目的 观察体外冲击波治疗髌腱末端病的效果。 方法 2006年1月－2010年12月67例髌腱末端病患者全部采用非手术治疗，其中38例采用体外冲击波治疗，11例采用手法按摩疗法，5例采用体外擦药酒、药膏，4例注射醋酸泼尼松龙加普鲁卡因，9例采用针灸疗法。观察体外冲击波治疗与其他非手术疗法之间的效果有无差异。 结果 经相同疗程治疗后，采用体外冲击波治疗者显效25例，有效10例，效果不明显3例；采用其他非手术疗法者显效9例，有效12例，效果不明显8例；两组治疗结果差异有统计学意义（Z=?2.966，P=0.003）。 结论 应用体外冲击波治疗髌腱末端病方法简便，操作安全，疗效显著，较其他非手术治疗方法有明显的优势。但对运动员患者应用此方法时，应与训练安排紧密结合起来，才能收到最大的效果。Objective To explore the therapeutic effect of extracorporeal shock wave therapy (ESWT) on patellar tendinopathy (PT). Methods A total of 67 cases who were diagnosed with PT between January 2006 and December 2010 were selected. All of the patients were treated with conservative treatment, including ESWT in 38, massage therapy in 11, ointment in 5, injection with prednisolon acetate and procaine in 4, and acupuncture in 9. The therapeutic effects of ESWT and other treatment were observed and compared. Results After the same treatment duration, the therapeutic effect was excellent in 65.79%, good in 26.32%, and fair in 7.89%, respectively in patients who had undergone ESWT; while the result was excellent in 31.03%, good in 41.38%, and fair in 27.59% , respectively in the patients who had received the other conservative treatments. The difference was significant (Z=?2.966, P=0.003). Conclusions ESWT is easy, safe, and effective for PT. It has more distinct advantages than other conservative treatments. However, it’s better to combine the treatment with training plans when the patients are athletes.
Objective To evaluate the value of Ureteral Stent Placement before Extracorporeal Shock Wave Lithotripsy (ESWL). Methods We searched the Cochrane Central Register of Controlled Trials (Issue 4, 2010), MEDLINE (OVID 1950 to April 2010), EMbase (1979 to April 2010), CBM (1978 to April 2010), CNKI (1979 to April 2010), and VIP (1989 to April 2010), and manually searched journals as well. All the randomized controlled trials (RCTs) of treating ureteral stone with ESWL after stent placement were included. We evaluated the risk of the bias of the included RCTs according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1. The Cochrane Collaboration’s software RevMan 5.0 was used for meta-analysis. Results Three RCTs with C-level evidence involving 319 ureteral stone patients were identified. The results of meta-analyses showed that: a) Effect of treatment: The ureteral stent placement before ESWL did not take better effects in aspects of the complete clearance rate (WMD= 1.10, 95%CI 0.87 to 1.38), the quantity of lithotripsy (WMD= 0.43, 95%CI – 1.05 to 0.19), the frequency of shock wave (WMD= 0.00, 95%CI – 0.25 to 0.25), and the power of shock wave (WMD= 0.20, 95%CI – 0.05 to 0.46); and b) Postoperative complications: The ureteral stent placement were prone to cause dysuria (RR= 2.30, 95%CI 1.62 to 3.26), microscopic hematuria (RR= 2.66, 95%CI 1.97 to 3.58), gross hematuria (RR= 6.50, 95%CI 1.50 to 28.15), pyuria (RR= 1.78, 95%CI 1.44 to 2.21), positive urine culture (RR= 2.13, 95%CI 1.71 to 2.64), and suprapubic pain (RR= 3.10, 95%CI 1.59 to 6.04). Conclusions Ureteral stent placement before ESWL is inadvisable. Multi-factors which lead to bias affected the authenticity of our review, such as low-quality and small amount of RCTs. Further large-scale trials are required.
ObjectiveTo evaluate the effects of low-energy radial extracorporeal shock wave therapy (rESWT) combing with moisture therapy on traumatic bone/tendon exposed wounds, and seek the best treatment project. MethodsThirty-three patients with bone/tendon exposed wounds treated from July 2013 to July 2015 were randomly divided into trial group (n=17) and control group (n=16) according to the sequence of admission. Patients in the control group accepted moisture therapy with proper dressings to deal with the wounds, while those in the experiment group accepted both moisture therapy and rESWT therapy. Then, we compared the two groups in terms of the frequency and total times of changing dressings, healing time, healing rate and wound contraction rate. ResultsThe healing rate of both the two groups was 100%. The trial group was significantly less than the control group in the frequency of changing dressings (P<0.05). The healing time of the trial group was significantly shorter than that of the control group (P<0.05), and wound contraction rate was higher than the control group (P<0.05). ConclusionLow-energy rESWT can shorten healing time, decrease frequency of changing dressings and total time of treatment, and perform better than moisture therapy only.
Extracorporeal shock wave treatment is capable of providing a non-surgical and effective treatment modality for patients suffering from osteoarthritis. The major objective of current works is to investigate how the shock wave (SW) field would change if a bony structure exists in the path of the acoustic wave. Firstly, a model of finite element method (FEM) was developed based on Comsol software in the present study. Then, high-speed photography experiments were performed to record cavitation bubbles with the presence of mimic bone. On the basis of comparing experimental with simulated results, the effectiveness of FEM model could be verified. Finally, the energy distribution during extracorporeal shock wave treatment was predicted. The results showed that the shock wave field was deflected with the presence of bony structure and varying deflection angles could be observed as the bone shifted up in the z-direction relative to shock wave geometric focus. Combining MRI/CT scans to FEM modeling is helpful for better standardizing the treatment dosage and optimizing treatment protocols in the clinic.
ObjectiveTo investigate the effectiveness of extracorporeal shock wave therapy combined with platelet-rich plasma (PRP) injection in treatment of knee osteoarthritis (KOA) by prospective clinical study.MethodsBetween June 2015 and June 2018, 180 patients with KOA met the inclusion criteria were included in study and randomly allocated to group A (n=60), group B (n=60), and group C (n=60). The patients were treated with autologous PRP intra-articular injection in group A, extracorporeal shock wave therapy in group B, and extracorporeal shock wave therapy combined with autologous PRP intra-articular injection in group C, once a week and 5 times a duration of treatment. There was no significant difference in age, gender, disease duration, side of KOA, and Kellgren-Lawrence grading between groups (P>0.05). The pain and function of knee joint were assessed by visual analogue scale (VAS) score, Lequesne Index score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and knee joint activity before treatment and at 1, 3, and 5 weeks after the first treatment.ResultsThere were significant differences in VAS score, Lequesne Index score, WOMAC score, and knee joint activity between pre- and post-treatment in all groups (P<0.05). VAS score, Lequesne Index score, and WOMAC score gradually decreased with the prolongation of treatment time (P<0.05); but there was no significant difference in knee joint activity between different time points (P>0.05). There was no significant difference in VAS score, Lequesne Index score, WOMAC score, and knee joint activity between groups before treatment (P>0.05); the scores of group C were superior to groups A and B (P< 0.05) at different time points after treatment; while the knee joint activities of 3 groups were similar (P>0.05).ConclusionThe extracorporeal shock wave therapy combined with PRP injection can relieve the pain synergistically for KOA.
Diabetic foot ulcer is one of the severe chronic complications that lead to disability and death of diabetic patients. In order to solve this problem, adjuvant therapy studies of diabetic foot ulcers have increased in recent years. Extracorporeal shock wave therapy is a novel adjuvant therapy that has been approved by the US Food and Drug Administration for diabetic foot ulcers wounds. In this paper, the mechanisms of extracorporeal shock wave therapy for diabetic foot ulcers are described, including wound angiogenesis, wound tissue blood perfusion, nerve regeneration, granulation tissue proliferation, inflammatory response, anti-infection, migration and differentiation of mesenchymal stem cells and endothelial progenitor cells. This study aims to provide a theoretical basis for the clinical application of extracorporeal shock wave therapy in clinical treatment of diabetic foot ulcers.
As a kind of extracorporeal shock wave therapy, radial extracorporeal shock wave therapy (rESWT) has been gradually applied to the rehabilitation treatment of diseases in various clinical systems and has become an important physiotherapy method in the department of rehabilitation medicine due to its benefits of high-efficiency, non-invasive, simple and safe, etc. Radial extracorporeal shock wave has unique biological and physical characteristics, and can play the role of anti-inflammatory, analgesia and neovascularization, etc. In this paper, the excellent efficacy of rESWT in orthopedic diseases, spastic paralysis, peripheral nerve injury, refractory wound and andrology diseases was described. This article aims to provide guidance for the clinical application of rESWT in the field of rehabilitation medicine.
ObjectiveTo systematically review the efficacy and safety of extracorporeal shock wave therapy (ESWT) in the treatment of rotator cuff tendinopathy to provide evidence for clinical practice. MethodsDatabases including CENTRAL, MEDLINE, EMbase, CINAHL plus, PEDro, CNKI, CBM, WanFang Data, and VIP were searched to collect randomized controlled trials (RCTs) of ESWT in the treatment of rotator cuff tendinopathy from inception to January 11th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. ResultsA total of 12 RCTs from 11 articles were included, including 529 subjects (273 in the case group and 256 in the control group). Meta-analysis showed that no significant difference between ESWT and placebo in pain improvement (SMD=−1.08, 95% CI −2.45 to 0.29, P=0.12), superior pain improvement in ESWT group than electroacupuncture group (SMD=−7.15, 95%CI −8.50 to −5.80, P<0.000 01), and no significant difference in pain improvement between ESWT as adjuvant therapy and acupuncture alone (SMD=−4.32, 95%CI −11.93 to 3.29, P=0.27). Regarding the Constant–Murley score (CMS) for shoulder joint function, ESWT was associated with an improved CMS compared with placebo (SMD=1.31, 95%CI 0.08 to 2.53, P=0.04). There was no significant difference in the improvement in the CMS between ESWT and other treatments (SMD=0.13, 95%CI −2.07 to 2.53, P=0.91). There was no significant difference in the improvement in the CMS between ESWT as adjuvant therapy and acupuncture alone (SMD=1.68, 95%CI −0.69 to 4.05, P=0.16). ConclusionsESWT may improve shoulder joint function in patients with rotator cuff tendinopathy, and the alleviation of pain in patients with rotator cuff tendinopathy requires further investigation. Due to the limited quality and quantity of included studies, the above conclusions requires further investigation by more high-quality studies.