Combined Effects of Extracorporeal Shockwave Therapy and Integrated Neuromuscular Inhibition on Myofascial Trigger Points of Upper Trapezius: A Randomized Controlled Trial

Does shockwave therapy have a role on trigger thumb?—a single-case design

Background

The trigger thumb is a clinically unusual and rare phenomenon. The trigger finger is most observed on the ring or middle fingers. Clinical signs include reduced tendon excursion and the formation of nodules at the base of the metacarpals. As a result, grip strength may be reduced, making gripping tasks uncomfortable. Many treatments have been proposed to treat trigger finger symptoms; however, the effectiveness of shockwave therapy is still being contested. As a result, the purpose of this trigger thumb case study is to assess the effect of shockwave therapy on grip performance.

Case presentation

A 53-year-old housewife reported to the outpatient department with pain at the base of her right thumb, recurring locking episodes, morning pain and stiffness, and a 10-year history of diabetes. Based on the clinical presentation and physical examination of the patient, an orthopedic sports physician diagnosed it as a trigger thumb. Analgesics were initially administered, and the patient was then referred to physiotherapy for rehabilitation. All outcomes improved substantially during the follow-up after six sessions of physical therapy, which included shockwave therapy and an exercise program.

Conclusion

This study concluded that the protocol developed specifically for the treatment of the trigger thumb is efficacious. Therefore, future research with a larger number of participants is required to validate this approach.

Water therapies (hydrotherapy, balneotherapy or aqua therapy) for patients with cancer: a systematic review

Background

Water therapies as hydrotherapy, balneotherapy or aqua therapy are often used in the relief of disease- and treatment-associated symptoms of cancer patients. Yet, a systematic review for the evidence of water therapy including all cancer entities has not been conducted to date.

Purpose

Oncological patients often suffer from symptoms which in patients with other diseases are successfully treated with water therapy. We want to gather more information about the benefits and risks of water therapy for cancer patients.

Method

In May 2020, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and PubMed) to find studies concerning the use, effectiveness and potential harm of water therapy on cancer patients.

Results

Of 3165 search results, 10 publications concerning 12 studies with 430 patients were included in this systematic review. The patients treated with water therapy were mainly diagnosed with breast cancer. The therapy concepts included aqua lymphatic therapy, aquatic exercises, foot bathes and whole-body bathes. Outcomes were state of lymphedema, quality of life, fatigue, BMI, vital parameters, anxiety and pain. The quality of the studies was assessed with the AMSTAR2-instrument, the SIGN-checklist and the IHE-Instruments. The studies had moderate quality and reported heterogeneous results. Some studies reported significantly improved quality of life, extent of lymphedema, neck and shoulder pain, fatigue and BMI while other studies did not find any changes concerning these endpoints.

Conclusion

Due to the very heterogeneous results and methodical limitations of the included studies, a clear statement regarding the effectiveness of water therapy on cancer patients is not possible.