Shockwave Therapy Associated With Eccentric Strengthening for Achilles Insertional Tendinopathy: A Prospective Study

Mansur, Nacime Salomão Barbachan; Baumfeld, Tiago; Villalon, Fernando; Aoyama, Bruno Takeshi; Matsunaga, Fábio Teruo; Santos, Paulo Roberto Dias dos; Santos, Bruno; Tamaoki, Marcel Jun Sugawara

doi:10.1177/1938640019826673

Cited by 22 publications

(26 citation statements)

References 29 publications

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“…Most studies on the effectiveness of ESWT for Achilles tendinopathy included in this narrative review are randomized controlled trials [6,[17][18][19][20][21][22][23][26][27][28]. Two casecontrol studies [7,29], a case series study [30], prospective audit [31], clinical trial protocol [32], and a pilot study [33] were also considered. e majority were prospective studies [6, 7, 17, 19-23, 26-30, 32-34].…”

Section: Resultsmentioning

confidence: 99%

“…e two modalities of shock wave therapy used for Achilles tendinopathy are focused shock waves [ BioMed Research International BioMed Research International waves [6,17,18,20,22,[30][31][32]38]. e volume of tissue affected is different for each of these modalities.…”

Section: Methods Of Shock Wave Applicationmentioning

confidence: 99%

“…A four-month duration was selected as the eligibility criterion by Costa et al [23], while others considered patients who had been suffering for six months [6,7,17,19,20,22,28,29,[34][35][36]. Santamato et al [33] and Lynen et al [27] used shorter eligibility periods, i.e., 4 and 6 weeks, respectively, while several authors did not specify the duration of Achilles tendinopathy symptoms at all [26,32,38]. Regarding acute tendinopathy, Ciccotti et al [41] emphasized that although patients describe the pain as acute, the degenerative character of the dysfunction indicates that the tendon's adaptation to tensile overloading has been impaired long before symptom occurrence.…”

Section: Achilles Tendon Dysfunction Characteristics a Chronicmentioning

confidence: 99%

“…While treating Achilles tendinopathy, most researchers used 3 sessions of ESWT [6, 18-20, 22, 26, 28, 31] with a oneweek break in between [6,20,22,26,31]. ere were also shorter breaks of 3 to 4 days [19,28] or longer 2-week breaks [30,32]. e number of pulses per session ranged from 800 to 3000 [6,18,20,22,26,[30][31][32]38]; the pulse frequency was 4 to 50 Hz [6, 18, 20-22, 30-32, 38].…”

Section: Biomed Research Internationalmentioning

confidence: 99%

“…ere were also shorter breaks of 3 to 4 days [19,28] or longer 2-week breaks [30,32]. e number of pulses per session ranged from 800 to 3000 [6,18,20,22,26,[30][31][32]38]; the pulse frequency was 4 to 50 Hz [6, 18, 20-22, 30-32, 38]. Focused shock waves were applied once [7,29], three [23,35] or five times [33], once a week [33,35], or once a month [23].…”

Section: Biomed Research Internationalmentioning

confidence: 99%

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Extracorporeal Shock Wave Therapy for Achilles Tendinopathy

Stania

Juras

Chmielewska

et al. 2019

BioMed Research International

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Extracorporeal shock wave therapy (ESWT) is among the conservative treatments for Achilles tendinopathy. Unfortunately, no optimal application parameters have been determined that would ensure ESWT effectiveness in this condition. The aim of the paper is to use research reports on ESWT in patients with Achilles tendinopathy to help practising physiotherapists establish the most effective intervention parameters. A search was conducted using the following databases: PubMed, Scopus, EBSCOhost, and Web of Science. The papers were checked for relevant content and were included based on the following criteria: full-text article published in English and including comprehensive description of shock wave application. Twenty-two articles met the inclusion criteria. Most studies on the effectiveness of ESWT for Achilles tendinopathy included in this narrative review were randomized controlled trials. Two case-control studies, a case series study, prospective audit, clinical trial protocol, and a pilot study were also considered. The majority were prospective studies. Only a few authors presented the findings from retrospective observations. The two modalities of shock wave therapy used for Achilles tendinopathy are focused shock waves and radial shock waves. The literature contains reports presenting mainly beneficial effects of ESWT in patients with Achilles tendinopathy.

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Section: Resultsmentioning

confidence: 99%

Section: Methods Of Shock Wave Applicationmentioning

confidence: 99%

Section: Achilles Tendon Dysfunction Characteristics a Chronicmentioning

confidence: 99%

Section: Biomed Research Internationalmentioning

confidence: 99%

Section: Biomed Research Internationalmentioning

confidence: 99%

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Extracorporeal Shock Wave Therapy for Achilles Tendinopathy

Stania

Juras

Chmielewska

et al. 2019

BioMed Research International

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Microenergy acoustic pulses promotes muscle regeneration through in situ activation of muscle stem cells

Zhang

Kim

Lin

et al. 2021

Journal Orthopaedic Research

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Microenergy acoustic pulses (MAP) is a modified low‐intensity extracorporeal shock wave therapy that currently used for treating musculoskeletal disorders. However, its function on muscle regeneration after ischemia‐reperfusion injury (IRI) remains unknown. This study aimed to explore the effect of MAP on muscle injury after IRI and its underlying mechanisms. Ten‐week‐old C57BL/6J mice underwent unilateral hindlimb IRI followed with or without MAP treatment. Wet weight of tibialis anterior muscles at both injury and contralateral sides were measured followed with histology analysis at 3 weeks after IRI. In in vitro study, the myoblasts, endothelial cells and fibro‐adipogenic progenitors (FAP) were treated with MAP. Cell proliferation and differentiation were assessed, and related gene expressions were measured by real‐time PCR. Our results showed that MAP significantly increased the muscle weight and centrally nucleated regenerating muscle fiber size along with a trend in activating satellite cells. In vitro data indicated that MAP promoted myoblast proliferation and differentiation and endothelial cells migration. MAP also induced FAP brown/beige adipogenesis, a promyogenic phenotype of FAPs. Our findings demonstrate the beneficial function of MAP in promoting muscle regeneration after IR injury by inducing muscle stem cells proliferation and differentiation.

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Achilles tendinopathy research has a gender data gap: A systematic review and meta‐analysis

Schuppisser,

Mondini Trissino da Lodi,

Albanese

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeA persisting gender bias has been recently highlighted in orthopaedics and sports medicine. The aim of this study was to evaluate the volume of gender‐specific data and gender‐specific results in the treatment of a common tendon disease, Achilles tendinopathy.MethodsPubmed, Cochrane, and Web of Science were searched to identify all clinical studies focusing on Achilles tendinopathy treatment. The Visual Analogue Scale (VAS) and Victorian Institute of Sport Assessment‐Achilles (VISA‐A) data of women and men of the studies that disaggregated results by gender were collected, and a meta‐analysis was conducted. Treatment response within and in between gender categories was evaluated, focusing on overall gender‐disaggregated data, as well as within each of the three treatment categories: conservative treatment, injective treatment and surgical treatment. A formal risk of bias analysis was conducted using Downs and Black's grading system.ResultsOut of the 8796 papers screened, 178 were included after the screening. The number of female study participants grew from 20% up to 1990 to 48% in the years 2019–2022. Only 373 out of 3423 (11%) female patients and 685 of 4352 (16%) male patients were found in sex‐disaggregated studies. A meta‐analysis was conducted on the 14 papers that reported sex‐disaggregated data for VAS and VISA‐A. The meta‐analysis revealed that there was no difference in the overall treatment response between women and men and that both genders showed an overall significant treatment benefit in terms of VAS and VISA‐A values. However, significant differences were documented within the treatment categories. While no differences were found in surgical studies, in conservative treatment studies, men experienced lower posttreatment VAS values (p = 0.004). The largest difference was found in injective treatments, with men experiencing a larger change in VAS values (men = −3.0, women = −1.0, p = 0.016) and higher posttreatment VISA‐A values (p = 0.032).ConclusionThis systematic review and meta‐analysis showed a lack of awareness of the importance of sex‐specific data within Achilles tendinopathy treatment research. The proportion of female study subjects has grown over the years, but there is still a large data gap caused by the absence of sex‐disaggregated data. The omission of sex‐disaggregated data causes the loss of valuable knowledge on the true effectiveness of current Achilles tendinopathy treatment. The results of this study indicate that women profit less from available treatments, particularly injective approaches, which prompts further research for treatment adaptation by gender.Level of Evidence: Level IV.

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Shockwave Therapy Associated With Eccentric Strengthening for Achilles Insertional Tendinopathy: A Prospective Study

Cited by 22 publications

References 29 publications

Extracorporeal Shock Wave Therapy for Achilles Tendinopathy

Extracorporeal Shock Wave Therapy for Achilles Tendinopathy

Microenergy acoustic pulses promotes muscle regeneration through in situ activation of muscle stem cells

Achilles tendinopathy research has a gender data gap: A systematic review and meta‐analysis

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