Extracorporeal shockwave therapy and therapeutic exercise for supraspinatus and biceps tendinopathies in 29 dogs

Abstract

Supraspinatus tendinopathy (ST) and biceps tendinopathy (BT) are common causes of forelimb lameness in large-breed dogs and have historically been treated with conservative management or surgery. Extracorporeal shockwave therapy (ESWT) and therapeutic exercise (TE) are thought to be treatment options for these conditions. The objectives of this study were to report the clinical presentations of dogs treated with ESWT for shoulder tendinopathies, to determine the association between shoulder lesion severity identified on ultrasonography or MRI and outcome, and to compare the outcomes of dogs treated with ESWT with and without TE. Medical records of 29 dogs diagnosed with shoulder tendinopathies and treated with ESWT were reviewed, and 24 dogs were diagnosed with either unilateral BT or BT and ST. None were found to have unilateral ST. Five dogs were diagnosed with bilateral disease. Eighty-five per cent of dogs had good or excellent outcomes determined by owner assessment 11-220 weeks after therapy. Outcomes were found to be better as tendon lesion severity increased (P=0.0497), regardless if ESWT was performed with or without TE (P=0.92). ESWT should be considered a safe primary therapeutic option for canine shoulder tendinopathies. Larger controlled prospective studies are needed to adequately assess these findings.

Extracorporeal shock wave therapy improves short‐term limb use after canine tibial plateau leveling osteotomy

“…Although previous studies have provided evidence of improved limb use in dogs after ESWT for musculoskeletal pain of various etiologies, a definitive mechanism of action has not been identified . Published reports of in vitro and in vivo studies in other species provide some proposed actions of the technology.…”

“…Although they are easier to perform, subjective scales may not correlate with lameness identified with force plate gait analysis . Previous studies in which lameness after treatment with ESWT has been evaluated have used both objective and subjective methods . Because the force platform quantitates kinetic forces without observer bias, it was used to assess outcome in this study.…”

“…ESWT, extracorporeal shock wave therapy; PI, propelling impulse; Pre, before surgery; PPF, peak propelling force; PVF, peak vertical force; SI, symmetry index; VI, vertical impulse Although previous studies have provided evidence of improved limb use in dogs after ESWT for musculoskeletal pain of various etiologies, a definitive mechanism of action has not been identified. [21][22][23] Published reports of in vitro and in vivo studies in other species provide some proposed actions of the technology. Reduction of inflammatory cytokines characteristic of the CrCL deficient stifle by ESWT may be responsible for improved limb use.…”

“…Dogs with stifle OA that were treated with ESWT did not show the same increase in lameness or decrease in stifle joint range of motion as control (untreated) dogs . In addition, ESWT subjectively reduced shoulder pain due to various orthopedic pathologies in 64% to 85% of treated dogs …”

“…21 In addition, ESWT subjectively reduced shoulder pain due to various orthopedic pathologies in 64% to 85% of treated dogs. 22,23 Based on published evidence that ESWT may alleviate musculoskeletal pain, this study was performed to quantitate the effects of ESWT in conjunction with standard pain management on limb function after elective canine TPLO. The tested hypothesis was that dogs treated with postoperative ESWT in addition to standard pain management would have greater hind limb ground reaction forces, greater stifle joint range of motion, and lower subjective pain scores in the surgically treated limb after TPLO compared with those that received only standard pain management.…”