Programa “Essentials”: innovación docente en fisioterapia

Garrido, Francisco; Garrido, Maite

doi:10.1016/s1138-6045(08)76323-8

Cited by 4 publications

(10 citation statements)

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“…The biological basis for the structural effect of PNE is still largely unknown; the early response may be due to both the mechanical and biochemical effects of PNE which provoke tenocyte disruption, as well as local inflammatory processes occurring in the soft tissue which enable phagocytosis and repair of the affected tissue. [27][28][29][30] The hypoechoic regions and the area of hypervascularisation are small and localised in chronic lateral epicondylitis, circumstances that could facilitate the elimination or significant short-term reduction in a few sessions. Our opinion is that changes in the structure of the tendon (tendon thickening) would take longer because they require a biomechanical process of remodelling and maturation.…”

Section: Discussionmentioning

confidence: 99%

“…The progress of patients seen at discharge and in the short term was not solely due to PNE and the natural history of the condition, but also to the EccEx and muscle stretching performed at home. In our opinion, PNE stimulates the tendon's biology and causes the initial inflammatory response in the repair phase, [27][28][29][30] while early controlled mechanical loading (EccEx and stretching) facilitates the process of collagen tissue proliferation, thus improving the biomechanical properties of the stimulated tendon. In this regard, Virchenko and Aspenberg 41 studied the effect of PRP on the Achilles tendon of rats subjected to subsequent loading or unloading and found that, after 14 days, the PRP effects in the unloading group disappeared and the mechanical properties of the stimulated tissue were reduced to less than half compared with normal tissue.…”

Section: Discussionmentioning

confidence: 99%

“…During PNE the patient was placed in a supine position with the affected elbow placed in a position of 90° flexion and pronation. The elbow was sterilised and the sonographic transducer, enclosed in a sterile cover over sterile applied gel, was placed at the lateral epicondyle (first approach) and over the humeroradial joint between the head of the radius and the capitulum of the humerus (second approach), 29 where it remained throughout the procedure. A common target area was the deep surface of the common extensor tendon (origin of the ECRB and the extensor digitorum communis) (first approach) and the deep surface of the ECRB, over the capsule and the lateral ulnar collateral ligament (second approach).…”

Section: Methodsmentioning

confidence: 99%

“…Real-time ultrasonographic imaging provided guidance for both procedures. 29 Once the needle reached the target tissue, readjustments of the needle position were made in order to ensure correct stimulation (see online supplementary video 1). The generation of the galvanic current (the cathodic flow is usable with fixed polarity) creates a white image (hyperechoic) as a result of the liberation of hydrogen gas due to the electrolysis (see online supplementary video 2).…”

Section: Methodsmentioning

confidence: 99%

“…The technique stimulates a local inflammatory response in which there is increased cellular activity and repair of the affected area. [28][29][30] PNE has proved to be effective in the short term (6 weeks from baseline) in patellar tendinosis, 28 but its effectiveness in chronic lateral epicondylitis is still unknown.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided Percutaneous Needle Electrolysis in Chronic Lateral Epicondylitis: Short-Term and Long-Term Results

2014

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BackgroundUltrasound (US)-guided percutaneous needle electrolysis (PNE) is a novel minimally invasive approach which consists of the application of a galvanic current through an acupuncture needle.ObjectiveTo evaluate the clinical and ultrasonographic effectiveness of a multimodal programme (PNE, eccentric exercise (EccEx) and stretching) in the short term for patients with chronic lateral epicondylitis, and to determine whether the clinical outcomes achieved decline over time.MethodsA one-way repeated measures study was performed in a clinical setting in 36 patients presenting with lateral epicondylitis. The patients received one session of US-guided PNE per week over 4–6 weeks, associated with a home programme of EccEx and stretching. The main outcome measures were severity of pain, disability (Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire), structural tendon changes (US), hypervascularity and patients’ perceptions of overall outcome. Measurements at 6, 26 and 52 weeks follow-up included recurrence rates (increase in severity of pain or disability compared with discharge), perception of overall outcome and success rates.ResultsAll outcome measures registered significant improvements between pre-intervention and discharge. Most patients (n=30, 83.3%) rated the overall outcome as ‘successful’ at 6 weeks. The ultrasonographic findings showed that the hypoechoic regions and hypervascularity of the extensor carpi radialis brevis changed significantly. At 26 and 52 weeks, all participants (n=32) perceived a ‘successful’ outcome. Recurrence rates were null after discharge and at follow-up at 6, 26 and 52 weeks.ConclusionsSymptoms and degenerative structural changes of chronic lateral epicondylitis are reduced after US-guided PNE associated with EccEx and stretching, with encouragingly low recurrences in the mid to long term.Trial registration numberClinicalTrials.gov identifier: NCT02085928.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided Percutaneous Needle Electrolysis in Chronic Lateral Epicondylitis: Short-Term and Long-Term Results

2014

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Structural and Functional Changes in Supraspinatus Tendinopathy through Percutaneous Electrolysis, Percutaneous Peripheral Nerve Stimulation and Eccentric Exercise Combined Therapy: A Single-Blinded Randomized Clinical Trial

Góngora-Rodríguez,

Rosety-Rodríguez,

Rodríguez-Almagro

et al. 2024

Biomedicines

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Shoulder tendinopathies produce pain and reduce functionality. The aim of this randomized clinical trial was to analyze the effects of Percutaneous electrolysis (PE), Percutaneous peripheral Nerve Stimulation (PNS) and eccentric exercise (EE) on pain (NPRS), strength, electromyographic activity, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and functionality (DASH and SPADI) in individuals with supraspinatus tendinopathy. Participants (n = 50) were divided into two groups; they received 4 treatment sessions, 1 per week, of PE and PNS (n = 25) or 10 treatment sessions of TENS and US (n = 25). Both groups performed the EE program consisting of 3 sets of 10 repetitions of each of the 3 exercises, twice a day, during the 4 weeks. Follow-up was carried out at 4, 12 and 24 weeks after the start of the intervention. There are statistically significant differences in the analysis between groups (p < 0.001) in the post-treatment and follow-up measurements favorable to the PE+PNS+EE treatment on pain (NPRS), strength, supraspinatus electromyographic amplitude, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and DASH and SPADI questionnaires. The combined treatment with PE, PNS and EE is an effective option in the clinical management of tendinopathies, with positive results in the short and long term on the variables studied.

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Effect of Ultrasound-Guided Percutaneous Neuromodulation of Sciatic Nerve on Hip Muscle Strength in Chronic Low Back Pain Sufferers: A Pilot Study

San-Emeterio-Iglesias

De-la-Cruz-Torres

Romero‐Morales

et al. 2022

JCM

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Background: Limited hip internal rotation range of motion (IR-ROM) and hip abductor weakness are recognized in low back pain (LBP) sufferers. The main aim was to investigate the effect of a ultrasound (US)-guided percutaneous neuromodulation (PNM) technique on hip strength in people with LBP. A second purpose was to discover whether the location along the sciatic nerve, where percutaneous neuromodulation was applied, could influence the change of strength response in these patients. Methods: Sixty LBP sufferers were recruited and divided randomly into three groups. All participants received an isolated percutaneous electrical stimulation at one of three different locations of the sciatic nerve pathway (proximal, middle, and distal), depending on the assigned group. Pain intensity, hip passive IR-ROM, hip muscle strength, and the Oswestry disability index (ODI) were analyzed. All variables were calculated before the intervention and one week after the intervention. Results: All interventions significantly decreased pain intensity and improved the IR-ROMs, strength, and functionality after one week (p = 0.001). However, between-group (treatment x time) differences were reported for flexion strength in the non-intervention limb (p = 0.029) and ODI (p = 0.021), although the effect size was small (Eta2 = 0.1) in both cases. Conclusions: The application of an isolated intervention of the US-guided PNM technique may be a useful therapeutic tool to increase the hip muscle strength in patients with chronic LBP.

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Programa “Essentials”: innovación docente en fisioterapia

Cited by 4 publications

References 0 publications

Ultrasound-Guided Percutaneous Needle Electrolysis in Chronic Lateral Epicondylitis: Short-Term and Long-Term Results

Ultrasound-Guided Percutaneous Needle Electrolysis in Chronic Lateral Epicondylitis: Short-Term and Long-Term Results

Structural and Functional Changes in Supraspinatus Tendinopathy through Percutaneous Electrolysis, Percutaneous Peripheral Nerve Stimulation and Eccentric Exercise Combined Therapy: A Single-Blinded Randomized Clinical Trial

Effect of Ultrasound-Guided Percutaneous Neuromodulation of Sciatic Nerve on Hip Muscle Strength in Chronic Low Back Pain Sufferers: A Pilot Study

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