed and extracted independently by 3 reviewers. Agreement was high between reviewers with regard to included studies. RESULTS A total of 78 randomized controlled trials (5308 patients) were included. A standardized mean difference (SMD) of 0.5 was established as the minimum for a clinically significant reduction in pain. A reduction in pain was associated with PRP at 3 months (SMD, -0.34; 95% CI, -0.48 to -0.20) and sustained until 1 year (SMD, -0.60; 95% CI, -0.81 to -0.39). Low- to moderate-quality evidence supports a reduction in pain for lateral epicondylitis (SMD, -0.69; 95% CI, -1.15 to -0.23) and knee osteoarthritis (SMD, -0.91; 95% CI, -1.41 to -0.41) at 1 year. PRP characteristics did not influence results. CONCLUSION PRP leads to a reduction in pain; however, evidence for clinically significant efficacy is limited. Available evidence supports the use of PRP in the management of lateral epicondylitis as well as knee osteoarthritis.
Collapse
Affiliation(s)
- Herman Johal
- Center for Evidence-Based Orthopaedics, Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Moin Khan
- Center for Evidence-Based Orthopaedics, Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Shu-Hang Patrick Yung
- Hong Kong Centre for Sports Medicine and Sports Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, People's Republic of China
| | - Mandeep S Dhillon
- Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Freddie H Fu
- Department of Orthopaedic Surgery, University of Pittsburgh Schools of the Health Sciences, UPMC Center for Sports Medicine, Pittsburgh, Pennsylvania
| | - Asheesh Bedi
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Mohit Bhandari
- Center for Evidence-Based Orthopaedics, Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
29
|
Autologous Blood-Derived Products Compared With Corticosteroids for Treatment of Plantar Fasciopathy. Am J Phys Med Rehabil 2019; 98:343-352. [DOI: 10.1097/phm.0000000000001070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
30
|
Similar effect of ultrasound-guided platelet-rich plasma versus platelet-poor plasma injections for chronic plantar fasciitis. Foot (Edinb) 2019; 38:30-33. [PMID: 30572281 DOI: 10.1016/j.foot.2018.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/11/2018] [Accepted: 11/25/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND There are conflicting reports regarding the therapeutic effect of platelet-rich plasma (PRP) versus autologous whole-blood (platelet poor plasma, PPP) injections for plantar fasciitis. Therefore, this study was conducted to compare the effectiveness of a single ultrasound (US)-guided PRP versus PPP injection in patients with chronic plantar fasciitis. MATERIALS AND METHODS 36 patients were recruited with clinical and sonographic evidence of chronic (>6 months) plantar fasciitis, refractory to analgesics and physical therapy in a double-blinded, randomized, prospective study. The patients were randomly allocated into two groups with a sealed envelope method. Group A included 18 patients who underwent a single US-guided PRP injection and group B included another 18 patients who underwent PPP injection with the same technique. Follow-up was set at 3 and 6 months; no patient was lost to follow-up. Pain, function and satisfaction were assessed using visual analogue scales, and occurrence of complications. RESULTS All scores statistically significantly improved for both groups from baseline at the 3- and 6-month follow-up evaluation, without, however, any statistically significant differences between the two groups with respect to pain, function and satisfaction scores. Complications were not observed. CONCLUSIONS A single US-guided PRP injection yields similar results with PPP injection in patients with chronic plantar fasciitis. Both treatments provide significant improvement at 3 and 6-month follow-up after the injection.
Collapse
|
31
|
A Systematic Review of Radiofrequency Treatment of the Ankle for the Management of Chronic Foot and Ankle Pain. Curr Pain Headache Rep 2019; 23:4. [PMID: 30661127 DOI: 10.1007/s11916-019-0745-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chronic pain of the lower extremity remains challenging to manage. Radiofrequency treatment applies heat to nerve fibers with the goal of mitigating chronic pain conditions. The clinical efficacy has not yet been adequately established for pathologies of the ankle and foot. In this review paper, we report the use and efficacy of radiofrequency treatment applied to foot and ankle pain. RECENT FINDINGS PubMed and the Cochrane Controlled Trials Register were searched (final search 30 March 2018) using the MeSH terms "radiofrequency ablation," "neurolysis," "radiofrequency therapy," "pain syndrome," "analgesia," "plantar heel pain," "plantar fascitis," and "chronic pain" in the English literature. Of the 23 papers screened, 18 were further investigated for relevance. Our final search methodology yielded 15 studies that investigated the use of radiofrequency treatment at the ankle. Of these 15 studies, there were three randomized control trials, four prospective studies, three retrospective studies, and five case reports. The quality of selected publications was assessed using the Cochrane risk of bias instrument. The evidence from our studies suggests that radiofrequency treatment can be used safely for the management foot and ankle pain. The technique (continuous vs pulsatile), temperature, location of treatment, and duration of administration need more thorough evaluation. Randomized control trials are needed to establish the efficacy and safety profile of radiofrequency ablation and its long-term benefits in patients with chronic pain of the foot and ankle. CONCLUSION The evidence from our studies suggests that radiofrequency treatment can be used safely for the management foot and ankle pain. The technique (continuous vs pulsatile), temperature, location of treatment, and duration of administration need more thorough evaluation. Randomized control trials are needed to establish the efficacy and safety profile of radiofrequency ablation and its long-term benefits in patients with chronic pain of the foot and ankle.
Collapse
|
32
|
Li S, Wang K, Sun H, Luo X, Wang P, Fang S, Chen H, Sun X. Clinical effects of extracorporeal shock-wave therapy and ultrasound-guided local corticosteroid injections for plantar fasciitis in adults: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018; 97:e13687. [PMID: 30558080 PMCID: PMC6320028 DOI: 10.1097/md.0000000000013687] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The argument on whether extracorporeal shock-wave therapy (ESWT) and corticosteroid injections (CSIs) exert an equivalent pain control or which is the better treatment for plantar fasciitis (PF) in adults remains to be resolved. It is important and necessary to conduct a meta-analysis to make a relatively more credible and overall assessment about which treatment method performs better pain control in treatment of PF in adults. METHODS From the inception to July 2018, the Embase, PubMed, Web of Science, and Cochrane Library electronic databases were searched for all relevant studies. Only randomized controlled trials (RCTs) focusing on comparing ESWT and CSI therapies in PF cases in adults were included. The primary outcome measure was visual analog scale (VAS) reduction, whereas the secondary outcomes included treatment success rate, recurrence rate, function scores, and adverse events. RESULTS Nine RCTs involving 658 cases were included in this meta-analysis. In the present study, meta-analysis showed that high-intensity ESWT had superior pain relief and success rates relative to the CSI group within 3 months, but the ESWT with low intensity was slightly inferior to CSI for efficacy within 3 months. In addition, patients with CSI may tend to increase the need for the analgesic and more adverse events may be associated with the ESWT. However, the ESWT and CSI present similar recurrent rate and functional outcomes. CONCLUSION Our analysis showed that the pain relief and success rates were related to energy intensity levels, with the high-intensity ESWT had the highest probability of being the best treatment within 3 months, followed by CSI, and low-intensity ESWT. More high-quality RCTs with long-term follow-up time are needed to further compare the differences of CSI and ESWT for adults with PF.
Collapse
|
33
|
Ling Y, Wang S. Effects of platelet-rich plasma in the treatment of plantar fasciitis: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018; 97:e12110. [PMID: 30212938 PMCID: PMC6156022 DOI: 10.1097/md.0000000000012110] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Plantar fasciitis is a common cause of heel pain, which often results in significant morbidity. There have been several treatment options that are used for plantar fasciitis, including nonsteroidal anti-inflammatory drugs, orthoses, physical therapy, and steroid injections. OBJECTIVES The aim of this meta-analysis was to compare the effects of platelet-rich plasma (PRP) and other treatments in patients with plantar fasciitis. SEARCH METHODS Medline, Web of Science, and Embase were systematically searched to identify relevant trials. SELECTION CRITERIA Randomized controlled trials (RCTs) that compared the effects of PRP and other treatments on plantar fasciitis were included. DATA COLLECTION AND ANALYSIS The main outcomes included changes from baseline in visual analog scale (VAS) score, American Orthopaedic Foot and Ankle Society Score (AOFAS), and Roles-Maudsley score (RMS). Results were expressed as weight mean difference (WMD) with 95% confidence interval (95% CI). The meta-analysis was performed using a fixed-effects or random-effects model according to heterogeneity. MAIN RESULTS Ten RCTs involving a total of 445 patients with plantar fasciitis were included. Among these studies, 9 compared PRP with steroid, and 1 compared PRP with whole blood.Four studies were categorized as being at low risk of bias, and the remaining 6 as being at unclear risk of bias.Pooled estimates suggested that PRP had greater changes in VAS and AOFAS scores than other treatments. However, it had no benefit effect in the RMS.Subgroup analysis for VAS and AOFAS showed that PRP had superior effect than other treatments at 12 months, but not at the 1, 3, 6 months.Subgroup analysis based on treatment regimens demonstrated that PRP was more effective than steroid in the change from baseline in AOFAS, but not in VAS and RMS scores. AUTHORS' CONCLUSION PRP was as effective as other treatments in reducing pain and improving function in patients with plantar fasciitis. Subgroup analysis indicated that PRP had better effect than steroid in AOFAS Score and its effect was durable in a long term. However, considering the potential limitations in this study, more large-scale RCTs are needed to confirm the current findings.
Collapse
Affiliation(s)
- Yan Ling
- Department of Rehabilitation, Research Center of Sports Rehabilitation of Shandong
| | - Shu Wang
- Department of Rehabilitation, Shandong Sports Hospital, Jinan, China
| |
Collapse
|
34
|
Li H, Lv H, Lin T. Comparison of efficacy of eight treatments for plantar fasciitis: A network meta‐analysis. J Cell Physiol 2018; 234:860-870. [PMID: 30078188 DOI: 10.1002/jcp.26907] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 06/12/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Haibo Li
- Department of Orthopaedics Tianjin Hospital Tianjin China
| | - Hao Lv
- Department of Pediatric Orthopedics Affiliated Hospital of Shandong University of Traditional Chinese Medicine Jinan China
| | - Ting Lin
- Department of Information Management and Information Systems College of Economics and Management, Tianjin University of Science & Technology Tianjin China
| |
Collapse
|
35
|
Lin MT, Chiang CF, Wu CH, Huang YT, Tu YK, Wang TG. Comparative Effectiveness of Injection Therapies in Rotator Cuff Tendinopathy: A Systematic Review, Pairwise and Network Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2018; 100:336-349.e15. [PMID: 30076801 DOI: 10.1016/j.apmr.2018.06.028] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/23/2018] [Accepted: 06/21/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To compare the effectiveness of diverse injections in patients with rotator cuff tendinopathy using pairwise and network meta-analysis. DATA SOURCES PubMed, EMBASE, Scopus, and Cochrane Library were searched for studies published up to September 31, 2017. STUDY SELECTION We included all published or unpublished randomized controlled trials (RCTs) comparing diverse injections including corticosteroid, nonsteroidal anti-inflammatory drugs, hyaluronic acid, botulinum toxin, platelet-rich plasma (PRP), and prolotherapy in patients with rotator cuff tendinopathy. Among the 1495 records screened, 18 studies were included in the meta-analysis. DATA EXTRACTION The quality of RCTs was assessed with Cochrane Risk of Bias Tool by 2 independent raters. The primary outcome was pain reduction, and the secondary outcome was functional improvement. DATA SYNTHESIS Standardized mean difference (SMD) was used for pairwise and network meta-analysis. In pairwise meta-analysis, corticosteroid was more effective only in the short term in both pain reduction and functional improvement. Network meta-analysis indicated that prolotherapy significantly reduced pain compared with placebo in the long term (over 24wk; SMD: 2.63; 95% confidence interval [CI], 1.88-3.38); meanwhile PRP significantly improved shoulder function compared with placebo in the long term (over 24wk; SMD: 0.44; 95% CI, 0.05-0.84). CONCLUSIONS For patients with rotator cuff tendinopathy, corticosteroid plays a role in the short term (3-6wk) but not in long-term (over 24wk) pain reduction and functional improvement. By contrast, PRP and prolotherapy may yield better outcomes in the long term (over 24wk). On account of heterogeneity, interpreting these results with caution is warranted.
Collapse
Affiliation(s)
- Meng-Ting Lin
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ching-Fang Chiang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chueh-Hung Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Yi-Ting Huang
- Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Yu-Kang Tu
- Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| |
Collapse
|
36
|
Babatunde OO, Legha A, Littlewood C, Chesterton LS, Thomas MJ, Menz HB, van der Windt D, Roddy E. Comparative effectiveness of treatment options for plantar heel pain: a systematic review with network meta-analysis. Br J Sports Med 2018; 53:182-194. [PMID: 29954828 DOI: 10.1136/bjsports-2017-098998] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the comparative effectiveness of current treatment options for plantar heel pain (PHP). DESIGN Systematic review and network meta-analysis (NMA). DATA SOURCES Medline, EMBASE, CINAHL, AMED, PEDro, Cochrane Database, Web of Science and WHO Clinical Trials Platform were searched from their inception until January 2018. STUDY SELECTION Randomised controlled trials (RCTs) of adults with PHP investigating common treatments (ie, corticosteroid injection, non-steroidal anti-inflammatory drugs, therapeutic exercise, orthoses and/or extracorporeal shockwave therapy (ESWT)) compared with each other or a no treatment, placebo/sham control. DATA EXTRACTION AND ANALYSIS Data were extracted and checked for accuracy and completeness by pairs of reviewers. Primary outcomes were pain and function. Comparative treatment effects were analysed by random effects NMA in the short term, medium term and long term. Relative ranking of treatments was assessed by surface under the cumulative ranking probabilities (0-100 scale). RESULTS Thirty-one RCTs (total n=2450 patients) were included. There was no evidence of inconsistency detected between direct and indirect treatment comparisons in the networks, but sparse data led to frequently wide CIs. Available evidence does not suggest that any of the commonly used treatments for the management of PHP are better than any other, although corticosteroid injections, alone or in combination with exercise, and ESWT were ranked most likely to be effective for the management of short-term, medium-term and long-term pain or function; placebo/sham/control appeared least likely to be effective; and exercise appeared to only be beneficial for long-term pain or function. CONCLUSIONS Current evidence is equivocal regarding which treatment is the most effective for the management of PHP. Given limited understanding of long-term effects, there is need for large, methodologically robust multicentre RCTs investigating and directly comparing commonly used treatments for the management of PHP. PROSPERO REGISTRATION NUMBER CRD42016046963.
Collapse
Affiliation(s)
- Opeyemi O Babatunde
- Research Institute for Primary Care & Health Sciences, Arthritis Research UK Primary Care Centre, Keele, Staffordshire, UK
| | - Amardeep Legha
- Research Institute for Primary Care & Health Sciences, Arthritis Research UK Primary Care Centre, Keele, Staffordshire, UK.,Centre for Prognosis Research, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK
| | - Chris Littlewood
- Research Institute for Primary Care & Health Sciences, Arthritis Research UK Primary Care Centre, Keele, Staffordshire, UK
| | - Linda S Chesterton
- Research Institute for Primary Care & Health Sciences, Arthritis Research UK Primary Care Centre, Keele, Staffordshire, UK
| | - Martin J Thomas
- Research Institute for Primary Care & Health Sciences, Arthritis Research UK Primary Care Centre, Keele, Staffordshire, UK.,Haywood Academic Rheumatology Centre, Staffordshire and Stoke-on-Trent Partnership NHS Trust, Haywood Hospital, Burslem, Staffordshire, UK
| | - Hylton B Menz
- Research Institute for Primary Care & Health Sciences, Arthritis Research UK Primary Care Centre, Keele, Staffordshire, UK.,School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora Victoria, Australia
| | - Danielle van der Windt
- Research Institute for Primary Care & Health Sciences, Arthritis Research UK Primary Care Centre, Keele, Staffordshire, UK.,Centre for Prognosis Research, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK
| | - Edward Roddy
- Research Institute for Primary Care & Health Sciences, Arthritis Research UK Primary Care Centre, Keele, Staffordshire, UK.,Haywood Academic Rheumatology Centre, Staffordshire and Stoke-on-Trent Partnership NHS Trust, Haywood Hospital, Burslem, Staffordshire, UK
| |
Collapse
|
37
|
Comparative efficacy of corticosteroid injection and non-invasive treatments for plantar fasciitis: a systematic review and meta-analysis. Sci Rep 2018; 8:4033. [PMID: 29507320 PMCID: PMC5838257 DOI: 10.1038/s41598-018-22402-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 02/21/2018] [Indexed: 11/28/2022] Open
Abstract
The first choice of treatment for patients with plantar fasciitis is non-invasive treatment, rather than corticosteroid injection (CSI). However, no comprehensive study has compared the effectiveness of CSI with non-invasive treatments for plantar fasciitis. We conducted a meta-analysis comparing CSI and non-invasive treatment effects on plantar fasciitis. The primary outcome was pain reduction. Nine randomized controlled trials comparing CSI with 4 non-invasive treatment types were included. A trend favoring CSI over non-invasive treatments was indicated regarding reduction in the visual analogue scale (VAS) score at 1–1.5 (mean difference (MD), 1.70; 95% confidence interval (CI) = 0.39–3.01; P = 0.01) and 2–3 months (MD, 1.67; 95% CI = 0.58–2.76; P = 0.003). At 1.5-month follow-up, CSI was associated with improved VAS score compared with physical therapy (PT) (MD, 2.5; 95% CI = 0.1–4.9; P = 0.04). No significant differences in the VAS score reduction were observed between CSI and shock wave therapy within 3 months. In summary, CSI tends to be more effective for pain reduction than non-invasive treatments within 3 months. Moreover, CSI provides significant pain relief at 1.5 months after treatment compared with PT. This study provides important clinical information for selecting therapeutics.
Collapse
|
38
|
Lin MT, Hsiao MY, Tu YK, Wang TG. Comparative Efficacy of Intra-Articular Steroid Injection and Distension in Patients With Frozen Shoulder: A Systematic Review and Network Meta-Analysis. Arch Phys Med Rehabil 2017; 99:1383-1394.e6. [PMID: 28899826 DOI: 10.1016/j.apmr.2017.08.471] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/14/2017] [Accepted: 08/07/2017] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To compare the efficacy of intra-articular (IA) steroid injection and distension in patients with frozen shoulder. DATA SOURCES Databases, including MEDLINE (via PubMed), Embase, Scopus, and Cochrane Library, were searched for studies published up to November 2016. STUDY SELECTION We included all published randomized controlled trials (RCTs), quasi-experimental studies, and observational studies investigating the effectiveness of IA steroid injection, distension, and physiotherapy in patients with frozen shoulder. Sixteen RCTs and 1 observational study were enrolled in meta-analysis. DATA EXTRACTION Full texts were independently reviewed, and quality of RCTs was assessed with The Cochrane Collaboration's tool. The primary outcome was functional improvement; the secondary outcomes included pain reduction and external rotation (ER) improvement. DATA SYNTHESIS In pairwise meta-analysis, pooled standardized mean difference (SMD) of functional improvement and pain reduction revealed equal efficacy at 3 follow-up time points. With respect to ER improvement, distension has a superior effect compared with IA steroid injection in the short term [(2-4wk; SMD, -.36; 95% confidence interval [CI], -.68 to -.04) and medium term (6-16wk; SMD, -0.80; 95% CI, -1.32 to -0.29). The network meta-analysis indicated a better efficacy for distension than for IA steroid injection in ER improvement only in the medium term (6-16wk; SMD, -0.70; 95% CI, -1.19 to -0.21). CONCLUSIONS IA steroid injection was as effective as distension in shoulder function improvement, pain reduction, and increasing ER of the shoulder. Distension yielded better ER improvement in the medium term but to a minor extent in the long term. For patients with predominant ER limitation, early distension could be considered the primary choice of treatment.
Collapse
Affiliation(s)
- Meng-Ting Lin
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Yen Hsiao
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Yu-Kang Tu
- Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| |
Collapse
|
39
|
Wu YT, Chang CY, Chou YC, Yeh CC, Li TY, Chu HY, Chen LC. Ultrasound-Guided Pulsed Radiofrequency Stimulation of Posterior Tibial Nerve: A Potential Novel Intervention for Recalcitrant Plantar Fasciitis. Arch Phys Med Rehabil 2017; 98:964-970. [DOI: 10.1016/j.apmr.2017.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 01/10/2017] [Accepted: 01/11/2017] [Indexed: 11/25/2022]
|
40
|
Autologous whole blood versus corticosteroid local injection in treatment of plantar fasciitis: A randomized, controlled multicenter clinical trial. Clin Rheumatol 2016; 36:661-669. [DOI: 10.1007/s10067-016-3484-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 10/08/2016] [Accepted: 11/11/2016] [Indexed: 12/20/2022]
|
41
|
Association Between Sarcopenia and Cognitive Impairment: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2016; 17:1164.e7-1164.e15. [DOI: 10.1016/j.jamda.2016.09.013] [Citation(s) in RCA: 217] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/19/2016] [Accepted: 09/19/2016] [Indexed: 11/15/2022]
|
42
|
Comparison of the Effectiveness of Suprascapular Nerve Block With Physical Therapy, Placebo, and Intra-Articular Injection in Management of Chronic Shoulder Pain: A Meta-Analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2016; 97:1366-80. [DOI: 10.1016/j.apmr.2015.11.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 11/17/2015] [Accepted: 11/17/2015] [Indexed: 11/19/2022]
|
43
|
Vahdatpour B, Kianimehr L, Ahrar MH. Autologous platelet-rich plasma compared with whole blood for the treatment of chronic plantar fasciitis; a comparative clinical trial. Adv Biomed Res 2016; 5:84. [PMID: 27274499 PMCID: PMC4879850 DOI: 10.4103/2277-9175.182215] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 07/15/2015] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Intralesional injection of autologous blood-derived products has recently gained attention as a potential treatment for plantar fasciitis (PF). We compared platelet-rich plasma (PRP) and whole blood (WB) for the treatment of chronic PF. MATERIALS AND METHODS Patients with chronic PF received either an intralesional injection of 3 cc PRP prepared by double centrifuge technique or WB (n = 17 in each group). Overall, morning and walking pain severity were assessed by 11-point numerical rating scale, and function was assessed by the Roles and Maudsley score (RMS) at baseline and 1-month and 3 months after treatment. Ultrasonography was performed to measure plantar fascia thickness at baseline and 3 months after treatment. RESULTS Pain scores were reduced over the study in the PRP (mean change = -5.00 ± 1.17 to -5.47 ± 1.46) and WB groups (mean change = -5.29 ± 2.56 to -6.47 ± 2.83), with no difference between groups (P > 0.05). One month and 3 months after treatment, successful treatment (RMS of ≤ 2) was respectively observed in 29.4% and 82.3% of the PRP and in 47.1% and 76.4% of the WB groups (P > 0.05). Also, fascia thickness was decreased in both the PRP and WB groups (mean change = -1.74 ± 1.11 vs. -1.21 ± 0.73 mm, respectively, P = 0.115). CONCLUSIONS Significant improvement in pain and function, as well as decrease in plantar fascia thickness, was observed by intralesional injection of the PRP and WB in patients with chronic PF. The study results indicate similar effectiveness between PRP and WB for the treatment of chronic PF in short-term.
Collapse
Affiliation(s)
- Babak Vahdatpour
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Lida Kianimehr
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | | |
Collapse
|
44
|
Chang KV, Wu WT, Özçakar L. An Uncommon Cause of Mid-foot Pain: Ultrasound Imaging for Plantar Fibromatosis and Entrapment of the Lateral Plantar Nerve. PAIN MEDICINE 2016; 17:1965-1966. [PMID: 27056958 DOI: 10.1093/pm/pnw059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Ke-Vin Chang
- *Department of Physical Medicine and Rehabilitation and Geriatric Research Center, National Taiwan University Hospital, BeiHu Branch and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| |
Collapse
|