Radial Shock Wave Therapy Research Articles

Clinical Efficacy and Safety of Low-Energy Extracorporeal Shock Wave Therapy for Various Conditions of Deep Dermal and Subdermal Fibrosis.

Extracorporeal shock wave therapy (ESWT) enhances extracellular matrix remodeling and tissue regeneration by promoting growth factor release, regulating blood and lymphatic flows, and reducing fat and fibrotic tissues. Focused shock wave therapy (F-SWT), radial shock wave therapy (R-SWT), and combined F-SWT and R-SWT have been used to deliver different patterns of shock energy depending on the characteristics of the target lesions. We investigated the efficacy and safety of ESWT in patients with dermal and subdermal fibrosis. Fifty-two patients treated with F-SWT and/or R-SWT for dermal and subdermal fibrosis caused due to various reasons were retrospectively analyzed by reviewing their medical records, clinical images, and ultrasound study images. The mean number of pulses administered for F-SWT on the cheek, temple, and chin were 2600.0 ± 1040.8 shocks/session and for R-SWT were 5080.0 ± 2234.6 pulses/session, and the number of treatment sessions were 8.0 ± 4.4. In patients who were treated with ESWT on the abdomen, the mean number of pulses for F-SWT were 2600.0 ± 2408.3 shocks/session and for R-SWT were 8400.0 ± 894.4 pulses/session, and the number of treatment sessions were 3.2 ± 1.6. Most patients were satisfied with the results. Pain during ESWT was well tolerated and post-ESWT edema was more common in R-SWT than in F-SWT. Our data demonstrated that ESWT effectively and safely improved the clinical appearance and functional movement of patients with dermal and subdermal fibrosis caused due to various reasons.

Immediate effect of extracorporeal shockwave therapy in patients with chronic non-specific low back pain: A randomised placebo-controlled triple-blind trial

Objective To compare the immediate effects of shockwave therapy using two different tips in patients with chronic non-specific low back pain. Design Randomised placebo-controlled study with three intervention groups. Setting The patients recruited for this study were sent for physiotherapy treatment at primary care between May and July 2022. Participants Eighty-one patients with chronic non-specific low back pain aged 18–80 years with pain for ≥3 months and pain intensity ≥3 were randomly recruited for the study. Intervention The patients received a single intervention of radial shockwave therapy with 2000 discharges at 100 mJ energy and 5 Hz frequency using concave or convex tips or placebo treatment. Main measures The primary outcome was pain intensity immediately post-intervention. The secondary outcomes were pressure pain threshold, temporal summation of pain, and functional performance. Data were collected at baseline and post-intervention. Results The post-intervention pain intensity in the concave tip group is an average of two points lower (95% CI = −3.6, −0.4; p < 0.01) than that in the placebo group. The post-intervention pressure pain threshold for the concave tip group was an average of 62.8 kPa higher (95% CI = 0.4, 125.1; p < 0.05) than for the convex tip group and 76.4 kPa higher (95% CI = 14, 138.7; p < 0.01) than in the placebo group. Conclusion The concave tip shockwave therapy is effective in reducing pain and local hyperalgesia in patients with chronic non-specific low back pain.

Efficacy of shock wave therapy and ultrasound therapy in non-insertional Achilles tendinopathy: a randomised clinical trial.

Physiotherapists and physicians continue to seek effective conservative treatments for Achilles tendinopathy. This study aimed to subjectively and objectively determine the therapeutic efficacy of radial shock wave therapy (RSWT) and ultrasound therapy in non-insertional Achilles tendinopathy. Thirty-nine patients with non-insertional Achilles tendinopathy were randomly assigned to three experimental groups, i.e., RSWT (group A), ultrasound therapy (group B), and placebo ultrasound (group C) groups. Before the intervention and at weeks 1 and 6 after the treatment, the patients were assessed using the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire and posturographic measurements of step initiation performed on the force platforms under two different conditions (non-perturbed transit and perturbed transit). Six weeks after therapy, all groups exhibited significantly increased VISA-A scores against the measurement at week 1 after therapy. The post-therapy percentage changes in VISA-A scores were significantly greater in group A compared to group B. The three-way ANOVA demonstrated that treatment type affected sway range in the frontal plane and mean velocity of the centre of foot pressure displacements in the sagittal and frontal planes during quiet standing before step initiation. The Bonferroni post-hoc test showed that the means of all those variables were significantly smaller for group A than for group B patients. The three-way ANOVA revealed an effect of the platform arrangement on transit time and double-support period. The Bonferroni post-hoc test revealed statistically longer transit time for the perturbed vs. non-perturbed trials; a reverse relationship was observed for the double-support period. The VISA-A showed that RSWT was significantly more effective than sonotherapy for alleviation of pain intensity as well as function and activity improvement in patients with non-insertional Achilles tendinopathy. Therefore, RSWT therapy can be used in clinical practice by physiotherapists to alleviate the symptoms of non-insertional Achilles tendinopathy. Objective data registered by force platforms during quiet standing before and after step initiation did not prove useful for monitoring the progress of treatment applied to patients with non-insertional Achilles tendinopathy between consecutive therapy interventions.Clinical trial registration:https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12617000860369, identifier (ACTRN12617000860369).

Comparison of the Short-Term Effect between Iontophoresis and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Randomized Controlled Trial.

A double-blinded randomized clinical trial was designed to evaluate the short-term efficacy of a physical treatment in chronic plantar fasciitis, namely iontophoresis, compared with radial shockwave therapy. Heel pain, health status using the EuroQol-5D questionnaire, and fascia thickness measured with ultrasound were evaluated. In total, 127 patients were randomly selected for group A and treated with iontophoresis therapy (lidocaine 0.4% and dexamethasone 0.5%), or for group B, in which they were treated with radial shockwave therapy (EWST). Measurements were taken at baseline and at follow-up during the 5 weeks of the study. Statistically significant differences were observed to the shockwave therapy group in respect to the final fascia thickness, and the VAS scale (p = 0.001). The differences between groups A and B showed that the shockwave group follow-up after 3 weeks experienced complete pain remission (1.0 ± 0.9; 95%CI 0.8-1.2) and after the 6-week follow-up, complete pain remission of plantar fasciitis was observed for both therapies. Patients had a better perception of the use of EWST at the end of the treatment, although in both groups it was satisfactory (p = 0.001). The results of this study showed a shorter-term effectiveness of shockwave treatment compared with the use of iontophoresis. However, both techniques were effective in satisfactorily reducing pain in this short period.

The Efficacy of Extracorporeal Shockwave Therapy Compared with Compression Therapy in Healing Venous Leg Ulcers.

Background: Innovative methods of physical therapy delivered via modern medical devices have significantly extended the possibility of applying conservative treatments in healing venous leg ulcers. The primary objective of this study was to compare the therapeutic efficacy of selected mechanical physical therapies (intermittent pneumatic compression vs. radial extracorporeal shockwave vs. focal extracorporeal shockwave) vs. standard care in the treatment of venous leg ulcers over a 4-week period. Materials: This study included 69 patients, comprising 45 females (65%) and 24 males (35%), with a mean age of 67.1 ± 8.6 years (range: from 52.0 to 80.0 years). Methods: The patients were allocated into four groups: the IPC group was treated with intermittent pneumatic compression therapy, the R-ESWT group was treated with radial extracorporeal shockwave therapy, the F-ESWT group was treated with focal extracorporeal shockwave therapy, and the SC group was treated with standard care. Results: After one month of therapy, the median percentage decrease in wound total surface area after treatment was as follows: in the IPC group, there was a 52.9% decrease (range: 3.3-100%); in the R-ESWT group, there was a 31.6% decrease (range: 2.4-95.8%); in the F-ESWT group, there was an 18.0% decrease (range: 1.9-76.1%); and in the SC group, there was a 16.0% decrease (range: 1.5-45.8%). Conclusions: All the studied therapies caused a statistically significant reduction in the surface area of venous leg ulcers. The best results were observed with the intermittent pneumatic compression, while the radial and focal extracorporeal shockwave therapies appeared less effective. The standard care alone turned out to be the least effective. Our results did not show statistically significant changes in the values of RBC deformability at the investigated shear rates.

Biceps brachii long head calcific tendinitis can be treated quickly and effectively with radial shockwave therapy: a case report

Calcific tendinitis, which mostly involves the supraspinatus and rotator cuff tendons, may very rarely involve the long head of the biceps brachii (LHBB). Arthroscopy is the first choice in cases of calcific tendinitis accompanied by a rotator cuff tear but in cases where the rotator cuff is intact, there are different treatment methods, such as non-steroidal anti-inflammatory drugs (NSAID), steroid injection, Extracorporeal Shock Wave Therapy (ESWT), and Radial Shock Wave Therapy (RSWT). A 28-year-old male presented at the outpatient clinic with right shoulder pain which had been ongoing for 6 months. The patient, who was a licensed table tennis player and amateur bodybuilder, had no systemic diseases. After clinical and radiological evaluation, ultrasonography showed calcification at the level of the greater tuberculum of the right humerus. The patient was diagnosed with calcific tendinitis of the bicipital tendon. Magnetic resonance imaging (MRI) was then performed to investigate any rotator cuff pathology or glenohumeral joint pathology. No additional pathology was observed. The patient was managed with the standard RSWT protocol of four sessions. 0.25 mJ/mm2 3 bar 2000 beats administered with an electromagnetic lithotriptor. Before RSWT, the VAS score was 9 over 10 and Constant score was 37, and after the first session of RSWT, the VAS score of the patient had decreased to 6. After the 4th session, treatment was terminated as the patient was completely pain-free. At the 1-year follow-up examination, the patient was still pain-free during daily activities and sports activities, and had full range of motion. In this case report, RSWT is presented as an effective treatment option for LHBB calcific tendinitis. RSWT may be a priority option over ultrasound-guided or arthroscopic barbotage in patients without tendon rupture.

High intensity laser therapy versus radial shock wave therapy in treatment of shoulder impingement syndrome

Background. Shoulder pain is very common problem in medical practice, ranked third after lower back and neck issues. Shoulder impingement syndrome is thought to be the most common reason for shoulder pain. It accounts for around 44% to 65% of all shoulder problems. Purpose. to compare between the effects of High Intensity Laser Therapy versus Radial Shock Wave Therapy in treatment of shoulder impingement syndrome. Methods. 45 patients were randomly enrolled into three equal groups. Group A (n = 15) received HILT plus conventional physical therapy program, Group B (n = 15) received RSWT plus the same conventional physical therapy program, and Group C (n = 15) received a conventional physical therapy program. The assessment were conducted pre and post treatment using the Visual Analogue Scale, Shoulder pain and disability index and electro goniometer to active shoulder flexion and abduction range of motion. Results. MANOVA test demonstrated a significant (P &lt; 0.05) decrease in VAS and SPADI and a significant (P &lt; 0.05) increase in shoulder flexion and abduction ROM in the three groups. VAS, SPADI, shoulder flexion, abduction ROM revealed that there was more improvement in-group A (P &lt; 0.05). Conclusion: HILT showed a superior effect compared with RSWT on pain, function and shoulder flexion and abduction ROM in treatment of SIS.

Efficacy of radial shock wave therapy on rat models of adjuvant arthritis

BackgroundExtracorporeal shock wave therapy (ESWT) is an effective treatment for musculoskeletal pain, tendinopathy, and fasciitis with an anti-inflammatory effect. ESWT can be categorized into two groups: radial pressure wave (RPW) and focused shock wave (FSW). Although there have been several studies on the inflammation and pain-improvement mechanisms of FSW, there are few studies on the pain-improvement mechanisms of RPW. This study aimed to elucidate the efficacy of RPW in a rat model of adjuvant arthritis. MethodsNinety-six rats were randomly categorized into three groups: RPW, control, and sham as follows: (I) RPW group, which received RPW application after complete Freund's adjuvant (CFA) injection; (II) Control group, which received only CFA injection; and (III) Sham group, which received only saline injection. All rats were evaluated at 0, 4, 7, 14, 28, and 56 days post-RPW application based on foot circumference, von Frey test, and immunohistochemistry of nerve fibers for calcitonin gene-related peptide (CGRP) and protein gene product (PGP) 9.5 in plantar skins. ResultsThere were no significant differences in foot circumference between the RPW and control groups at any time point. The RPW group showed significant improvements in the von Frey test results on days 7 and 14. The total CGRP-immunoreactive (ir) and PGP9.5-ir nerve fiber lengths in the RPW group decreased on day 0; however, both were increased in the control group. The CGRP-ir and PGP9.5-ir nerve fibers in the RPW group were significantly shorter than those in the control group until day 14 after RPW. ConclusionsRPW improved the mechanical hypersensitivity between days 7 and 14 after application. Like FSW, RPW also induced the degeneration of sensory nerve fibers in the skin in the early period after irradiation, and reinnervation occurred between 14 and 28 days. Thus, our results demonstrate one of the pain relief mechanisms after RPW application.

DEFOCUSED AND RADIAL SHOCK WAVE THERAPY, MESOTHERAPY, AND KINESIO TAPING EFFECTS IN PATIENTS WITH LIPEDEMA: A PILOT STUDY

The aim of this pilot study was to investigate the effects of defocused and radial shock wave therapy, mesotherapy, and kinesio taping on pain, circumferences of lower limbs, echographic/ elastosonographic pattern of subcutaneous adipose tissue (SAT), and quality of life in patients with lipedema. Fifteen women affected by lower limb lipedema in stage II were treated with shock wave therapy, mesotherapy, and kinesio taping on thighs and legs (eight sessions, twice a week). The primary outcome was pain, as assessed by Numeric Rating Scale (NRS). Secondary outcomes included the limb circumferences measurements, the SF-12 Health Survey for quality of life, the International Classification of Functioning (ICF) for disability, and echographic/ elastosonographic changes of SAT. Significant reductions of pain and circumference measurements were seen in patients at each follow up. This was associated with significant reduction of thickness, echographic pattern improvement, and increased elasticity of SAT, with consequent positive impact on the quality of life and disability reported by the patients. The results demonstrate improved clinical and functional ultrasound findings in patients affected by lipedema in the early stages of lower limbs, and this combination therapy needs to be investigated in larger

Management of Upper-Limb Spasticity Using Modern Rehabilitation Techniques versus Botulinum Toxin Injections Following Stroke.

Our purpose is to emphasize the role of botulinum toxin in spasticity therapy and functional recovery in patients following strokes. Our retrospective study compared two groups, namely ischemic and hemorrhagic stroke patients. The study group (BT group) comprised 80 patients who received focal botulinum toxin as therapy for an upper limb with spastic muscle three times every three months. The control group (ES group) comprised 80 patients who received only medical rehabilitation consisting of electrostimulation and radial shockwave therapy for the upper limb, which was applied three times every three months. Both groups received the same stretching program for spastic muscles as a home training program. We evaluated the evolution of the patients using muscle strength, Ashworth, Tardieu, Frenchay, and Barthel scales. The analysis indicated a statistically significant difference between the two groups for all scales, with better results for the BT group (p < 0.0001 for all scales). In our study, the age at disease onset was an important prediction factor for better recovery in both groups but not in all scales. Better recovery was obtained for younger patients (in the BT group, MRC scale: rho = -0.609, p-value < 0.0001; Tardieu scale: rho = -0.365, p-value = 0.001; in the ES group, MRC scale: rho = -0.445, p-value < 0.0001; Barthel scale: rho = -0.239, p-value = 0.033). Our results demonstrated the effectiveness of botulinum toxin therapy compared with the rehabilitation method, showing a reduction of the recovery time of the upper limb, as well as an improvement of functionality and a reduction of disability. Although all patients followed a specific kinetic program, important improvements were evident in the botulinum toxin group.

Electrophysiological assessment of radial shock wave therapy for carpal tunnel syndrome.

This study presents an electrophysiological assessment of radial extracorporeal shock wave therapy on patients with carpal tunnel syndrome (CTS). Sixteen CTS subjects received radial extracorporeal shock wave therapy once a week for five consecutive weeks. Outcome performance was assessed using the Boston Carpal Tunnel Questionnaire (BCTQ) and electrodiagnostic measurements including a nerve conduction study of the median nerve and a compound muscle action potential (CMAP) scan of the abductor pollicis brevis muscle. The BCTQ and the sensory conduction test measurements were all statistically improved after the treatment. However, the motor conduction test measurements were not significantly different before and after the treatment. The CMAP scan examination revealed MScanFit motor unit number estimation (MUNE) was significantly higher after the treatment, while no significant change was found in StairFit MUNE and step index. These results confirmed the effectiveness of shock wave therapy for treating CTS symptoms and the associated sensory property changes. The reasons for the inconsistencies from different CMAP scan processing methods are worthwhile targets for further investigation.

Comparison of the Effectiveness of Selected Physiotherapy Methods in the Treatment of Tennis Elbow Syndrome: a case report

Background: Tennis elbow is a common ailment with which patients present to the physiotherapy office. It is characterized by pain in the area of the attachment of the tendons of the extensor muscles of the wrist to the lateral epicondyle of the humerus and the proximal part of the extensor muscles of the wrist, reduced grip strength and limited function of the upper limb. The condition can result from trauma, but in most cases it is the result of overload, with factors such as degeneration and relative ischemia, repetitive grasping movements, scar tissue and contracture playing a role. In this case, there is a diagnosis including history, functional tests and palpation of structures within the lateral epicondyle of the humerus.Aim of the study: To compare and evaluate the effectiveness of selected physiotherapy methods used in the treatment of tendinopathy of the lateral epicondyle region of the humerus Case report: Medical cases of four men aged 40-55 years complaining of pain in the lateral epicondyle region of the humerus are presented. Palpation examination, functional tests and symptoms indicated that we were dealing with "tennis elbow syndrome." Treatment included low-energy laser ultrasound, low-frequency magnetic field, radial shock wave, nitrogen vapor cryotherapy, deep transverse massage (DTM) according to Cyriax.Conclusions: Among the selected physiotherapeutic methods, radial shock wave therapy and deep transverse massage according to Cyriax showed the greatest effectiveness.

Effects of Additional Radial Shock Wave Therapy on Spasticity of Upper Extremity Muscle

Background: Spasticity is one of the most common problems and greatly interferes with the functional capacity of chronic stroke patients. The most commonly used treatments are infrared therapy and stretching exercises, but they have not reduced spasticity effectively. The addition of Radial Shock Wave Therapy (RSWT) was expected to be more effective in reducing spasticity in chronic stroke patients. Aim: The purpose of this study is to prove that the addition of RSWT is more effective reducing spasticity of chronic stroke patients. Material and methods: This study was a simple randomized controlled pre- and post-experimental design. The total sample of 30 chronic spastic stroke patients with the Modified Asworth Scale 2-3 was divided into 2 groups: the study group and the control group. RSWT was provided once a week to the muscle belly of the flexor wist muscle on the ventral aspect of the forearm, the intrinsic muscle of the hand, and flexor digitorum tendon. They were added to infrared therapy and stretching exercises in the upper extremities which are provided three times a week for six weeks consecutively. The level of spasticity was measured by the Tardieu Scale, which measures quality and angle of resistance at the beginning and end of the study. Results: A significantly greater reduction was obtained (p&lt;0.05) from the level of spasticity measured by the Tardieu Scale, both on the quality and angle of resistance, in the study group. Conclusion: The addition of RSWT has been shown to have a greater reduction in spasticity in upper extremity muscle in chronic stroke patients.

A preliminary investigation into the impact of shock wave therapy and sonotherapy on postural control of stepping tasks in patients with Achilles tendinopathy.

The outcomes of physical therapy are commonly assessed with subjective scales and questionnaires. Hence, a continuous search to identify diagnostic tests that would facilitate objective assessment of symptom reduction in those patients with Achilles tendinopathy who undergo mechanotherapy. The main aim of this study was to evaluate and compare the effectiveness of shock wave and ultrasound treatments, using objective posturographic assessment during step-up and step-down initiation. The patients with non-insertional Achilles tendinopathy and pain lasting for more than 3 months were randomly assigned to one of the experimental groups, i.e., radial shock wave therapy (RSWT), ultrasound therapy, or placebo ultrasound. All groups also received deep friction massage as the primary therapy. The transitional locomotor task was performed with the affected and unaffected limb in random order, on two force platforms under two conditions (step-up and step-down). The recording of center of foot pressure displacements was divided into three phases: quiet standing before step-up/step-down, transit, and quiet standing until measurement completion. Pre-intervention measurements were performed and then short-term follow-ups at weeks 1 and 6 post-therapy. The three-way repeated measures ANOVA showed few statistically significant two-factor interactions between therapy type, time point of measurement and the type of the locomotor task. Significant increases in postural sway were observed in the entire study population throughout the follow-up period. Three-way ANOVAs revealed a group effect (shock wave vs. ultrasound) on almost all variables of the quiet standing phase prior to step-up/step-down initiation. Overall, postural stability before the step-up and step-down tasks appeared to be more efficient in patients who had undergone RSWT compared to the ultrasound group. Objective posturographic assessment during step-up and step-down initiation did not demonstrate therapeutic superiority of any of the three therapeutic interventions used in patients with non-insertional Achilles tendinopathy.Clinical Trial Registration: The trial was prospectively registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12617000860369; registration date: 9.06.2017).

Effect of radial shock wave and ultrasound therapy combined with traditional physical therapy exercises on foot function and dorsiflexion range in plantar fasciitis: a prospective randomized clinical trial.

This study aimed to assess the effect of radial shock wave and ultrasound therapy combined with traditional physical therapy on foot function and range of motion in chronic plantar fasciitis. Sixty-nine participants with chronic plantar fasciitis (25-56 years) were allocated randomly into three groups. Group (A) received ultrasound (US) therapy plus conventional physical therapy exercises (in the form of stretching, strengthening exercise, and deep friction massage), Group (B) received a radial shock wave (RSW) therapy plus conventional physical therapy exercises, and Group (C) received a combination of both RSW and US therapy in addition to conventional physical therapy exercises, with 3 sessions per week for US therapy and one session for RSW therapy, in addition to 45 minutes of exercises for all groups for 4 consecutive weeks. Foot function was assessed using the foot function index (FFI), and ankle dorsiflexion range of motion was measured using the Baseline® bubble inclinometer at baseline and 4 weeks following treatment. ANOVA revealed significant differences (p<0.05) in the measured outcomes among the groups after treatment. Tukey's honest significant difference post-hoc test demonstrated a highly statistically significant (p<0.001) improvement in the assessed outcomes of group C in the post-intervention settings when compared to the other groups. After 4 weeks of intervention, the mean (SD) of FFI in groups A, B, and C were (64.54±4.91, 61.93±4.17, and 45.16±4.57) respectively, and the active range of motion (ROM) of the ankle dorsiflexion were (35.27±3.22, 36.59±2.91, and 41.85±3.04) respectively. The addition of RSW to US with the conventional physical therapy program improved foot function and ankle dorsiflexion range of motion significantly for patients with chronic plantar fasciitis.

Radial Shock Wave Therapy with "Intelect Prw Lite" for Calcifying Tendinopathy of the Shoulder, Comparative Effectiveness with Conventional Physical Therapy and Follow Up

Radial shock wave therapy (RSWT) is a well-known treatment for a different variety of musculoskeletal conditions, its efficacy proven by a wide range of scientific research. It is still controversial however in terms of the doses, methodology and the required follow-up activities regarding the treatment of chronic calcifying tendinopathy of the shoulder.

BENEFITS OF RADIAL SHOCK WAVE THERAPY AND LASER THERAPY ON MYALGIA LOW BACK PAIN

Low Back Pain (LBP) does not cause death, but causes individuals to become unproductive so that it will cause an enormous economic burden for individuals, families, communities and the government. Indonesian BPS data explains that people over 15 years of age have health problems. With increasing age, the anatomical structure and function of tissues will decrease, such as muscles, bones and joints, ligaments and other soft tissues. These changes are relevant to a person's decrease in activity. Pain is a major problem in patients with LBP disorders. Physiotherapy measures to overcome these complaints are extracorporeal shock wave therapy and laser. Physiotherapeutic intervention using shock wave therapy and extracorporeal laser methods can be given to LBP myalgia patients through community service activities carried out at Grandmed Lubuk Pakam Hospital. To evaluate the results of the intervention, the measuring tool used is the Verbal Analog Scale (VAS). This activity was attended by 12 respondents who complained of low back pain. Before and after the intervention the value will be measured using the VAS. Based on the results of the last evaluation, it can be seen that the respondents' pain complaints before and after the intervention experienced withdrawal, namely 5.8 (moderate pain) before the intervention and after the intervention the value became 0.8 (mild pain). The results of these actions prove that physiotherapy interventions such as radial shock wave therapy and laser therapy are useful/effective in dealing with complaints of LBP myalgia.

The Effect of Radial Shock Wave Therapy and Laser Therapy on Pain in Myalgia Pain Low Back at EMC Hospital, Cikarang in 2022

Low Back Pain (LBP) is a leading cause of disability worldwide, which places a significant economic burden on the healthcare system. Nonspecific low back pain Low back pain (LBP) is defined as low back pain that is not caused by a recognized and recognized specific pathology. Low back pain does not cause death, but causes individuals who experience it to become unproductive so that it will cause a very large economic burden for individuals, families, communities, and governments. Promising physiotherapy measures for the treatment of LBP myalgia are extracorporeal shock wave therapy and laser. The purpose of this study was to determine the effect of radial shock wave therapy and laser therapy on pain in low back pain myalgia patients at EMC Hospital Cikarang in 2022. This research method was experimental with a quasi-experimental approach, namely research by conducting experiments to determine the symptoms or effects that arise. as a result of a certain treatment or experiment with a one group pretest posttest design, with the aim of knowing the effect of radial shockwave therapy and laser therapy on pain in low back pain myalgia patients at EMC Hospital Cikarang in 2022. The number of samples from this study was 12 people. who is an employee of EMC Cikarang Hospital in 2022 with complaints of LBP myalgia. Respondents will be measured the value of pain using Verval Analogue Scale (VAS) before and after being given radial shockwave therapy and laser therapy. The test used to analyze the data is the Wilcoxon test. The results of data analysis using the Wilcoxon test obtained a significance value (p-value) of 0.001 which is smaller than 0.05 (p&lt;0.05), which means that there is a difference in the value of pain before and after giving radial shock wave therapy and laser therapy to pain in patients. low back pain myalgia. The conclusion is that there is an effect of giving radial shock wave therapy and laser therapy to reducing pain in low back pain myalgia patients at EMC Hospital Cikarang in 2022

Patient Outcomes on Treatment of Insertional Achilles Tendinopathy with Extracorporeal Shockwave Therapy: A Retrospective Study

Category: Ankle; Other Introduction/Purpose: Insertional achilles tendinopathy (IAT) affects approximately one-third of patients who report achilles tendon pain during their lifetime. It is characterized by stiffness and pain that are aggravated by prolonged rest and physical activity, respectively. Known treatments for IAT include eccentric exercises, night splints, pharmacologic or biologic injections, and extracorporeal shockwave therapy (ESWT). However, pain and functional outcomes following ESWT treatment for IAT vary throughout the literature. In addition, ESWT protocols have varied across studies. This retrospective study aimed to collect information on patient outcomes following ESWT treatment for IAT at a single institution to better characterize patient-reported pain and functional outcomes and to determine if patient-reported outcomes differ according to varying ESWT protocols. Methods: 44 patients who presented with IAT and received ESWT from 2/1/2016 to 10/1/2021 were included. Confirmation of IAT was determined by a review of each patient's chart. Patient-reported outcomes included NRS or VAS scores and PROMIS-10 were collected prior to ESWT sessions and at follow-up time points. Additionally, demographic information for each patient was collected including age, gender, race, ethnicity. Information regarding their achilles tendinopathy included symptom duration, laterality, prior interventions before ESWT, concurrent foot or ankle injuries on the same side, pain (baseline and follow-ups), PROMIS-10 (baseline and follow-ups) was also collected. Finally, ESWT information was reviewed including focused vs radial, number of sessions, number of pulses, energy intensity, frequency, any adverse outcomes after ESWT (e.g., tendon rupture, increase in pain; immediate or delayed), and if any interventions were needed during or after ESWT (physical therapy, cortisone injection, PRP, surgery, medications, orthotics). Results: Out of the 44 patients who were included in the study, 27 were female and 17 male. Mean symptom duration was 23.3 months (SD 26.7 months). 34 patients had unilateral pain while 5 had bilateral pain. Every patient had undergone previous treatment with a majority having tried physical therapy (n=33) and bracing (n=21). Mean number of ESWT sessions between patients was 3.3 (SD 1.5 sessions). 30 patients received focused shockwave therapy, 3 received radial shockwave therapy and 1 received both. The remaining 10 patient charts were inconclusive as to which type of shockwave was performed. 13 patients reported no improvement whereas the remaining 31 patients reported improvement, with a majority (n=18) reporting at least 50% improvement or greater. Conclusion: Insertional achilles tendinopathy can be treated with a wide variety of modalities, therapies and adjuncts. When considering treatment for cases that do not respond to the traditional methods including physical therapy, bracing and injections, ESWT shows promising data to be an effective treatment option, regardless of type or intensity. Most patients require more than 1 ESWT to be effective.

Comparison of the effects of ultrasound- guided needle puncture, radial shock wave therapy, and combined treatments on calcific tendinitis of the shoulder: A single-blind randomized controlled trial.

Calcific tendinitis of the shoulder is a common disorder resulting in restricted motion and pain. This study compared the effects of ultrasound-guided fine-needle puncture (USNP), radial shock wave therapy (RSWT), and the combination of both treatments (COMB) on calcific tendinitis of the shoulder. We enrolled 62 patients who had unilateral shoulder pain for more than 3 months. The patients were randomly divided into three groups: USNP, RSWT, and COMB. All USNP needle punctures were guided with ultrasound (US), and RSWT was delivered at 2 Hz (2000 shock waves; 0.26 mJ/mm2) once a week for 3 weeks. The COMB group received three weekly rounds of RSWT after a single US-guided needle puncture. The primary outcome was the pain visual analog scale (VAS), and secondary outcomes were the Constant scores, 36-Item Short-Form Health Survey, and range of motion. A within-group comparison at 3 months revealed significant improvements in the pain VAS (p< 0.05, during activity) and Constant (p< 0.05) scores, but between-group comparisons revealed no statistically significant differences in the pain VAS (p> 0.05) or Constant (p= 0.089) scores. Only improvement differences in role-emotional (SF-36; p= 0.01) and active external rotation (p= 0.035) were determined over time, which favored the USNP and COMB groups. Although no significant differences were observed among the groups in the treatment of calcific tendinitis of the shoulder, more satisfactory outcomes were noted in the USNP and COMB groups than in the RSWT group. Larger samples, longer follow-up times, and other treatment protocols are suggested for future studies.