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This study investigates the effect of Radial Shock Wave Therapy (RSWT) on 38 subjects suffering subacute and chronic tendinopathy. All subjects are treated once a week for four weeks with high energy shock wave (> 20 mJ/mm). The effect was measured by the use of the Likert Scale. Outcomes on pain were measured by Visual Analogue Scale (VAS) and by the Numerous Rating Scale (NRS). The results of this study show that RSWT might be an effective treatment on chronic tendinopathy (N=19) and on subacute tendinopathy (n=14). Significance is not found in both groups (P<0.05). This study also describes parameters for dosage, prognostic factors and practical implementation for the use of RSWT in (sports) physiotherapy.
Because most Achilles tendon injuries take place in sports and there has been a general increase in the popularity of sporting activities, the number and incidence of Achilles tendon overuse injuries have increased in the industrialized countries during the last few decades. The term "Achilles paratendinopathy" is used in clinical practice to describe activity-related Achilles pain combined with tenderness on palpation, providing that there is no suspicion of intratendinous pathology on the basis of patient history, clinical examination, or imaging examinations. This article discusses Achilles paratendinopathy.
Extracorporeal shockwave treatment has shown mixed short-term results for plantar fasciitis. However, the long-term results are not available.
Long-term results of shockwave treatment are comparable with short-term results.
Randomized controlled clinical trial; Level of evidence, 1.
This prospective study consisted of 149 patients (168 heels) with an established diagnosis of chronic plantar fasciitis, including 79 patients (85 heels) in the shockwave treatment group and 70 patients (83 heels) in the control group. In the shockwave group, patients received 1500 impulses of shockwaves at 16 kV to the affected heel in a single session. Patients in the control group received conservative treatment consisting of nonsteroidal anti-inflammatory drugs, orthotics, physical therapy, an exercise program, and/or a local cortisone injection. Patients were evaluated at 60 to 72 months (shockwave group) or 34 to 64 months (control group) with a 100-point scoring system including 70 points for pain and 30 points for function. The clinical outcomes were rated as excellent, good, fair, or poor.
Before treatment, the groups showed no significant differences in the scores for pain and function. After treatment, the shockwave group showed significantly better pain and function scores as compared with the control group. The overall results were 69.1% excellent, 13.6% good, 6.2% fair, and 11.1% poor for the shockwave group; and 0% excellent, 55% good, 36% fair, and 9% poor for the control group (P < .001). The recurrence rate was 11% (9/81 heels) for the shockwave group versus 55% (43/78 heels) for the control group (P < .001). There were no systemic or local complications or device-related problems.
Extracorporeal shockwave treatment is effective and safe for patients with plantar fasciitis, with good long-term results.