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Li S, Winston P, Mas MF. Spasticity Treatment Beyond Botulinum Toxins. Phys Med Rehabil Clin N Am 2024; 35:399-418. [PMID: 38514226 DOI: 10.1016/j.pmr.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Botulinum toxin (BonT) is the mainstream treatment option for post-stroke spasticity. BoNT therapy may not be adequate in those with severe spasticity. There are a number of emerging treatment options for spasticity management. In this paper, we focus on innovative and revived treatment options that can be alternative or complementary to BoNT therapy, including phenol neurolysis, cryoneurolysis, and extracorporeal shock wave therapy.
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Affiliation(s)
- Sheng Li
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, University of Texas Health Science Center - Houston, Houston, TX, USA; TIRR Memorial Herman.
| | - Paul Winston
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Victoria, British Columbia, Canada; Canadian Advances in Neuro-Orthopedics for Spasticity Consortium, Victoria, British Columbia, Canada
| | - Manuel F Mas
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico
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Alkhawashki HM, Al-Boukai AA, Al-Harbi MS, Al-Rumaih MH, Al-Khawashki MH. The use of extracorporeal shock wave therapy (ESWT) in treating osteonecrosis of the femoral head (AVNFH): a retrospective study. Int Orthop 2023; 47:2953-2960. [PMID: 37498339 DOI: 10.1007/s00264-023-05904-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/16/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE As most of the cases of avascular necrosis (AVN) in Saudi Arabia is seen in young population and as literature showed good effect of extracorporeal shock wave therapy (ESWT) in reducing pain and oedema in avascular necrosis and delaying the need of surgical intervention. Our purpose of this study is to assess the effectiveness of ESWT in reducing pain, improving range of motion (ROM) and delaying the surgical intervention in patient with AVN of femoral head and compare our results to published literature. MATERIAL AND METHODS We have treated 24 patients, 13 males and 11 females with a mean age of 29 years (range 14-48) with 34 hips affected. There were 14 unilateral and ten bilateral lesions. In our series 11 out of 24 patients (45.8%) were due to sickle cell disease. Other causes included idiopathic in five patients (20.8%), corticosteroids use and systemic lupus erythematous in three patients each (12.5% each) and post-traumatic AVN in two patients (8.3%). Extracorporeal shock wave therapy was implanted in FICAT stage I, II and III. All patients had two sessions of extracorporeal shock wave therapy, four to six weeks apart, each with 4000 impulses divided into four points. Radiological and MRI assessment were performed at regular time intervals with a minimum follow-up of two years. Clinical assessment was based on Visual Analog Scale and Harris Hip Score (HHS). The end point outcome measurement was the need for any operative intervention. RESULTS Operative intervention was necessary in eight out of 34 hips (23.5%), within an average of 2.5 years (range 1 to 5 years). A hip salvage was achieved in 76.5%. Function was improved with the Harris Hip Score from a mean of 54.6 to 80.4 (P value using paired t test ≤ 0.05). Pain assessed with Visual Analog Scale improved from 5.73 to 2.75 (P value using paired t test ≤ 0.05). CONCLUSION We do recommend the use of ESWT in treating AVN of bone whether of femoral head or other sites prior to the collapse of the articular surface. Further studies are needed to compare using two or more sessions as well as using four or six points for ESWT.
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Affiliation(s)
- Hazem M Alkhawashki
- Department of Orthopaedic Surgery, Advanced Medical Center, Riyadh, Saudi Arabia.
| | - Ahmad A Al-Boukai
- Department of Radiology and Medical Imaging, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed S Al-Harbi
- Department of Orthopaedic Surgery, College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Mohammed H Al-Rumaih
- Department of Orthopaedic Surgery, Prince Sultan Military Medical City, Armed Forces Medical Services, Ministry of Defense, P.O. Box: 7897, Riyadh, 11159, Saudi Arabia.
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Yuan Z, Luo J, Cheng QF, Zhang Q. Clinical efficacy of ultrasound-guided stellate ganglion block combined with extracorporeal shock wave therapy on limb spasticity in patients with ischemic stroke. BMC Neurol 2023; 23:349. [PMID: 37794321 PMCID: PMC10548723 DOI: 10.1186/s12883-023-03391-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/14/2023] [Indexed: 10/06/2023] Open
Abstract
INTRODUCTION To observe the clinical efficacy of ultrasound-guided stellate ganglion block (SGB) + extracorporeal shock wave therapy (ESWT) for limb spasticity in patients with ischemic stroke. METHODS A total of 60 patients with post-stroke limb spasticity in our hospital were selected and randomly divided into four groups (n = 15). In the control group, patients received routine rehabilitation training. Based on routine rehabilitation training, SGB group patients underwent ultrasound-guided SGB, ESWT group patients received ESWT, and SGB + ESWT group patients received ultrasound-guided SGB combined with ESWT. The total treatment course was one month. The Modified Barthel Index (MBI) score, Fugl-Meyer Assessment and upper limb rehabilitation training system were applied to evaluate the activities of daily living, upper limb motor function and upper limb performance before and after treatment. Finally, the improvement after treatment was compared among different groups. RESULTS After treatment, compared with the control group, the MBI score and the upper limb score based on Fugl-Meyer Assessment in the SGB, ESWT, and SGB + ESWT groups were significantly increased (P < 0.05). Furthermore, compared with the SGB and ESWT groups, SGB + ESWT exhibited a higher upper limb function score (P < 0.05), while the MBI score was not significantly different (P > 0.05). In terms of upper limb performance ability, patients in the SGB, ESWT and SGB + ESWT groups had better fitting degree, participation and exertion of exercise than those in the control group, and the SGB + ESWT group patients had the same movement trajectory as robots. CONCLUSION Ultrasound-guided SGB and ESWT can reduce the muscle tension of patients, alleviate spasticity, promote the motor function of the upper limb, and improve the working performance of patients. However, the effect of SGB combined with ESWT is better.
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Affiliation(s)
- Zhen Yuan
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China
- Rehabilitation medicine and physiotherapy, Medical Department of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Jun Luo
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China
| | - Qing-Feng Cheng
- Urology Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China
| | - Qiao Zhang
- Department of Orthopedics, The Second Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, China.
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Zhang X, Ma Y. Global trends in research on extracorporeal shock wave therapy (ESWT) from 2000 to 2021. BMC Musculoskelet Disord 2023; 24:312. [PMID: 37081473 PMCID: PMC10116688 DOI: 10.1186/s12891-023-06407-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/07/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND This study intended to analyze the application of extracorporeal shock wave therapy in medicine and to evaluate the quality of related literature. METHODS All publications were extracted from 2000 to 2021 from the Web of Science Core Collection (WoSCC). The literature characteristics were depicted by VOSviewer (version 1.6.15) and the online bibliometric website ( http://bibliometric.com/ ). The future trends and hotspots were conducted by Bibliographic Item Co-occurrence Matrix Builder (version 2.0) and gCLUTO software. RESULTS We analyzed 1774 articles corresponding to the criteria for ESWT publications from 2000 to 2021. Most studies were conducted within the United States and China which besides have the most cooperation. The most published research institutions are Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, and Kaohsiung Medical University. Six research hotspots were identified by keyword clustering analysis: Cluster0: The effects of ESWT on muscle spasticity; Cluster1: The application of ESWT in osteoarthritis (OA); Cluster2: Therapeutic effect of ESWT on tendon diseases; Cluster3: Early application of ESWT/ESWL in urolithiasis; Cluster4: The Role of angiogenesis in ESWT and the efficiency of ESWT for penile disease; Cluster5: The Special value of radial extracorporeal shock wave therapy (rESWT). CONCLUSIONS A comprehensive and systematic bibliometric analysis of ESWT was conducted in our study. We identified six ESWT-related research hotspots and predicted future research trends. With the gradual increase of research on ESWT, we find that ESWT is used more and more extensively, such in musculoskeletal disease, bone delay union, neurological injury, andrology disorders, lymphedema, and so on. In addition, the mechanism is not destructive damage, as initially thought, but a restorative treatment. Furthermore, delayed union, cellulite, burn, and diabetic foot ulcers may be the future direction of scientific study.
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Affiliation(s)
- Xinyu Zhang
- Department of Rehabilitation, The First Affiliated Hospital of China Medical University, 155 Nanjing Street, 110001, Shenyang, P.R. China
| | - Yuewen Ma
- Department of Rehabilitation, The First Affiliated Hospital of China Medical University, 155 Nanjing Street, 110001, Shenyang, P.R. China.
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Fan Y, Liu F, Li M, Ruan X, Wu M, Su K, Gao J, Feng X. Observation of curative effect on meridian theory-based extracorporeal shock wave therapy for non-specific low back pain: study protocol for a randomized controlled trial. J Orthop Surg Res 2022; 17:265. [PMID: 35562830 PMCID: PMC9107249 DOI: 10.1186/s13018-022-03146-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Non-specific low back pain (NLBP) is a major global socioeconomic burden, and the prevalence of NLBP is still on the rise. At present, there is no ideal drug to cure this disease. This may be the reason why patients often use complementary therapies. Among them, extracorporeal shock wave therapy (ESWT) has gradually received more attention and has become the main treatment method for NLBP. The purpose of this study is to provide scientific evidence for the effect and safety of meridian theory-based ESWT on NLBP. Objective This study aims to evaluate the effect and safety of meridian theory-based ESWT on NLBP. This study will also provide more high-quality experimental evidence for the clinical application of meridian theory-based ESWT for the treatment of NLBP in future. Methods The study design is a single-blind, multi-center, randomized controlled trial. 66 patients with NLBP, aged 18 to 60 years, will be randomly divided into two groups: the experimental group (N = 33), which will receive meridian theory-based ESWT application, and the control group (N = 33) which will receive conventional ESWT treatment. These two applications will be carried out twice a week for two weeks. The primary outcome will be the Visual Analog Scale (VAS), and the secondary outcomes will be Oswestry Disability Index (ODI), Surface Electromyography (sEMG), and Patient Health Questionnaire-15 (PHQ-15). All outcomes will be evaluated at baseline and after the intervention (7 days, 14 days). Discussion Results of this trial will contribute to providing rigorous clinical evidence for the efficacy and security of meridian theory-based ESWT for NLBP. Trial registration: Chinese Clinical Trial Registry, ChiCTR2100051049. Registered on 10 September 2021, http://www.chictr.org.cn/showproj.aspx?proj=46316.
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Affiliation(s)
- Yongfu Fan
- Henan University of Chinese Medicine, Zhengzhou, 450000, China
| | - Feilai Liu
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, 19# Renmin Road, Jinshui District, Zhengzhou, 450000, Henan Province, China
| | - Mengna Li
- Institute of Pain Medicine and Special Environmental Medicine, Nantong University, Nantong, 226019, China
| | - Xiaodi Ruan
- Henan University of Chinese Medicine, Zhengzhou, 450000, China
| | - Mingli Wu
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, 19# Renmin Road, Jinshui District, Zhengzhou, 450000, Henan Province, China
| | - Kaiqi Su
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, 19# Renmin Road, Jinshui District, Zhengzhou, 450000, Henan Province, China
| | - Jing Gao
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, 19# Renmin Road, Jinshui District, Zhengzhou, 450000, Henan Province, China
| | - Xiaodong Feng
- Henan University of Chinese Medicine, Zhengzhou, 450000, China. .,Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, 19# Renmin Road, Jinshui District, Zhengzhou, 450000, Henan Province, China.
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Lee SY, Joo SY, Cho YS, Hur GY, Seo CH. Effect of extracorporeal shock wave therapy for burn scar regeneration: A prospective, randomized, double-blinded study. Burns 2020; 47:821-827. [PMID: 32917473 DOI: 10.1016/j.burns.2020.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/22/2020] [Accepted: 08/18/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE This study aimed to investigate the regeneration effect of extracorporeal shock wave therapy (ESWT) on hypertrophic scar regeneration using objective measurements. METHODS This was a double-blinded, randomized, controlled trial of 48 participants who had undergone autologous split-thickness skin grafting (STSG) with same artificial dermis. The ESWT group (n=25) received shock waves with low-energy flux density (0.05-0.30mJ/mm2). The interval between treatments is a 1-week. The ESWT group also received recommended treatment. The control group (n=23) only received standard treatment. We measured skin characteristics before treatment and after 6 weeks for both groups. RESULTS No significant intergroup difference was noted at the initial evaluations (p>0.05). The pre- to post-treatment change in the scar thickness (p=0.03) and erythema (p=0.03), greater reduction was found in the ESWT group than control group. The pre- to post-treatment change in the sebum level (p=0.02), more increase was found in the ESWT group. We found no significant differences in the change measurements between the two groups for melanin levels (p=0.62) and transepidermal water loss (TEWL) (p=0.94). The changes (skin distensibility, biological skin elasticity, gross skin elasticity, and skin viscoelasticity) measured with the Cutometer showed no significant differences between the two groups (p=0.87, p=0.32, p=0.37, and p=0.29, respectively). CONCLUSION This is the first report of ESWT on hypertrophic scar after burn using objective tools (melanin, erythema, sebum, TEWL, elasticity and thickness). ESWT has objective beneficial effects on burn-associated scar characteristics.
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Affiliation(s)
- Seung Yeol Lee
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - So Young Joo
- Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea
| | - Yoon Soo Cho
- Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea
| | - Gi Yeun Hur
- Department of plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea
| | - Cheong Hoon Seo
- Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea.
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Kobayashi M, Chijimatsu R, Yoshikawa H, Yoshida K. Extracorporeal shock wave therapy accelerates endochondral ossification and fracture healing in a rat femur delayed-union model. Biochem Biophys Res Commun 2020; 530:632-637. [PMID: 32762942 DOI: 10.1016/j.bbrc.2020.07.084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/12/2020] [Indexed: 11/30/2022]
Abstract
Extracorporeal shock wave therapy (ESWT) has been demonstrated to accelerate bone healing; however, the mechanism underlying ESWT-induced bone regeneration has not been fully elucidated. This study aimed to examine the effects of ESWT and the process of fracture healing. A rat model of femur delayed-union was established by cauterizing the periosteum. ESWT treatment at the fracture site was performed 2 weeks after the operation and the site was radiographically and histologically evaluated at weeks 4, 6, and 8. The bone union rate and radiographic score of the ESWT group were significantly higher than those of the control group at 8 weeks. Histological evaluation revealed enhanced endochondral ossification at the fracture site. The effects of ESWT on ATDC5 cells were examined in vitro. ESWT promoted chondrogenic differentiation without inhibiting the proliferation of ATDC5 cells. ESWT may induce significant bone healing by promoting endochondral ossification at the fracture site.
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Affiliation(s)
- Masato Kobayashi
- Osaka University, Graduate School of Medicine, Department of Orthopaedic Surgery, 2-2, Yamadaoka, Suita, Osaka, Japan
| | - Ryota Chijimatsu
- The University of Tokyo, Bone and Cartilage Regenerative Medicine, Bunkyo-ku, Tokyo, Japan
| | - Hideki Yoshikawa
- Osaka University, Graduate School of Medicine, Department of Orthopaedic Surgery, 2-2, Yamadaoka, Suita, Osaka, Japan
| | - Kiyoshi Yoshida
- Osaka University, Graduate School of Medicine, Department of Orthopaedic Surgery, 2-2, Yamadaoka, Suita, Osaka, Japan.
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Ryu BJ, Ha KW, Lee JY, Kim SH, Kwak HJ, Seol PH. Radial extracorporeal shock wave therapy for heterotopic ossification. J Phys Ther Sci 2016; 28:701-4. [PMID: 27064476 PMCID: PMC4793037 DOI: 10.1589/jpts.28.701] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 10/30/2015] [Indexed: 12/01/2022] Open
Abstract
[Purpose] To report the effects of radial extracorporeal shock wave therapy (RSWT) on
heterotopic ossification (HO). [Subjects and Methods] Two cases of neurogenic HO in the
upper extremity were administered RSWT using the MASTER PLUS® MP 2000 (Storz,
Tägerwilen, Switzerland) and ultrasonographic guidance. The RSWT protocol consisted of
3,000 pulses at a frequency of 12 Hz during each treatment. The intensity level ranged
from 2–5 bars, and it was administered 5 times a week for 4 weeks, a total of 20
treatments. [Results] RSWT improved pain, range of motion, and hand function in 2 patients
with neurogenic HO in the upper extremity. [Conclusion] Further studies are needed to
support these results and to understand the mechanism and to devise the protocol of RSWT
for neurogenic HO.
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Affiliation(s)
- Byung-Ju Ryu
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Republic of Korea
| | - Kang-Wook Ha
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Republic of Korea
| | - Jin-Young Lee
- Department of Physical Medicine and Rehabilitation, National Traffic Injury Rehabilitation Hospital, Republic of Korea
| | - Sung-Hwan Kim
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Republic of Korea
| | - Ho-Jun Kwak
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Republic of Korea
| | - Pyong-Hwa Seol
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Republic of Korea
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Park JW, Yoon K, Chun KS, Lee JY, Park HJ, Lee SY, Lee YT. Long-term outcome of low-energy extracorporeal shock wave therapy for plantar fasciitis: comparative analysis according to ultrasonographic findings. Ann Rehabil Med 2014; 38:534-40. [PMID: 25229032 PMCID: PMC4163593 DOI: 10.5535/arm.2014.38.4.534] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 04/22/2014] [Indexed: 12/21/2022] Open
Abstract
Objective To investigate the long-term effect of low-energy extracorporeal shock wave therapy (ESWT) for plantar fasciitis (PF) according to ultrasonography (US) findings. Methods Thirty feet of 25 patients with clinical diagnosis of PF were enrolled and divided into two groups (Apparent-US and Uncertain-US) according to US findings, such as plantar fascia thickening or hypoechogenicity. Inclusion criteria were symptom duration >6 months and a fair or poor grade in Roles-Maudsley score (RMS). ESWT (0.10 mJ/mm2, 600 shocks) was given once a week for 6 weeks. Numeric rating scale (NRS) and RMS were evaluated prior to each ESWT session, at short-term follow-up (one week after all ESWT sessions) and long-term follow-up telephone interview (mean 24 months after ESWT). Good and excellent grade in RMS were considered as treatment success. Results Repeated measure ANOVA demonstrated that NRS significantly decreased with time after ESWT up to the long-term follow-up (time effect, p<0.001) without group-time interaction (p=0.641), indicating that ESWT equally decreased pain in both groups. Overall success rate was 63.3% (short-term follow-up) and 80.0% (long-term follow-up). In comparative analysis between groups, success rate of Apparent-US and Uncertain-US at short-term follow-up was 61.9% and 66.7%, respectively, and 85.7% and 66.7%, respectively, at long-term follow-up. Conclusion If other causes of heel pain are ruled out through meticulous physical examination and ultrasonography, low-energy ESWT in PF seems to be beneficial regardless of US findings. In terms of success rate, however, long-term outcome of Apparent-US appears to be superior to Uncertain-US.
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Affiliation(s)
- Jong-Wan Park
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyungjae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwang-Soo Chun
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon-Youn Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee-Jin Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So-Yeon Lee
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong-Taek Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee SS, Kang S, Park NK, Lee CW, Song HS, Sohn MK, Cho KH, Kim JH. Effectiveness of initial extracorporeal shock wave therapy on the newly diagnosed lateral or medial epicondylitis. Ann Rehabil Med 2012. [PMID: 23185733 PMCID: PMC3503944 DOI: 10.5535/arm.2012.36.5.681] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of initial extracorporeal shock wave therapy (ESWT) for patients newly diagnosed with lateral or medial epicondylitis, compared to local steroid injection. METHOD An analysis was conducted of twenty-two patients who were newly confirmed as lateral or medial epicondylitis through medical history and physical examination. The ESWT group (n=12) was treated once a week for 3 weeks using low energy (0.06-0.12 mJ/mm(2), 2,000 shocks), while the local steroid injection group (n=10) was treated once with triamcinolone 10 mg mixed with 1% lidocaine solution. Nirschl score and 100 point score were assessed before and after the treatments of 1st, 2nd, 4th and 8th week. And Roles and Maudsley score was assessed one and eight weeks after the treatments. RESULTS Both groups showed significant improvement in Nirschl score and 100 point score during the entire period. The local steroid injection group improved more in Nirschl score at the first week and in 100 point score at the first 2 weeks, compared to those of the ESWT group. But the proportion of excellent and good grades of Roles and Maudsley score in the ESWT group increased more than that of local steroid injection group by the final 8th week. CONCLUSION The ESWT group improved as much as the local steroid injection group as treatment for medial and lateral epicondylitis. Therefore, ESWT can be a useful treatment option in patients for whom local steroid injection is difficult.
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Affiliation(s)
- Sang Seok Lee
- Department of Rehabilitation Medicine, Daejeon Sun Hospital, Daejeon 301-725, Korea
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