体外冲击波治疗慢性跟腱病变的系统评价
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摘要
目的系统评价体外冲击波(ESWT)治疗慢性跟腱病变方面的疗效。方法采用Cochrane系统评价方法,检索Cochrane图书馆临床对照试验数据库、MEDLINE网上数据库、Science Direct、中国生物医学文献服务系统等数据库,2名评价员独立提取信息并评价文献质量后交叉比对。结果共有11篇文献进入体外冲击波在慢性跟腱病变治疗方面的系统评价。11项研究共纳入慢性跟腱病变患者635人,共684足。患者的年龄分布在18~80岁,患病时间均在3个月以上,最长患病时间为95个月。冲击波治疗组的疗效满意度为64%~90%。对照组疗效满意度为27.0%~39.4%。冲击波治疗组相比于对照组,疼痛减轻及足踝部功能评分增加优势明显。结论 (1)体外冲击波治疗慢性跟腱病变有效减轻疼痛,恢复足踝部功能,患者满意度较好;(2)对于止点性和非止点性跟腱病变均有效;(3)选用聚焦式和发散式体外冲击波均显示了良好的治疗效果;(4)治疗时为减轻疼痛使用局部麻醉会对治疗效果产生负面影响。
Objective Systemic review on effects of Extracorporeal shock wave therapy(ESWT) on chronic Achilles tendinopathy. Methods Use Cochrane systemic literatures was independently evaluated and cross-checked by two evaluators. ResultsEleven articles were involved in the systemic review of effects of Extracorporeal shock wave therapy on chronic Achilles tendinopathy, with total 635 patients, 684 feet. Patients' age range from 18-80 years, mean age was 39.2-58.0 years. Mean time since disease was more than three months to 95 months. Satisfaction of ESWT group was range from 64%-90%, which in control group was range from 27.0%-39.4%. Pain relief and increase in foot and ankle scores were superior in ESWT group. Conclusion(1) ESWT could effectively relieve pain for patients who suffer from chronic Achilles tendinopathy;(2) ESWT is effective for both insertional and non-insertional Achilles tendinopathy;(3) Both radial and focused ESWT are effective;(4) Local anesthesia during ESWT treatment would reduce the therapeutic effect of ESWT.
Objective Systemic review on effects of Extracorporeal shock wave therapy(ESWT) on chronic Achilles tendinopathy. Methods Use Cochrane systemic literatures was independently evaluated and cross-checked by two evaluators. ResultsEleven articles were involved in the systemic review of effects of Extracorporeal shock wave therapy on chronic Achilles tendinopathy, with total 635 patients, 684 feet. Patients' age range from 18-80 years, mean age was 39.2-58.0 years. Mean time since disease was more than three months to 95 months. Satisfaction of ESWT group was range from 64%-90%, which in control group was range from 27.0%-39.4%. Pain relief and increase in foot and ankle scores were superior in ESWT group. Conclusion(1) ESWT could effectively relieve pain for patients who suffer from chronic Achilles tendinopathy;(2) ESWT is effective for both insertional and non-insertional Achilles tendinopathy;(3) Both radial and focused ESWT are effective;(4) Local anesthesia during ESWT treatment would reduce the therapeutic effect of ESWT.
引文
[1]Alrashidi Y,Alrabai HM,Alsayed H,et al.Achilles tendon in Sport[J].Sport Orthop Traumatol,2015,31(4):282-292.
[2]Al-Abbad H,Simon JV.The Effectiveness of Extracorporeal Shock Wave Therapy on Chronic Achilles Tendinopathy[J].Foot Ankle Int,2013,34(1):33-41.
[3]Ahn JH,Ahn CY,Byun CH,et al.Operative Treatment of Haglund Syndrome With Central Achilles Tendon-Splitting Approach[J].J Foot Ankle Surg,2015,54(6):1053-1056.
[4]Herrington L,Mcculloch R.The role of eccentric training in the management of Achilles tendinopathy:A pilot study[J].Physical Therapy in Sport,2007,8(4):191-196.
[5]Morrison RJM,Brock TM,Reed MR,et al.Radiofrequency Microdebridement Versus Surgical Decompression for Achilles Tendinosis:A Randomized Controlled Trial[J].J Foot Ankle Surg,2017,56(4):708-712.
[6]Wang C-J.Extracorporeal shockwave therapy in musculoskeletal disorders[J].J Orthop Surg Res,2012,7(1):11.
[7]Wan Y-CS,Lie WHC,Pun CTT,et al.The Effect of Low Dose Extracorporeal Shock Wave Therapy(ESWT)on Plantar Fasciitis:A Trial Study in Queen Mary Hospital[J].J Orthop Trauma Rehabil,2015,19(2):60-65.
[8]Rompe JD,Furia J,Cacchio A,et al.Radial shock wave treatment alone is less efficient than radial shock wave treatment combined with tissue-specific plantar fascia-stretching in patients with chronic plantar heel pain[J].Int J Surg,2015,24:135-142.
[9]Notarnicola A,Moretti B.The biological effects of extracorporeal shock wave therapy(eswt)on tendon tissue[J].Muscles Ligaments Tendons J,2012,2(1):33-37.
[10]Gerdesmeyer L,Mittermayr R,Fuerst M,et al.Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy[J].Int J Surg,2015,24:154-159.
[11]Magnussen RA,Dunn WR,Thomson AB.Nonoperative Treatment of Midportion Achilles Tendinopathy:A Systematic Review[J].Clin J Sport Med,2009,19(1):54-64.
[12]Centre for Evidence-Based Physiotherapy at The George Institute for Global Health.Physiotherapy Evidence Database(PEDro)[CP/OL].(1999-06-21)[2012-03-30].http://www.pedro.org.au/english/downloads/pedro-scale.
[13]Lakshmanan P,O’Do herty DP.Chronic achillestendinopathy:Treatment with extracorporeal shock waves[J].Foot Ankle Surg,2004,10(3):125-130.
[14]Furia JP.High-Energy Extracorporeal Shock Wave Therapy as a Treatment for Insertional Achilles Tendinopathy[J].Am J Sports Med,2005,34(5):733-740.
[15]Furia JP.High-Energy Extracorporeal Shock Wave Therapy as a Treatment for Chronic Noninsertional Achilles Tendinopathy[J].Am J Sports Med,2008,36(3):502-508.
[16]Rompe JD,Furia J,Maffulli N.Eccentric Loading Compared with Shock Wave Treatment for Chronic Insertional Achilles Tendinopathy[J].J Bone Jt Surgery-American Vol,2008,90(1):52-61.
[17]Rasmussen S,Christensen M,Mathiesen I,et al.Shockwave therapy for chronic Achilles tendinopathy:A double-blind,randomized clinical trial of efficacy[J].Acta Orthop,2008,79(2):249-256.
[18]Vulpiani MC,Trischitta D,Trovato P,et al.Extracorporeal shockwave therapy(ESWT)in Achilles tendinopathy.A longterm follow-up observational study[J].J Sports Med Phys Fitness,2009,49(2):171-176.
[19]Saxena A,Ramdath S,O’Halloran P,et al.Extra-corporeal Pulsed-activated Therapy(“EPAT”Sound Wave)for Achilles Tendinopathy:A Prospective Study[J].J Foot Ankle Surg,2011,50(3):315-319.
[20]Carulli C,Tonelli F,Innocenti M,et al.Effectiveness of extracorporeal shockwave therapy in three major tendon diseases[J].J Orthop Trau matol,2016,17(1):15-20.
[21]Taylor J,Dunkerley S,Silver D,et al.Extracorporeal shockwave therapy(ESWT)for refractory Achilles tendinopathy:A prospective audit with 2-year follow up[J].Foot,2016,26:23-29.
[22]Vito Pavone,Luca Cannavò,Antonio Di Stefano,et al.Low-Energy Extracorporeal Shock-Wave Therapy in the Treatment of Chronic Insertional Achilles Tendinopathy:A Case Series[J].Biomed Res Int,2016,2016:7123769.
[23]Lee J-Y,Yoon K,Yi Y,et al.Long-Term Outcome and Factors Affecting Prognosis of Extracorporeal Shockwave Therapy for Chronic Refractory Achilles Tendinopathy[J].Ann Rehabil Med,2017,41(1):42-50.
[24]Robinson JM,Cook JL,Purdam C,et al.The V.I.S.A-A questionnaire:a valid and reliable index of the clinical severity of achillestendinopathy[J].Br J Sports Med,2001,35(5):335-341.
[25]Kitaoka HB,Alexander IJ,Adelaar RS,et al.Clinical rating systems for the ankle-hindfoot,midfoot,hallux,and lesser toes[J].Foot Ankle Int,1994,15(7):349-353.
[26]Waugh C,Morrissey D,Jones E,et al.In vivo biological response to extracorporeal shockwave therapy in human tendinopathy[J].Eur Cells Mater,2015,29:268-280.
[27]Lin TC,Lin CY,Chou CL,et al.Achilles tendon tear following shock wave therapy for calcific tendinopathy of the Achilles tendon:A case report[J].Phys Ther Sport,2012,13(3):189-192.
[2]Al-Abbad H,Simon JV.The Effectiveness of Extracorporeal Shock Wave Therapy on Chronic Achilles Tendinopathy[J].Foot Ankle Int,2013,34(1):33-41.
[3]Ahn JH,Ahn CY,Byun CH,et al.Operative Treatment of Haglund Syndrome With Central Achilles Tendon-Splitting Approach[J].J Foot Ankle Surg,2015,54(6):1053-1056.
[4]Herrington L,Mcculloch R.The role of eccentric training in the management of Achilles tendinopathy:A pilot study[J].Physical Therapy in Sport,2007,8(4):191-196.
[5]Morrison RJM,Brock TM,Reed MR,et al.Radiofrequency Microdebridement Versus Surgical Decompression for Achilles Tendinosis:A Randomized Controlled Trial[J].J Foot Ankle Surg,2017,56(4):708-712.
[6]Wang C-J.Extracorporeal shockwave therapy in musculoskeletal disorders[J].J Orthop Surg Res,2012,7(1):11.
[7]Wan Y-CS,Lie WHC,Pun CTT,et al.The Effect of Low Dose Extracorporeal Shock Wave Therapy(ESWT)on Plantar Fasciitis:A Trial Study in Queen Mary Hospital[J].J Orthop Trauma Rehabil,2015,19(2):60-65.
[8]Rompe JD,Furia J,Cacchio A,et al.Radial shock wave treatment alone is less efficient than radial shock wave treatment combined with tissue-specific plantar fascia-stretching in patients with chronic plantar heel pain[J].Int J Surg,2015,24:135-142.
[9]Notarnicola A,Moretti B.The biological effects of extracorporeal shock wave therapy(eswt)on tendon tissue[J].Muscles Ligaments Tendons J,2012,2(1):33-37.
[10]Gerdesmeyer L,Mittermayr R,Fuerst M,et al.Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy[J].Int J Surg,2015,24:154-159.
[11]Magnussen RA,Dunn WR,Thomson AB.Nonoperative Treatment of Midportion Achilles Tendinopathy:A Systematic Review[J].Clin J Sport Med,2009,19(1):54-64.
[12]Centre for Evidence-Based Physiotherapy at The George Institute for Global Health.Physiotherapy Evidence Database(PEDro)[CP/OL].(1999-06-21)[2012-03-30].http://www.pedro.org.au/english/downloads/pedro-scale.
[13]Lakshmanan P,O’Do herty DP.Chronic achillestendinopathy:Treatment with extracorporeal shock waves[J].Foot Ankle Surg,2004,10(3):125-130.
[14]Furia JP.High-Energy Extracorporeal Shock Wave Therapy as a Treatment for Insertional Achilles Tendinopathy[J].Am J Sports Med,2005,34(5):733-740.
[15]Furia JP.High-Energy Extracorporeal Shock Wave Therapy as a Treatment for Chronic Noninsertional Achilles Tendinopathy[J].Am J Sports Med,2008,36(3):502-508.
[16]Rompe JD,Furia J,Maffulli N.Eccentric Loading Compared with Shock Wave Treatment for Chronic Insertional Achilles Tendinopathy[J].J Bone Jt Surgery-American Vol,2008,90(1):52-61.
[17]Rasmussen S,Christensen M,Mathiesen I,et al.Shockwave therapy for chronic Achilles tendinopathy:A double-blind,randomized clinical trial of efficacy[J].Acta Orthop,2008,79(2):249-256.
[18]Vulpiani MC,Trischitta D,Trovato P,et al.Extracorporeal shockwave therapy(ESWT)in Achilles tendinopathy.A longterm follow-up observational study[J].J Sports Med Phys Fitness,2009,49(2):171-176.
[19]Saxena A,Ramdath S,O’Halloran P,et al.Extra-corporeal Pulsed-activated Therapy(“EPAT”Sound Wave)for Achilles Tendinopathy:A Prospective Study[J].J Foot Ankle Surg,2011,50(3):315-319.
[20]Carulli C,Tonelli F,Innocenti M,et al.Effectiveness of extracorporeal shockwave therapy in three major tendon diseases[J].J Orthop Trau matol,2016,17(1):15-20.
[21]Taylor J,Dunkerley S,Silver D,et al.Extracorporeal shockwave therapy(ESWT)for refractory Achilles tendinopathy:A prospective audit with 2-year follow up[J].Foot,2016,26:23-29.
[22]Vito Pavone,Luca Cannavò,Antonio Di Stefano,et al.Low-Energy Extracorporeal Shock-Wave Therapy in the Treatment of Chronic Insertional Achilles Tendinopathy:A Case Series[J].Biomed Res Int,2016,2016:7123769.
[23]Lee J-Y,Yoon K,Yi Y,et al.Long-Term Outcome and Factors Affecting Prognosis of Extracorporeal Shockwave Therapy for Chronic Refractory Achilles Tendinopathy[J].Ann Rehabil Med,2017,41(1):42-50.
[24]Robinson JM,Cook JL,Purdam C,et al.The V.I.S.A-A questionnaire:a valid and reliable index of the clinical severity of achillestendinopathy[J].Br J Sports Med,2001,35(5):335-341.
[25]Kitaoka HB,Alexander IJ,Adelaar RS,et al.Clinical rating systems for the ankle-hindfoot,midfoot,hallux,and lesser toes[J].Foot Ankle Int,1994,15(7):349-353.
[26]Waugh C,Morrissey D,Jones E,et al.In vivo biological response to extracorporeal shockwave therapy in human tendinopathy[J].Eur Cells Mater,2015,29:268-280.
[27]Lin TC,Lin CY,Chou CL,et al.Achilles tendon tear following shock wave therapy for calcific tendinopathy of the Achilles tendon:A case report[J].Phys Ther Sport,2012,13(3):189-192.