Objective: Extracorporeal shockwave lithotripsy (SWL) currently plays an important role in the treatment of urinary tract lithiasis. The purpose of this article was to describe new concepts and procedural strategies t...Objective: Extracorporeal shockwave lithotripsy (SWL) currently plays an important role in the treatment of urinary tract lithiasis. The purpose of this article was to describe new concepts and procedural strategies that would improve results using SWL as a treatment for urolithiasis, thereby achieving better clinical practice.Methods: A systematic review process was carried in PubMed/PMC from January 2003 to March 2023. A narrative synthesis of the most important aspects has been made.Results: The important recommendations for the adequate selection of the candidate patient for treatment with SWL are summarized, as well as the new strategies for a better application of the technique. Aspects about intraoperative position, stone localization and monitoring, analgesic control, machine and energy settings, and measures aiming at reduced risk of complications are described.Conclusion: To achieve the therapeutic goal of efficient stone disintegration without increasing the risk of complications, it is necessary to make an adequate selection of patients and to pay special attention to several important factors in the application of treatment. Technological development in later generation devices will help to improve current SWL results.展开更多
Objectives: Peripheral neuropathy (PN) is a significant contributor to disability in the elderly. It is also one of the most prevalent complications of type 2 diabetes, prediabetes and metabolic syndrome. PN is common...Objectives: Peripheral neuropathy (PN) is a significant contributor to disability in the elderly. It is also one of the most prevalent complications of type 2 diabetes, prediabetes and metabolic syndrome. PN is commonly associated with pain, numbness, tingling, burning, and cramping in the feet and legs. Current treatment options are limited to controlling pain, seizures and use of antidepressant medications. These treatments have undesirable side effects and don’t stop PN progression. Here we utilized a combination of individual-specific modalities to improve local circulation and relieve PN symptoms. Methods: We conducted an open-label, multicenter pilot trial with 34 subjects (19 males and 15 females ranging from 40 - 85 years of age). All of the participants were diagnosed with peripheral neuropathy and had bilateral symptoms in their feet, and many reported the same symptoms (pain, numbness, tingling, burning, and cramping) in their lower legs. The duration of symptoms ranged from four months to over six years. On Day 0, subjects were given a 90-day supply of the oral supplement with dosing instructions and a LED light therapy device. They also received three platelet-rich plasma (PRP) injections in their lower extremities. Subjects also received an extracorporeal shockwave therapy (ESWT) treatment for each foot and subsequently twice per week for the first six weeks, then once weekly for the duration of the study. Subjects filled out the Brief Pain Index (BPI) at weekly intervals. On Day 90, subjects completed the Patient Global Impression of Change (PGIC) survey. Results: There were significant responses to pain, as evidenced by BPI scores at weeks 8, 9, 10 and 11 (p = 0.02, 0.01, 0.02, and 0.003, respectively). Analysis of the final day PGIC survey showed a favorable outcome for 73% of participants (p = 0.003), with the majority reporting Very Much Improved. Conclusions: By utilizing a multi-modality treatment protocol that includes PRP, LED light therapy, ESWT and an oral dietary supplement, we observed significant reductions in BPI scores. Quality of life and their overall impression of change (PGIC) were significantly improved, and there were no significant side effects.展开更多
Aim: To determine retrospectively the safety and efficacy of extracorporeal shock wave therapy (ESWT) in patients with Peyronie's disease. Methods: Fifty-three patients with stable Peyronie's disease underwent E...Aim: To determine retrospectively the safety and efficacy of extracorporeal shock wave therapy (ESWT) in patients with Peyronie's disease. Methods: Fifty-three patients with stable Peyronie's disease underwent ESWT (group 1). Fifteen patients matched with the baseline characteristic of the patients in group 1, who received no treatment, were used as the control (group 2). The patients' erectile function (International Index of Erectile Function [IIEF-5] score), pain severity (visual analog scale), plaque size and degree of penile angulation were assessed before and after the treatment in group 1 and during the follow-up in group 2. Results: The mean follow-up time was 32 months (range: 6-64 months) in group 1 and 35 months (range: 9-48 months) in group 2. All the patients were available for the follow-up. Considering erectile function and plaque size, no significant changes (P 〉 0.05) were observed in group 1 before or after the ESWT. A total of 39 patients (74%) reported a significant effect in pain relief in group 1 after ESWT. However, regarding improvement in pain, IIEF-5 score and plaque size, no significant differences were observed between the two groups. In 21 patients (40%) of group 1, the deviation angle was decreased more than 10° with a mean reduction in all patients of 11° (range: 6-20°). No serious complications were noted considering ESWT procedure. Conclusion: ESWT is a minimally invasive and safe alternative procedure for the treatment of Peyronie's disease. However, the effect of ESWT on penile pain, sexual function and plaque size remains questionable.展开更多
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...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.展开更多
Objective:To provide evidence-based evidence for the clinical use of shockwave therapy in KOA.Methods: Two researchers independently searched the randomized controlled study of shockwave therapy for KOA in the databas...Objective:To provide evidence-based evidence for the clinical use of shockwave therapy in KOA.Methods: Two researchers independently searched the randomized controlled study of shockwave therapy for KOA in the databases of CNKI、VIP、WanFang Data、 Sinomed and PubMed. Jadad rating scale was used for literature quality evaluation, and the extracted data was meta-analyzed by RevMan5.3 software.Results: A total of 15 randomized controlled trials involving 1248 patients were included. The results of meta-analysis showed: The clinical effective rate of shock wave therapy for knee osteoarthritis was reliable[RR=1.12, 95%CI(1.03, 1.20), p=0.005], and the efficacy was reliable in reducing the visual analogue scale [MD=-1.73, 95%CI(-2.31, -1.14), p<0.00001] , Lequesne osteoarthritis severity index[MD=-1.60, 95%CI(-2.55, -0.64), p<0.00001] and WOMAC[MD=-6.03, 95%CI(-9.49,-2.57) p=0.0006] of KOA patients, without serious adverse reactions.Conclusion:At present, the evidence shows that shock wave can effectively improve the pain and other related symptoms in KOA patients, and the curative effect is reliable.展开更多
The purpose of this study was to report the use and assess the effects of extracorporeal shockwave therapy (ESWT) for the treatment of carpal joint valgus deformities (CJVDs) in young foals. Only foals with CJVDs grea...The purpose of this study was to report the use and assess the effects of extracorporeal shockwave therapy (ESWT) for the treatment of carpal joint valgus deformities (CJVDs) in young foals. Only foals with CJVDs greater than 5° were included in the study. Foals were assigned to 3 treatment groups based on their degree of CJVD measured during the initial evaluation: valgus deformity (VD) of 5° to 8.9° (Group 1), VD of 9° to 11.9° (Group 2) and VD greater than or equal to 12° (Group 3). ESWT was applied on the convex side of the angular deformity immediately following the initial radiographic evaluation. Foals were subsequently evaluated clinically and radiologically followed by treatment every 10 days until resolution of the VD, with resolution defined as a deviation less than 5 degrees. Each treatment group received specific exercise, hoof trimming and hoof/shoe extension recommendations. Sixty-four (64) foals were included in the study;ages ranged from 8 to 60 days old at inclusion in the study with a mean age of 26.7 days. Of the 28 foals included in Group 1, 10 had bilateral CJVD. There were 21 in Group 2, and 15 in Group 3. Treatment success was defined as a VD angle less than 5°, and was reached in all foals in Groups 1 and 2. Five (5) foals in Group 3 completed the study with a VD angle of 5° to 6.7° at the last radiographic assessment. No major complications were observed during the study. In conclusion, ESWT in conjunction with controlled exercise, hoof trimming and hoof/shoe extensions corrected severe CJVDs in young foals. The use of ESWT eliminates possible negative side effects of general anesthesia and surgical techniques to treat VDs. Future studies should include a control population, more severe cases, other types of angular limb deformities, and older foals.展开更多
Low intensity shockwave (LiSW) treatment is known to improve revascularization. The method has been evaluated and is used to treat vasculogenic erectile dysfunction (ED). The present study aimed to demonstrate the eff...Low intensity shockwave (LiSW) treatment is known to improve revascularization. The method has been evaluated and is used to treat vasculogenic erectile dysfunction (ED). The present study aimed to demonstrate the efficacy of a linear focused piezoelectric shockwave device (Richard Wolf/ELvationPiezowave<sup>2</sup>) to treat patients with vasculogenic ED using a novel linear shockwave tissue coverage LSTC-ED<sup><sup>®</sup> </sup>technique. A total of 75 patients were treated using the Piezowave<sup>2</sup> device and the LSTC-ED<sup><sup>®</sup></sup> technique. Patients’ erectile function was evaluated using the modified IIEF-5 (International Index of Erectile Function) scale at the beginning of treatment and at 1 month post treatment;patients were additionally questioned using our own Treatment Satisfaction Questionnaire (TSQ). The study also included a group of 50 patients treated by placebo;the outcomes of both groups were compared. The average IIEF-5 score of patients in the treatment group increased from 14.4 at baseline to 18.6 at 1 month post treatment. According to the IIEF-5 scale, treatment was successful in 81.33% of patients (61/75). According to the Treatment Satisfaction Questionnaire (answers 1 to 3 of the TSQ), treatment was successful in 77.3% of patients (58/75). In the placebo group of 50 patients only 5 patients showed an improvement based on IIEF score, and 8 reported an improvement based on their answers to the TSQ. No significant adverse effects were observed during treatment or in the follow-up period. The Piezowave<sup>2</sup> device and the LSTC-ED<sup><sup>®</sup> </sup>technique proved to be suitable and effective to treat erectile dysfunction.展开更多
OBJECTIVE:To assess the efficacy and safety of extracorporeal shockwave therapy(ESWT)combined with sodium hyaluronate(HA)for the treatment of knee osteoarthritis(KOA).METHODS:PubM ed,Embase,the Cochrane Library,Web of...OBJECTIVE:To assess the efficacy and safety of extracorporeal shockwave therapy(ESWT)combined with sodium hyaluronate(HA)for the treatment of knee osteoarthritis(KOA).METHODS:PubM ed,Embase,the Cochrane Library,Web of Science,China National Knowledge Infrastructure,Wanfang database,China Science and Technology Journal Database,and SinoMed were searched from inception to July 2020.The quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic Reviews.The identified articles were then screened individually using EndnoteX9 for eligibility in this Meta-analysis.The heterogeneity among the articles was evaluated using I2.RESULTS:A total of 17 studies,comprising 2000 individuals,were included in this Meta-analysis.The results showed that a significant improvement was observed in knee pain and function based on the clinical efficacy of ESWT combined with HA.Statistical analysis of clinical efficacy showed that[relative risk(RR)=1.21,95%confidence interval(CI)(1.12,1.30),P<0.01].Statistical analysis of visual analog scale showed that[standardized mean difference(SMD)=-2.84,95%CI(-4.01,-1.66),P<0.01].Western Ontario and McMaster University osteoarthritis index statistical analysis showed that[SMD=-1.57,95%CI(-2.52,-0.61),P<0.01].Lysholm score statistical analysis showed that[SMD=1.71,95%CI(0.98,2.44),P<0.01].In addition,only minor side effects,such as redness and swelling of the skin,were observed.CONCLUSIONS:Medium to low quality evidence showed that ESWT combined with HA offers an inexpensive,welltolerated,safe,and effective method to improve pain and functionality in patients with KOA.However,tightly controlled,randomized,large multicenter trials are warranted to validate the current findings.展开更多
Low-intensity extracorporeal shockwave therapy(LiESWT)represents a promising treatment for patients with erectile dysfunction(ED).We investigated the efficacy of LiESWT combined with tadalafil 5 mg once daily in men w...Low-intensity extracorporeal shockwave therapy(LiESWT)represents a promising treatment for patients with erectile dysfunction(ED).We investigated the efficacy of LiESWT combined with tadalafil 5 mg once daily in men with type 2 diabetes mellitus(T2DM)and ED and compared LiESWT protocols administering different number of shockwaves.We performed a retrospective matched-pair comparison using data from a prospectively maintained database.Seventy-eight patients who received tadalafil 5 mg once dai7ly for 12 weeks+LiESWT performed with an electrohydraulic source for 3 weeks(Group A)were matched 1:1 to patients who received tadalafil 5 mg once daily alone for 12 weeks(Group B).A subgroup analysis was performed according to the number of shockwaves delivered during each session(1500,1800,and 2400 in subgroup A1,A2,and A3,respectively).The mean International Index of Erectile Function-5(IIEF-5)score variations with respect to baseline recorded at 4,12,and 24 weeks after the end of the treatment were investigated as treatment outcomes.The mean IIEF-5 scores significantly improved in all groups and subgroups at 4-week follow-up without intergroup differences.At 12-and 24-week follow-up,the mean IIEF-5 improvement was significantly higher among patients in the A3 subgroup(+5.0±2.1[P<0.001]and+4.7±2.3[P<0.001],respectively).The combined approach with tadalafil 5 mg once daily and LiESWT with a protocol involving 2400 shockwaves provides significant advantages in terms of IIEF-5 improvement and durability compared to tadalafil 5 mg once daily alone in patients with T2DM and ED.展开更多
Background:Histological and functional recovery after peripheral nerve injury(PNI)is of significant clinical value as delayed surgical repair and longer distances to innervate terminal organs may account for poor outc...Background:Histological and functional recovery after peripheral nerve injury(PNI)is of significant clinical value as delayed surgical repair and longer distances to innervate terminal organs may account for poor outcomes.Low-intensity extracorporeal shock wave therapy(LiESWT)has already been proven to be beneficial for injured tissue recovery on various pathological conditions.The objective of this study was to explore the potential effect and mechanism of LiESWT on PNI recovery.Methods:In this project,we explored LiESWT’s role using an animal model of sciatic nerve injury(SNI).Shockwave was delivered to the region of the SNI site with a special probe at 3 Hz,500 shocks each time,and 3 times a week for 3 weeks.Rat Schwann cells(SCs)and rat perineurial fibroblasts(PNFs)cells,the two main compositional cell types in peripheral nerve tissue,were cultured in vitro,and LiESWT was applied through the cultured dish to the adherent cells.Tissues and cell cultures were harvested at corresponding time points for a reverse transcription-polymerase chain reaction,Western blotting,and immunofluorescence staining.Multiple groups were compared by using one-way analysis of variance followed by the Tukey-Kramer test for post hoc comparisons.Results:LiESWT treatment promoted the functional recovery of lower extremities with SNI.More nerve fibers and myelin sheath were found after LiESWT treatment associated with local upregulation of mechanical sensitive yes-associated protein(YAP)/transcriptional co-activator with a PDZ-binding domain(TAZ)signaling pathway.In vitro results showed that SCs were more sensitive to LiESWT than PNFs.LiESWT promoted SCs activation with more expression of p75(a SCs dedifferentiation marker)and Ki67(a SCs proliferation marker).The SCs activation process was dependent on the intact YAP/TAZ signaling pathway as knockdown of TAZ by TAZ small interfering RNA significantly attenuated this process.Conclusion:The LiESWT mechanical signal perception and YAP/TAZ upregulation in SCs might be one of the underlying mechanisms for SCs activation and injured nerve axon regeneration.展开更多
We analyzed the efficacy of penile low-intensity extracorporeal shockwave treatment for erectile dysfunction(ED)combined with cavernous artery disease(CAD).ED was evaluated by the International Index of Erectile Funct...We analyzed the efficacy of penile low-intensity extracorporeal shockwave treatment for erectile dysfunction(ED)combined with cavernous artery disease(CAD).ED was evaluated by the International Index of Erectile Function,subdividing patients into mild and moderate/severe forms.CAD was assessed using penile color Doppler ultrasonography.Patients(n=111)with a positive outcome after treatment,based upon the minimal clinically important difference of the International Index of ED,were followed up for 3 months and 6 months.We found a significant mean increase in the index of erectile function,with an overall improvement in hemodynamic parameters of the cavernous artery.In particular,93.9%of the patients with mild ED without CAD responded to treatment and 72.7%resumed normal erectile function.Only 31.2%of the patients with moderate/severe ED and CAD responded to treatment,and none resumed normal erectile function.All patients with mild ED and no CAD maintained the effects of therapy after 3 months,while no patients with moderate/severe ED and CAD maintained the benefits of treatment after 3 months.Thus,patients with mild ED and no CAD have better and longer lasting responses to such treatment,with a higher probability of resuming normal erectile function than patients with moderate/severe ED and CAD.展开更多
Tendinopathy is a chronic degenerative musculoskeletal disorder that is common in both athletes and the general population.Exercise and extracorporeal shockwave therapy(ESWT)is among the most common treatments used to...Tendinopathy is a chronic degenerative musculoskeletal disorder that is common in both athletes and the general population.Exercise and extracorporeal shockwave therapy(ESWT)is among the most common treatments used to mediate tendon healing and regeneration.The review presents the current understanding of mechanisms of action of ESWT and exercise in isolation and briefly synthesises evidence of their effectiveness for various tendinopathies.The central purpose of the review is to synthesize research findings investigating the combination of ESWT and exercise for five common tendinopathies(plantar heel pain,rotator cuff,lateral elbow,Achilles,and patellar tendinopathy)and provide recommendations on clinical applicability.Collectively,the available evidence indicates that ESWT combined with exercise in the form of eccentric training,tissue-specific stretching,or heavy slow resistance training are effective for specific tendinopathies and can therefore be recommended in treatment.Whilst there are at present a limited number of studies investigating combined EWST and exercise approaches,there is evidence to suggest that the combination improves outcomes in the treatment of plantar heel pain,Achilles,lateral elbow,and rotator cuff tendinopathy.However,despite overall positive outcomes in patellar tendinopathy,the combined treatment has not been shown at present to offer additional benefit over eccentric exercise alone.展开更多
目的比较体外冲击波与药物治疗距骨骨髓水肿的疗效。方法选取河北医科大学第三医院康复科门诊2021年9月至2022年3月收治的距骨骨髓水肿损伤患者40例。采用随机数表法将患者随机分为两组,每组20例。实验组患者给予冲击波治疗,对照组患者...目的比较体外冲击波与药物治疗距骨骨髓水肿的疗效。方法选取河北医科大学第三医院康复科门诊2021年9月至2022年3月收治的距骨骨髓水肿损伤患者40例。采用随机数表法将患者随机分为两组,每组20例。实验组患者给予冲击波治疗,对照组患者给予非甾体抗炎药双氯芬酸钠缓释片与双膦酸盐类药阿仑膦酸钠治疗。在治疗前及治疗结束后3个月,采用美国足踝外科协会(American Orthopaedic of Foot and Ankle Society,AOFAS)踝与后足评分评估踝关节功能、视觉模拟评分法(visual analogue scale,VAS)评估疼痛程度、MRI评价距骨骨髓水肿面积。应用Footscan足底压力系统比较治疗前后患者的足底压力变化及踝关节跖屈、背屈角度。结果治疗3个月后,两组VAS评分与AOFAS评分均较治疗前改善(P<0.05),且实验组评分改善幅度优于对照组(P<0.05);两组MRI显示的距骨骨髓水肿面积均较治疗前减少(P<0.05);两组在足底最大压力与平均压力方面均较治疗前提高(P<0.05),且实验组提高幅度优于对照组(P<0.05);在步态周期中,两组的全足支撑期与实验组的足跟着地期均延长(P<0.05)。结论体外冲击波治疗与药物治疗均可改善距骨骨髓水肿患者的疼痛、踝关节功能,减小骨髓水肿的面积,改善患者足底压力,以及延长患侧足在步行周期中的支撑期占比。展开更多
文摘Objective: Extracorporeal shockwave lithotripsy (SWL) currently plays an important role in the treatment of urinary tract lithiasis. The purpose of this article was to describe new concepts and procedural strategies that would improve results using SWL as a treatment for urolithiasis, thereby achieving better clinical practice.Methods: A systematic review process was carried in PubMed/PMC from January 2003 to March 2023. A narrative synthesis of the most important aspects has been made.Results: The important recommendations for the adequate selection of the candidate patient for treatment with SWL are summarized, as well as the new strategies for a better application of the technique. Aspects about intraoperative position, stone localization and monitoring, analgesic control, machine and energy settings, and measures aiming at reduced risk of complications are described.Conclusion: To achieve the therapeutic goal of efficient stone disintegration without increasing the risk of complications, it is necessary to make an adequate selection of patients and to pay special attention to several important factors in the application of treatment. Technological development in later generation devices will help to improve current SWL results.
文摘Objectives: Peripheral neuropathy (PN) is a significant contributor to disability in the elderly. It is also one of the most prevalent complications of type 2 diabetes, prediabetes and metabolic syndrome. PN is commonly associated with pain, numbness, tingling, burning, and cramping in the feet and legs. Current treatment options are limited to controlling pain, seizures and use of antidepressant medications. These treatments have undesirable side effects and don’t stop PN progression. Here we utilized a combination of individual-specific modalities to improve local circulation and relieve PN symptoms. Methods: We conducted an open-label, multicenter pilot trial with 34 subjects (19 males and 15 females ranging from 40 - 85 years of age). All of the participants were diagnosed with peripheral neuropathy and had bilateral symptoms in their feet, and many reported the same symptoms (pain, numbness, tingling, burning, and cramping) in their lower legs. The duration of symptoms ranged from four months to over six years. On Day 0, subjects were given a 90-day supply of the oral supplement with dosing instructions and a LED light therapy device. They also received three platelet-rich plasma (PRP) injections in their lower extremities. Subjects also received an extracorporeal shockwave therapy (ESWT) treatment for each foot and subsequently twice per week for the first six weeks, then once weekly for the duration of the study. Subjects filled out the Brief Pain Index (BPI) at weekly intervals. On Day 90, subjects completed the Patient Global Impression of Change (PGIC) survey. Results: There were significant responses to pain, as evidenced by BPI scores at weeks 8, 9, 10 and 11 (p = 0.02, 0.01, 0.02, and 0.003, respectively). Analysis of the final day PGIC survey showed a favorable outcome for 73% of participants (p = 0.003), with the majority reporting Very Much Improved. Conclusions: By utilizing a multi-modality treatment protocol that includes PRP, LED light therapy, ESWT and an oral dietary supplement, we observed significant reductions in BPI scores. Quality of life and their overall impression of change (PGIC) were significantly improved, and there were no significant side effects.
文摘Aim: To determine retrospectively the safety and efficacy of extracorporeal shock wave therapy (ESWT) in patients with Peyronie's disease. Methods: Fifty-three patients with stable Peyronie's disease underwent ESWT (group 1). Fifteen patients matched with the baseline characteristic of the patients in group 1, who received no treatment, were used as the control (group 2). The patients' erectile function (International Index of Erectile Function [IIEF-5] score), pain severity (visual analog scale), plaque size and degree of penile angulation were assessed before and after the treatment in group 1 and during the follow-up in group 2. Results: The mean follow-up time was 32 months (range: 6-64 months) in group 1 and 35 months (range: 9-48 months) in group 2. All the patients were available for the follow-up. Considering erectile function and plaque size, no significant changes (P 〉 0.05) were observed in group 1 before or after the ESWT. A total of 39 patients (74%) reported a significant effect in pain relief in group 1 after ESWT. However, regarding improvement in pain, IIEF-5 score and plaque size, no significant differences were observed between the two groups. In 21 patients (40%) of group 1, the deviation angle was decreased more than 10° with a mean reduction in all patients of 11° (range: 6-20°). No serious complications were noted considering ESWT procedure. Conclusion: ESWT is a minimally invasive and safe alternative procedure for the treatment of Peyronie's disease. However, the effect of ESWT on penile pain, sexual function and plaque size remains questionable.
基金Supported by Beijing Municipal Natural Science Foundation,No.7212117.
文摘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.
基金National natural science fund of China(81874476)Hunan natural science fund project(2018JJ2303)
文摘Objective:To provide evidence-based evidence for the clinical use of shockwave therapy in KOA.Methods: Two researchers independently searched the randomized controlled study of shockwave therapy for KOA in the databases of CNKI、VIP、WanFang Data、 Sinomed and PubMed. Jadad rating scale was used for literature quality evaluation, and the extracted data was meta-analyzed by RevMan5.3 software.Results: A total of 15 randomized controlled trials involving 1248 patients were included. The results of meta-analysis showed: The clinical effective rate of shock wave therapy for knee osteoarthritis was reliable[RR=1.12, 95%CI(1.03, 1.20), p=0.005], and the efficacy was reliable in reducing the visual analogue scale [MD=-1.73, 95%CI(-2.31, -1.14), p<0.00001] , Lequesne osteoarthritis severity index[MD=-1.60, 95%CI(-2.55, -0.64), p<0.00001] and WOMAC[MD=-6.03, 95%CI(-9.49,-2.57) p=0.0006] of KOA patients, without serious adverse reactions.Conclusion:At present, the evidence shows that shock wave can effectively improve the pain and other related symptoms in KOA patients, and the curative effect is reliable.
文摘The purpose of this study was to report the use and assess the effects of extracorporeal shockwave therapy (ESWT) for the treatment of carpal joint valgus deformities (CJVDs) in young foals. Only foals with CJVDs greater than 5° were included in the study. Foals were assigned to 3 treatment groups based on their degree of CJVD measured during the initial evaluation: valgus deformity (VD) of 5° to 8.9° (Group 1), VD of 9° to 11.9° (Group 2) and VD greater than or equal to 12° (Group 3). ESWT was applied on the convex side of the angular deformity immediately following the initial radiographic evaluation. Foals were subsequently evaluated clinically and radiologically followed by treatment every 10 days until resolution of the VD, with resolution defined as a deviation less than 5 degrees. Each treatment group received specific exercise, hoof trimming and hoof/shoe extension recommendations. Sixty-four (64) foals were included in the study;ages ranged from 8 to 60 days old at inclusion in the study with a mean age of 26.7 days. Of the 28 foals included in Group 1, 10 had bilateral CJVD. There were 21 in Group 2, and 15 in Group 3. Treatment success was defined as a VD angle less than 5°, and was reached in all foals in Groups 1 and 2. Five (5) foals in Group 3 completed the study with a VD angle of 5° to 6.7° at the last radiographic assessment. No major complications were observed during the study. In conclusion, ESWT in conjunction with controlled exercise, hoof trimming and hoof/shoe extensions corrected severe CJVDs in young foals. The use of ESWT eliminates possible negative side effects of general anesthesia and surgical techniques to treat VDs. Future studies should include a control population, more severe cases, other types of angular limb deformities, and older foals.
文摘Low intensity shockwave (LiSW) treatment is known to improve revascularization. The method has been evaluated and is used to treat vasculogenic erectile dysfunction (ED). The present study aimed to demonstrate the efficacy of a linear focused piezoelectric shockwave device (Richard Wolf/ELvationPiezowave<sup>2</sup>) to treat patients with vasculogenic ED using a novel linear shockwave tissue coverage LSTC-ED<sup><sup>®</sup> </sup>technique. A total of 75 patients were treated using the Piezowave<sup>2</sup> device and the LSTC-ED<sup><sup>®</sup></sup> technique. Patients’ erectile function was evaluated using the modified IIEF-5 (International Index of Erectile Function) scale at the beginning of treatment and at 1 month post treatment;patients were additionally questioned using our own Treatment Satisfaction Questionnaire (TSQ). The study also included a group of 50 patients treated by placebo;the outcomes of both groups were compared. The average IIEF-5 score of patients in the treatment group increased from 14.4 at baseline to 18.6 at 1 month post treatment. According to the IIEF-5 scale, treatment was successful in 81.33% of patients (61/75). According to the Treatment Satisfaction Questionnaire (answers 1 to 3 of the TSQ), treatment was successful in 77.3% of patients (58/75). In the placebo group of 50 patients only 5 patients showed an improvement based on IIEF score, and 8 reported an improvement based on their answers to the TSQ. No significant adverse effects were observed during treatment or in the follow-up period. The Piezowave<sup>2</sup> device and the LSTC-ED<sup><sup>®</sup> </sup>technique proved to be suitable and effective to treat erectile dysfunction.
基金Natural Science Foundation-funded Project:Yang Deficiency Constitution of Knee Osteoarthritis and the Wnt/β-catenin Signaling Pathway Regulates the Level of Correlation,and the Constitution Theraphy(No.81260546)Construction Project of Chinese Medicine Inheritance Innovation Platform:Basic and Clinical Application Research on Osteoarthritis of the Knee(Gan Wei Chinese Medicine Letter[2020]No.203)Gansu Provincial Science and Technology Plan Project:Clinical Medical Research Centre for Bone and Joint Degenerative Diseases(18JR2FA009)。
文摘OBJECTIVE:To assess the efficacy and safety of extracorporeal shockwave therapy(ESWT)combined with sodium hyaluronate(HA)for the treatment of knee osteoarthritis(KOA).METHODS:PubM ed,Embase,the Cochrane Library,Web of Science,China National Knowledge Infrastructure,Wanfang database,China Science and Technology Journal Database,and SinoMed were searched from inception to July 2020.The quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic Reviews.The identified articles were then screened individually using EndnoteX9 for eligibility in this Meta-analysis.The heterogeneity among the articles was evaluated using I2.RESULTS:A total of 17 studies,comprising 2000 individuals,were included in this Meta-analysis.The results showed that a significant improvement was observed in knee pain and function based on the clinical efficacy of ESWT combined with HA.Statistical analysis of clinical efficacy showed that[relative risk(RR)=1.21,95%confidence interval(CI)(1.12,1.30),P<0.01].Statistical analysis of visual analog scale showed that[standardized mean difference(SMD)=-2.84,95%CI(-4.01,-1.66),P<0.01].Western Ontario and McMaster University osteoarthritis index statistical analysis showed that[SMD=-1.57,95%CI(-2.52,-0.61),P<0.01].Lysholm score statistical analysis showed that[SMD=1.71,95%CI(0.98,2.44),P<0.01].In addition,only minor side effects,such as redness and swelling of the skin,were observed.CONCLUSIONS:Medium to low quality evidence showed that ESWT combined with HA offers an inexpensive,welltolerated,safe,and effective method to improve pain and functionality in patients with KOA.However,tightly controlled,randomized,large multicenter trials are warranted to validate the current findings.
文摘目的:比较体外冲击波疗法(extracorporeal shockwave therapy,ESWT)联合传统治疗和单纯传统治疗对膝内侧副韧带陈旧性损伤患者的效果。方法:回顾性分析2019年11月—2022年1月在珠海市第五人民医院治疗的85例膝内侧副韧带陈旧性损伤患者,根据治疗方案不同分组,其中对照组41例予以传统治疗,治疗组44例予以ESWT联合传统治疗。评估患者治疗前、治疗后和随访时的疼痛视觉模拟评分法(visual analog scale,VAS)评分、膝关节活动度、Lysholm膝关节评分和疗效。结果:在治疗后及随访时,两组患者在VAS评分、膝关节活动度、Lysholm膝关节评分方面均较治疗前有改善(P<0.05)。治疗组各项指标的改善效果明显优于对照组(P<0.05)。对照组临床治疗总有效率达46.34%,治疗组总有效率达95.45%,治疗组的总有效率显著高于对照组,差异有统计学意义(P<0.05)。结论:ESWT联合传统治疗能明显缓解膝内侧副韧带陈旧性损伤患者膝关节疼痛,改善膝关节功能,疗效优于单纯传统治疗。
文摘Low-intensity extracorporeal shockwave therapy(LiESWT)represents a promising treatment for patients with erectile dysfunction(ED).We investigated the efficacy of LiESWT combined with tadalafil 5 mg once daily in men with type 2 diabetes mellitus(T2DM)and ED and compared LiESWT protocols administering different number of shockwaves.We performed a retrospective matched-pair comparison using data from a prospectively maintained database.Seventy-eight patients who received tadalafil 5 mg once dai7ly for 12 weeks+LiESWT performed with an electrohydraulic source for 3 weeks(Group A)were matched 1:1 to patients who received tadalafil 5 mg once daily alone for 12 weeks(Group B).A subgroup analysis was performed according to the number of shockwaves delivered during each session(1500,1800,and 2400 in subgroup A1,A2,and A3,respectively).The mean International Index of Erectile Function-5(IIEF-5)score variations with respect to baseline recorded at 4,12,and 24 weeks after the end of the treatment were investigated as treatment outcomes.The mean IIEF-5 scores significantly improved in all groups and subgroups at 4-week follow-up without intergroup differences.At 12-and 24-week follow-up,the mean IIEF-5 improvement was significantly higher among patients in the A3 subgroup(+5.0±2.1[P<0.001]and+4.7±2.3[P<0.001],respectively).The combined approach with tadalafil 5 mg once daily and LiESWT with a protocol involving 2400 shockwaves provides significant advantages in terms of IIEF-5 improvement and durability compared to tadalafil 5 mg once daily alone in patients with T2DM and ED.
基金the National Natural Science Foundation of China(No.81701434).
文摘Background:Histological and functional recovery after peripheral nerve injury(PNI)is of significant clinical value as delayed surgical repair and longer distances to innervate terminal organs may account for poor outcomes.Low-intensity extracorporeal shock wave therapy(LiESWT)has already been proven to be beneficial for injured tissue recovery on various pathological conditions.The objective of this study was to explore the potential effect and mechanism of LiESWT on PNI recovery.Methods:In this project,we explored LiESWT’s role using an animal model of sciatic nerve injury(SNI).Shockwave was delivered to the region of the SNI site with a special probe at 3 Hz,500 shocks each time,and 3 times a week for 3 weeks.Rat Schwann cells(SCs)and rat perineurial fibroblasts(PNFs)cells,the two main compositional cell types in peripheral nerve tissue,were cultured in vitro,and LiESWT was applied through the cultured dish to the adherent cells.Tissues and cell cultures were harvested at corresponding time points for a reverse transcription-polymerase chain reaction,Western blotting,and immunofluorescence staining.Multiple groups were compared by using one-way analysis of variance followed by the Tukey-Kramer test for post hoc comparisons.Results:LiESWT treatment promoted the functional recovery of lower extremities with SNI.More nerve fibers and myelin sheath were found after LiESWT treatment associated with local upregulation of mechanical sensitive yes-associated protein(YAP)/transcriptional co-activator with a PDZ-binding domain(TAZ)signaling pathway.In vitro results showed that SCs were more sensitive to LiESWT than PNFs.LiESWT promoted SCs activation with more expression of p75(a SCs dedifferentiation marker)and Ki67(a SCs proliferation marker).The SCs activation process was dependent on the intact YAP/TAZ signaling pathway as knockdown of TAZ by TAZ small interfering RNA significantly attenuated this process.Conclusion:The LiESWT mechanical signal perception and YAP/TAZ upregulation in SCs might be one of the underlying mechanisms for SCs activation and injured nerve axon regeneration.
文摘We analyzed the efficacy of penile low-intensity extracorporeal shockwave treatment for erectile dysfunction(ED)combined with cavernous artery disease(CAD).ED was evaluated by the International Index of Erectile Function,subdividing patients into mild and moderate/severe forms.CAD was assessed using penile color Doppler ultrasonography.Patients(n=111)with a positive outcome after treatment,based upon the minimal clinically important difference of the International Index of ED,were followed up for 3 months and 6 months.We found a significant mean increase in the index of erectile function,with an overall improvement in hemodynamic parameters of the cavernous artery.In particular,93.9%of the patients with mild ED without CAD responded to treatment and 72.7%resumed normal erectile function.Only 31.2%of the patients with moderate/severe ED and CAD responded to treatment,and none resumed normal erectile function.All patients with mild ED and no CAD maintained the effects of therapy after 3 months,while no patients with moderate/severe ED and CAD maintained the benefits of treatment after 3 months.Thus,patients with mild ED and no CAD have better and longer lasting responses to such treatment,with a higher probability of resuming normal erectile function than patients with moderate/severe ED and CAD.
文摘Tendinopathy is a chronic degenerative musculoskeletal disorder that is common in both athletes and the general population.Exercise and extracorporeal shockwave therapy(ESWT)is among the most common treatments used to mediate tendon healing and regeneration.The review presents the current understanding of mechanisms of action of ESWT and exercise in isolation and briefly synthesises evidence of their effectiveness for various tendinopathies.The central purpose of the review is to synthesize research findings investigating the combination of ESWT and exercise for five common tendinopathies(plantar heel pain,rotator cuff,lateral elbow,Achilles,and patellar tendinopathy)and provide recommendations on clinical applicability.Collectively,the available evidence indicates that ESWT combined with exercise in the form of eccentric training,tissue-specific stretching,or heavy slow resistance training are effective for specific tendinopathies and can therefore be recommended in treatment.Whilst there are at present a limited number of studies investigating combined EWST and exercise approaches,there is evidence to suggest that the combination improves outcomes in the treatment of plantar heel pain,Achilles,lateral elbow,and rotator cuff tendinopathy.However,despite overall positive outcomes in patellar tendinopathy,the combined treatment has not been shown at present to offer additional benefit over eccentric exercise alone.
文摘目的比较体外冲击波与药物治疗距骨骨髓水肿的疗效。方法选取河北医科大学第三医院康复科门诊2021年9月至2022年3月收治的距骨骨髓水肿损伤患者40例。采用随机数表法将患者随机分为两组,每组20例。实验组患者给予冲击波治疗,对照组患者给予非甾体抗炎药双氯芬酸钠缓释片与双膦酸盐类药阿仑膦酸钠治疗。在治疗前及治疗结束后3个月,采用美国足踝外科协会(American Orthopaedic of Foot and Ankle Society,AOFAS)踝与后足评分评估踝关节功能、视觉模拟评分法(visual analogue scale,VAS)评估疼痛程度、MRI评价距骨骨髓水肿面积。应用Footscan足底压力系统比较治疗前后患者的足底压力变化及踝关节跖屈、背屈角度。结果治疗3个月后,两组VAS评分与AOFAS评分均较治疗前改善(P<0.05),且实验组评分改善幅度优于对照组(P<0.05);两组MRI显示的距骨骨髓水肿面积均较治疗前减少(P<0.05);两组在足底最大压力与平均压力方面均较治疗前提高(P<0.05),且实验组提高幅度优于对照组(P<0.05);在步态周期中,两组的全足支撑期与实验组的足跟着地期均延长(P<0.05)。结论体外冲击波治疗与药物治疗均可改善距骨骨髓水肿患者的疼痛、踝关节功能,减小骨髓水肿的面积,改善患者足底压力,以及延长患侧足在步行周期中的支撑期占比。