Instrumented assisted soft tissue mobilization vs extracorporeal shock wave therapy in treatment of myofascial pain syndrome

BACKGROUND Active myofascial trigger points(TrPs)often occur in the upper region of the upper trapezius(UT)muscle.These TrPs can be a significant source of neck,shoulder,and upper back pain and headaches.These TrPs and their related pain and disability can adversely affect an individual’s everyday routine functioning,work-related productivity,and general quality of life.AIM To investigate the effects of instrument assisted soft tissue mobilization(IASTM)vs extracorporeal shock wave therapy(ESWT)on the TrPs of the UT muscle.METHODS A randomized,single-blind,comparative clinical study was conducted at the Medical Center of the Egyptian Railway Station in Cairo.Forty patients(28 females and 12 males),aged between 20-years-old and 40-years-old,with active myofascial TrPs in the UT muscle were randomly assigned to two equal groups(A and B).Group A received IASTM,while group B received ESWT.Each group was treated twice weekly for 2 weeks.Both groups received muscle energy technique for the UT muscle.Patients were evaluated twice(pre-and posttreatment)for pain intensity using the visual analogue scale and for pain pressure threshold(PPT)using a pressure algometer.RESULTS Comparing the pre-and post-treatment mean values for all variables for group A,there were significant differences in pain intensity for TrP1 and TrP2(P=0.0001)and PPT for TrP1(P=0.0002)and TrP2(P=0.0001).Also,for group B,there were significant differences between the pre-and post-treatment pain intensity for TrP1 and TrP2 and PPT for TrP1 and TrP2(P=0.0001).There were no significant differences between the two groups in the post-treatment mean values of pain intensity for TrP1(P=0.9)and TrP2(P=0.76)and PPT for TrP1(P=0.09)and for TrP2(P=0.91).CONCLUSION IASTM and ESWT are effective methods for improving pain and PPT in patients with UT muscle TrPs.There is no significant difference between either treatment method.

Ultrasonographic evaluation of the effect of extracorporeal shock wave therapy on calcific tendinopathy of the rectus femoris tendon:A case report

BACKGROUND Calcific tendinopathy denotes calcific deposits in a specific tendon.It is also known as calcifying tendinitis,calcifying periarticulitis,or periarticular apatite deposition disease.Recently,extracorporeal shock wave therapy(ESWT)has been reported to be effective in relieving and treating pain in calcific tendinopathy.CASE SUMMARY A 36-year-old female patient suffered from left hip joint pain for six months.The pain was increased during abduction of the hip,waking,and jumping.B-mode ultrasonography was performed by a physiatrist with an L12-5 linear transducer.A single session of ESWT was given in the marking area under ultrasound guidance at 4 Hz,2500 shots with intensity of stimulation using energy of 0.1 mJ/mm2.The hip pain of the patient slowly decreased within 4 wk after starting the ESWT.After six weeks of ESWT,her hip pain was completely resolved.However,the size of calcification showed almost no reduction in simple radiography at the final follow-up.CONCLUSION Ultrasonography is a very good modality not only for diagnosing calcified tendinitis by classical appearance,but also for evaluating the effect of ESWT during the follow-up period.

Low-intensity extracorporeal shock wave therapy for midshaft clavicular delayed union: A case report and review of literature

BACKGROUND One of the most common complications following surgery for midshaft clavicle fracture is nonunion/delayed union.Extracorporeal shock wave therapy(ESWT)is an alternative to promote new bone formation without surgical complications.To date,no literature has reported low-intensity ESWT(LI-ESWT)in delayed union of midshaft clavicle fracture.CASE SUMMARY We reported a 66-year-old Chinese amateur cyclist with clavicle delayed union treated with 10 sessions of LI-ESWT(radial,0.057 mJ/mm^(2),3 Hz,3000 shocks).No anesthetics were applied,and no side effects occurred.At the 4 mo and 7 mo follow-ups,the patient achieved clinical and radiographical recovery,respectively.CONCLUSION In conclusion,our findings indicated that LI-ESWT could be a good option for treating midshaft clavicular delayed union.

Extracorporeal shock wave for plantar flexor spasticity in spinal cord injury:A case report and review of literature

BACKGROUND Approximately 65%-78%of patients with a spinal cord injury(SCI)develop any symptom of spasticity.The aim of this study was to investigate the tolerability and short-term effects of radial extracorporeal shock wave therapy(r ESWT)on plantar flexor spasticity in a patient with incomplete SCI.CASE SUMMARY An 18-year-old man with an incomplete SCI completed five sessions of r ESWT.The primary outcomes were the changes in ankle-passive range of motion(APROM)and passive resistive force to ankle dorsiflexion.The outcomes were assessed at baseline(T0),immediately after treatment(T1)and 1 wk after the end of treatment(T2).The A-PROM increased by 15 degrees at T1 and 25 degrees at T2 compared with T0.The passive resistive force to ankle dorsiflexion at low velocity decreased by 33%at T1 and 55%at T2 in the gastrocnemius muscle and by 41%at T1 and 39%at T2 in the soleus muscle compared with T0.At high velocity,it also decreased by 44%at T1 and 30%at T2 in the gastrocnemius muscle compared with T0.However,in the soleus muscle,the change was minor,with a decrease of 12%at T1 and increased by 39%at T2 compared with T0.CONCLUSION In this patient,the findings showed that r ESWT combined with conventional therapy was well-tolerated and could be effective in improving A-PROM and passive resistive force to ankle dorsiflexion in the short-term.Further randomized controlled clinical trials with longer period of follow-up are necessary to confirm the results obtained in patients with SCI.

Extracorporeal shock wave therapy treatment of painful hematoma in the calf:A case report

BACKGROUND Extracorporeal shock wave therapy (ESWT) can be applied to variousmusculoskeletal conditions including calcific tendinitis. Muscle injuries can leadto hematomas, and unabsorbed hematomas sometimes cause pain. We report acase of painful hematoma successfully treated with ESWT. To our knowledge, thisis the first reported case of painful intramuscular hematoma treated with ESWT.CASE SUMMARY A 65-year-old man visited the outpatient department for left calf pain withswelling that had persisted since he slipped two weeks prior. The calf pain hadpersisted and was rated visual analog scale 7. On physical examination, there wasa localized, stiff, ovoid mass on his left upper posterior calf. The pain wasaggravated by dorsiflexion of the left ankle or weight-bearing on the left foot.Initial diagnostic ultrasonography showed a hematoma in the left gastrocnemiusmuscle;its texture was firm with low heterogeneity. We applied ESWT to thehematoma. His pain decreased immediately to a visual analog scale 3, and themass was softened. The texture of the hematoma became more heterogeneous onultrasonography. Due to planned overseas travel, he returned three months afterthe initial visit to report that the pain and swelling were dramatically relievedafter ESWT.CONCLUSION We propose that painful hematomas could be a new indication for ESWT. Furtherinvestigation on the effects of ESWT for hematomas is needed.

Selection of Reference Genes in Equine White Blood Cells for Real Time PCR Normalization Following Extracorporeal Shock Wave Therapy

Selection of proper reference genes (RGs) is an essential step needed for accurate normalization of results from genomic studies. Expression of RGs is regulated by many factors such as species, age, gender, type of tissue, the presence of disease, and the administration of therapeutic treatment. The aim of the present study was to identify optimal RGs in a set of blood samples collected at different time points (0, 24, 48, 72 h) from horses following administration of extracorporeal shock wave therapy (ESWT). The mRNA expression of twelve RGs: HPRT1, ACTB, HSP90A, SDHA, GUSB, B2M, UBC, NONO, TBP, H6PD, RPL32, GAPDH was determined using real time quantitative polymerase chain reaction (qPCR). An SAS program developed on the algorithm of geNorm, SASqPCR, was used to determine stability of the expression and the number of optimal RGs. The results showed that the range of quantification cycle (Cq) values of the evaluated genes varied between 17 and 26 cycles, and that one optimal RG, ACTB, was sufficient for normalization of gene expression. Results of stability of expression demonstrated that ACTB was the optimal choice for all the samples studied. Notably, in samples collected at 72 h post ESWT, TBP showed a significant change in the expression level, and was not suitable for use as a RG. These results substantiate the importance of validating and selecting an appropriate RG.

Can extracorporeal shock-wave therapy be used for the management of lateral elbow tendinopathy?

Lateral elbow tendinopathy(LET) is one of the two most common tendinopathies of the upper limb. The most effective treatment in the management of LET is the exercise program. Clinicians combine exercise program with other physiotherapy, electrotherapeutic and no, techniques. Extracorporeal shock wave therapy(ESWT) is one of the most common recommended electrotherapeutic modalities for the management of LET. Further research is needed to find out the optimal treatment protocol of ESWT in the management of

Indications and contraindications for shock wave lithotripsy and how to improve outcomes

For over 35 years shock wave lithotripsy has proven to be an effective,safe and truly minimally invasive option for the treatment of nephrolithiasis.Various technical factors as well as patient selection can impact the success of the procedure.We used published work focusing on outcomes of shock wave lithotripsy,risk of complications,and strategies for improving stone fragmentation to create this review.Multiple patient and technical factors have been found to impact success of treatment.Skin to stone distance,stone density and composition,size and location of the stone within the urinary system all influence stone free rates.A slower rate with a gradual increasing voltage,precise targeting,proper coupling will improve stone fragmentation and decrease risk of complications.The selection of appropriate patients through a shared decision making process and attention to the technical factors that improve stone free rates is key to providing an effective treatment and patient satisfaction.

基于PVDF柔性传感器的不同介质中冲击波波源测量与频谱分析

目的明确体外冲击波系统冲击头在不同介质界面产生的冲击波波源特征。方法采用冲击气压可调的体外冲击波产生与信号采集实验系统,结合聚偏二氟乙烯(PVDF)柔性传感器,通过实验测量方法研究冲击头在不同介质(仿体组织、水和空气)界面产生的冲击波形,分析波源的时域特征和频谱特性。结果在相同气压冲击下,冲击头在仿体界面和水界面产生的冲击波波形相似,二者与空气界面产生的冲击波波形存在较大差异,空气界面的正负压绝对值明显减小;不同介质中产生的冲击波频谱特性相似,都存在3个明显的峰值频率,仿体、水和空气中调制频率分别为12.2、8.5、7.2 kHz,载波频率基本无变化(82~83 kHz)。不同气压冲击下,冲击头在同一介质界面产生的冲击脉冲波波形差异不大,冲击气压仅影响冲击波幅度,不影响峰值频率。随着冲击气压的增大,介质界面正负压绝对值增大,变化基本呈线性。结论PVDF柔性传感器可以有效测量冲击波波源,不同介质界面产生的冲击波在时域和频域都存在一定差异,不能简单以空气或水中的冲击波传播特性代替生物组织中的传播特性。研究结果可以为冲击波设备的评估和临床冲击波治疗方案的制定提供重要信息。

物理因子促进干细胞的成骨分化

背景:针对骨缺损传统修复方法的局限性,干细胞广泛应用于再生医学的研究。化学性因子是当前的研究热点,但是近年来的研究证实,国内外应用物理因素调控干细胞分化的研究不断深入,物理因子联合生物支架在骨组织工程中为解决骨缺损修复难题提供了一种新的思路和方法,具有良好的发展前景。目的:就物理因子如电磁场、超声等对干细胞成骨分化的分子机制以及信号通路的调控、在骨组织工程中应用的可行性等方面做一总结。方法:应用计算机检索中国知网和PubMed数据库中近20年的相关文献,在标题和摘要中以“干细胞,骨缺损,成骨分化,电磁场,超声,冲击波,低强度激光,机械力,骨组织工程”或“stem cell,osteoporosis,osteogenic differentiation,Electromagnetic Fields,Ultrasound,Bone Tissue Engineering”为检索词进行检索,对相关文章94篇进行综述分析。结果与结论:(1)物理因子作为一种无创、非接触的辅助疗法对骨组织工程有着显著影响,在调控干细胞的成骨分化、促进细胞的增殖以及在骨工程支架内的生存能力方面有着积极作用。(2)除了激活信号通路和成骨基因转录外,物理因子还可以改善血管化、增加支架中形成的骨的体积、面积和厚度,可以促进骨整合,提高骨支架再生健康骨组织的成功率。(3)然而,将物理因子用于骨组织工程的研究均采用不同的实验条件,如支架类型、细胞类型及干预条件等,无法直接进行比较以确定最佳参数设置,在临床应用中,这些不同干预对促进骨折愈合的有效性研究结果也缺乏一致性,因此未来还需要进一步确定物理因子用于骨组织工程的最佳参数。(4)总体而言,物理因子作为一种理想的辅助疗法,在与各种生物材料结合并应用于骨组织工程方面具有巨大的潜力。

体外冲击波治疗脑卒中后功能障碍的研究进展

体外冲击波疗法(ESWT)由于其安全、无创、方便及疗效好等特点,一直以来被广泛应用于康复医学中,特别是肌肉骨骼康复的骨科术后或外伤炎症康复当中,而相比之下,ESWT在神经康复中的应用较少。神经系统疾患中的脑卒中,已成为我国居民的第一位死亡原因,具有高发病率、高死亡率和高致残率等特点。脑卒中后遗留的功能障碍,给无数患者及其家庭造成了极大的困扰。近些年来,越来越多的研究者开始尝试把体外冲击波应用在脑卒中后功能障碍的康复治疗中,本文对其近十年的相关临床应用进行统合、对比及分析,希望能为未来的脑卒中康复提供新的思路与应用依据。

早期体外心脏震波通过抑制TGF-β1-Smad2/3-MMP-9信号通路改善心肌纤维化

目的 探究急性心肌梗死(AMI)大鼠早期经体外心脏震波治疗(CSWT)后心功能和心肌纤维化改善与转化生长因子β1-细胞信号转导分子2/3-基质金属蛋白酶9(TGF-β1-Smad2/3-MMP-9)信号通路的相关性。方法 采用随机数字表法将30只SD大鼠分为sham、AMI、AMI+CSWT、AMI+SB431542和AMI+SB431542+CSWT组,每组各6只。sham组仅开胸,其他4组构建AMI模型。AMI+SB431542组和AMI+SB431542+CSWT组在术后4d行SB431542处理,持续3d。AMI+CSWT组和AMI+SB431542+CSWT组均行9次CSWT[于术后7d开始行CSWT,两次之间间隔1d,能量:0.09m J/mm~2,一个缺血区域共1800震,频率:3Hz(3震/s)]。各组均在术后4d和62d行超声心动图检测左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、左心室舒张末期容积(LVEDV)和左心室收缩末期容积(LVESV)。术后62d行心脏组织取材,HE染色、Masson染色评估心肌组织病理形态学改变及心肌纤维化程度;于心肌梗死边缘区检测TGF-β1-Smad2/3-MMP-9信号通路相关蛋白表达水平及COL-Ⅰ、COL-Ⅲ蛋白表达水平。结果 (1)术后4d,与sham组相比,AMI、AMI+CSWT、AMI+SB431542和AMI+SB431542+CSWT组的LVEF、LVFS明显降低,LVESV明显扩大(均为P<0.05)。(2)术后62d,与sham组相比,AMI组的LVEF、LVFS明显降低,LVEDV、LVESV明显扩大(均为P<0.05);与AMI组相比,AMI+CSWT组的LVEF、LVFS明显改善,LVEDV、LVESV明显回缩(均为P<0.05);与AMI+CSWT组相比,AMI+SB431542+CSWT组的LVEF、LVFS、LVEDV和LVESV无统计学差异(均为P>0.05)。(3)HE染色显示,AMI组较sham组红色区域排列紊乱、蓝色区域增多;AMI+CSWT组较AMI组红色区域排列整齐、蓝色区域减少,但较sham组蓝染区域增多。(4)Masson染色显示,与sham组相比,AMI组胶原容积分数(CVF)明显升高(P<0.001);与AMI组相比,AMI+CSWT和AMI+SB431542组的CVF明显降低(均为P<0.05);与AMI+CSWT组相比,AMI+SB431542+CSWT组CVF较高,但无统计学差异(P=0.65)。(5)Westernblot结果显示,与sham组相比,AMI组的TGF-β1、Smad3、MMP-9、COL-Ⅰ和COL-Ⅲ表达水平明显升高(均为P<0.05);Smad2水平有升高趋势,但无统计学差异(P=0.40);与sham组和AMI组相比,AMI+CSWT组的TGF-β1、Smad2、Smad3、MMP-9、COL-Ⅰ和COL-Ⅲ表达水平明显降低(均为P<0.05);与AMI+CSWT组相比,AMI+SB431542+CSWT组的TGF-β1、Smad2、Smad3和MMP-9表达水平明显降低,COL-Ⅰ和COL-Ⅲ表达水平明显增加(均为P<0.05)。结论 早期CSWT可改善心功能、抑制心肌纤维化,且与抑制TGF-β1-Smad2/3-MMP-9信号通路相关。

体外冲击波治疗通过激活Wnt5a/Ca^(2+)信号通路改善大鼠股骨牵张成骨的分子机制

目的 探究体外冲击波治疗通过激活Wnt5a/Ca^(2+)信号改善大鼠股骨牵张成骨的机制。方法 60只8周龄Sprague Dawley雄性大鼠分为对照组、股骨牵张模型组和体外冲击波疗法(extracorporeal shock wave therapy,SWT)组(n=20)。使用Cat Walk XT系统测量大鼠步态参数。通过显微CT(Micro-CT)扫描分析大鼠股骨形态。组织病理学分级采用Mankin评分标准,并分析软骨下骨各区域Wnt5a阳性细胞百分比。实时聚合酶链反应分析大鼠股骨Ⅰ型胶原和骨桥蛋白mRNA表达。免疫组织化学染色分析骨形态发生蛋白2(bone morphogenetic protein 2,BMP2)、血管内皮生长因子(vascular endothelial growth factor,VEGF)和增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)的表达。蛋白印迹分析Wnt5a/Ca^(2+)信号通路蛋白表达。结果 模型组摆动速度、最大接触面积、单站姿、占空比和支架摆动时间低于对照组,ESWT组摆动速度、最大接触面积、单站姿、占空比和支架摆动时间高于模型组(P<0.05)。模型组骨小梁体积分数、小梁厚度和骨密度小于对照组,ESWT组骨小梁体积分数、小梁厚度和骨密度大于模型组(P<0.05)。模型组股关节病理组织学(Mankin)评分高于对照组,Wnt5a阳性细胞数量少于对照组,ESWT组股关节Mankin评分低于模型组,Wnt5a阳性细胞数量多于模型组(P<0.05)。与对照组相比,模型组大鼠软骨下骨板浅表区可见骨细胞陷窝,ESWT组股关节面损伤程度明显减轻(P<0.05)。ESWT诱导模型大鼠Wnt5a标记明显增加(P<0.05)。模型组Ⅰ型胶原和骨桥蛋白mRNA表达低于对照组,ESWT组Ⅰ型胶原和骨桥蛋白mRNA表达高于模型组(P<0.05)。模型组BMP2、VEGF和PCNA染色阳性细胞少于对照组,ESWT组BMP2、VEGF和PCNA染色阳性细胞多于模型组(P<0.05)。模型组CaMKⅡ、PLC、Wnt5a蛋白表达高于对照组,PKC蛋白表达高于对照组,ESWT组CaMKⅡ、PLC、Wnt5a蛋白表达低于模型组,PKC蛋白表达低于模型组(P<0.05)。结论 体外冲击波治疗通过激活Wnt5a/Ca^(2+)信号通路促进大鼠股骨牵张成骨新生血管形成、细胞增殖和成骨生长因子的表达,改善骨力学性能和骨矿化加速。

关刺结合体外冲击波治疗卒中后下肢痉挛的疗效观察

目的观察关刺结合体外冲击波治疗卒中后下肢痉挛的疗效并探寻其作用机制。方法70例患者随机分为观察组(35例,脱落2例)与对照组(35例,脱落1例)。两组均予以常规内科治疗及常规康复训练,对照组进行体外冲击波治疗,观察组在对照组基础上联合关刺治疗,治疗前和治疗3周后分别评定两组患者改良Ashworth量表(MAS)、Fugl-Meyer运动功能评分下肢部分(FMA-LE)、改良Barthel指数(MBI),并运用超声评估偏瘫侧腓肠肌的肌肉厚度(MT)、肌纤维长度(FL)、羽状角(PA),最后进行临床疗效评定。结果两组治疗后MAS评分与治疗前比较均下降,FMA-LE评分、MBI评分则均提高,且观察组均优于对照组(P<0.05)。两组治疗后患者腓肠肌超声各指标MT、FL、PA均改善,且观察组均优于对照组(均P<0.05)。观察组总有效率为81.82%,高于对照组的58.82%(P<0.05)。两组均未出现严重不良反应。结论关刺结合体外冲击波治疗能够改善卒中后下肢痉挛状态,可提高下肢运动功能与日常生活活动能力,有利于卒中后下肢痉挛的恢复。

体外冲击波治疗膝关节骨性关节炎的研究进展

膝关节骨关节炎是一种常见的肌肉骨骼疾病,其发病机制复杂,且手术及药物等治疗效果欠佳,因此寻找一种延缓疾病进展、改善关节功能的治疗手段具有重要意义。体外冲击波疗法是一种特殊治疗,主要由气动、电动液压、电磁或压电发电机诱导产生单脉冲瞬态声波,聚焦于需要治疗的区域。它被证实能够有效抑制多种炎症因子释放,改善软骨代谢,促进软骨细胞增殖分化,对于软骨的修复有一定的疗效。因此,作为一项新的治疗手段,在一些动物实验和临床研究中都显示出对骨关节炎的作用;作为一种安全有效的无创疗法,可推荐用于骨关节炎的治疗,但推荐的等级需要在进一步的研究中进行讨论。文章就体外冲击波在膝关节骨性关节炎中的作用机制和应用展开综述。

排石汤联合体外震波碎石术治疗肾结石临床观察

目的探讨对肾结石患者采用排石汤联合体外震波碎石术的临床效果。方法对2020年4月—2021年5月就诊的88例肾结石患者依据疗法的不同分组,即实施体外震波碎石术治疗的参照组44例,实施排石汤联合体外震波碎石术治疗的研究组44例。比较治疗效果。结果研究组的总有效率95.45%(42/44)高于参照组的75.00%(33/44)(P<0.05);研究组平均碎石次数少于参照组,平均排石时间短于参照组(P<0.05);且研究组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平较参照组更低(P<0.05)。结论排石汤与体外震波碎石术联合应用,较体外震波碎石术单用效果更佳,可促进肾结石患者预后改善。

四金排石汤联合耳穴压豆在行体外冲击波碎石术后的输尿管结石中的应用

目的观察四金排石汤联合耳穴压豆治疗行体外冲击波碎石术(ESWL)后的输尿管结石的临床效果。方法选取70例行ESWL后的输尿管结石患者,根据治疗方案分为观察组和对照组,各35例。所有患者均接受ESWL治疗,术后观察组给予四金排石汤联合耳穴压豆治疗,对照组行常规排石治疗,比较两组临床效果、排石效果以及并发症发生情况。结果观察组临床疗效为91.43%(32/35),明显高于对照组的60.00%(21/35)(P<0.05)。观察组临床并发症发生率为34.29%(12/35),明显低于对照组的71.43%(25/35)(P<0.05)。观察组患者当日排石率及术后1周、2周净石率均明显高于对照组(P<0.05)。结论四金排石汤联合耳穴压豆应用于行ESWL后的输尿管结石患者,可提高临床疗效、提高排石率、降低并发症,值得临床推广使用。

中医骨伤手法配合针刺、体外冲击波疗法治疗腰椎间盘突出症患者的效果

目的:观察并分析腰椎间盘突出症患者应用中医骨伤手法配合针刺、体外冲击波疗法的效果。方法:收集2022年2月—2023年5月厦门市第三医院收治的100例腰椎间盘突出症患者作为受试者,采用中心区组随机化方法,列出流水号为1~100所对应的治疗分配表进行分组处理(观察组和对照组),各50例。对照组给予针刺配合体外冲击波治疗,观察组在对照组基础上加用中医骨伤手法治疗,比较两组腰痛评分、运动功能、炎症指标。结果:治疗28 d后,两组视觉模拟评分法(visual analogue scale,VAS)评分、腰椎功能障碍指数评分量表(Oswestry disability index,ODI)评分及白细胞介素-8(interleukin-8,IL-8)、白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive Protein,CRP)水平低于治疗前,且观察组低于对照组,两组日本骨科协会(Japanese Orthopaedie Association,JOA)评分高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:腰椎间盘突出症患者应用中医骨伤手法配合针刺、体外冲击波疗法可有效缓解腰痛症状,改善腰椎功能及运动障碍,降低炎症因子水平,效果良好。

牵张推拿手法联合放散式体外冲击波治疗早期原发性冻结肩的多中心随机对照临床研究

目的:观察牵张推拿手法联合放散式体外冲击波治疗早期原发性冻结肩的临床疗效。方法:将240例符合诊断标准的早期原发性冻结肩患者,分为3组,观察组和对照组各90例,空白对照组60例,观察组予牵张推拿手法联合放散式体外冲击波治疗,对照组予放散式体外冲击波治疗,空白对照组予塞来昔布口服,比较3组的CMS评分、VAS评分和疗效。结果:VAS评分比较,3组均较治疗前评分降低,观察组评分最低,对照组次之,空白对照组评分最高,P<0.05,差异具有统计学意义。3组CMS评分比较,空白对照组评分最低,对照组次之,观察组评分最高,P<0.05,差异具有统计学意义。3组疗效比较,P<0.05,差异具有统计学意义。结论:牵张推拿手法联合放散式体外冲击波治疗早期原发性冻结肩有着良好的疗效,值得临床推广。

体外冲击波治疗慢性肌肉骨骼疼痛及其机制研究进展

慢性肌肉骨骼疼痛是指发生在肌肉、骨骼、关节、肌腱或其他软组织的超过3个月的疼痛。此类疾病既往以药物治疗为主,而近年来,以体外冲击波治疗为代表的无创治疗方式已逐渐普及。本文总结归纳了体外冲击波对不同躯体部位的慢性肌肉骨骼疼痛的治疗效果及其差异,如腰部、四肢及肩颈部等。最新研究显示,冲击波的能量可通过机械转导效应作用于机械敏感相关离子通道并激活其下游信号通路,发挥抑制炎症、促进成骨与软组织修复、促进血管再生以及参与神经保护等作用。总之,体外冲击波为慢性肌肉骨骼疼痛提供了一种非侵入性的新型治疗手段,尽管其具体机制仍需进一步研究,但其在多个躯体部位的疼痛管理中的潜力和效果已经得到了广泛的临床肯定。