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محمد رضا جودکی »وبلاگ ها

ساکن تهران, استان تهران ایران · متولد اردیبهشت 9
محمد رضا جودکی

Radial Extracorporeal Shockwave Therapy in Fibromyalgia Silvia Ramon (1), Leonor Hernandez-Sierra (1), Antonio Gomez-Centeno (2), Elena Morales-Espeleta (1), Oscar Ares (3), Maria Garcia-Manrique de Lara (2), Fernando Vidiella (1), Ramon Cugat (3) Institution: (1) Dept. of Rehabilitation, (2) Dept. of Rheumatology, (3) Dept. of Orthopedic Surgery, Hospital Quiron, Barcelona, Spain Device and producing company: Physiogold 50, MTS Introduction: The purpose of this study is to evaluate the evidence of rESWT in fibromyalgia (FM). Methods: We performed a randomized, prospective study with 24 FM patients. All patients were female, mean age 52, 13 years (45-67). Patients were divided into two groups and asked to select the 3 most painful myofascial and asymmetrical regions. Both groups received 5 weekly sessions of radial ESWT (rESWT), using 2000 shocks of rESWT at each of the 3 points. Group 1 (treatment) N= 13 treated with 500 shocks, 1,5 bar, 5 Hz; then 1000 shocks, 2 bar, 8 Hz; and 500 shocks, 1,5 bar, 15 Hz; Group 2 (placebo) N= 11 (using a soft rubber cap leaving air between transmitter and the cap) received 500 shocks, 15 Hz; then 1000 shocks, 8 Hz; and 500 shocks, 15 Hz, with the pressure constant 1,5 bar. Outcome variables were: 1) Pain: VAS, algometer (Wagner instruments®) at 3 points and contralateral; McGill Questionnaire; 2) Emotional status (BDI; Hamilton test) and 3) QOL measures: Fibromyalgia-Impact-Questionnaire; Fibromyalgia-R808-NP2; SF-36. Both groups received a home FM exercise program, according to Fibromyalgia Information Foundation. All patients were assessed for pain before each rESWT and at 6 weeks post treatment. Results: We found clinical improvement on pain at 6 weeks after treatment and excellent-good results according to Roles and Maudsley in FM patients treated compared to placebo, without side effects. Discussion: Patient follow-up 6 to 12 months post-treatment will determine shockwave efficacy over time. Conclusion: In a multi-disciplinary approach, rESWT appears to be safe and effective as an early adjunctive therapy in fibromyalgia....
محمد رضا جودکی

Dynamic Myofascial Treatment and ESWT Jiri Nedelka (1), Tomas Nedelka (2) Institution: (1) Rehabilitation Center and Pain Clinic, (2) Charles University, 2nd Faculty of Medicine, Dept. of Neurology Praha, CZ Device and producing company: BTL 5000, 6000, Storz Duolith Radial Applicator Introduction: The authors are presenting the original method of treatment of locomotive system. This technique proceed from experience of Prague rehabilitation school, rehabilitation techniques in combination with the effect of shockwave therapy based on the principle of mechanotransduction. Long time experience with shockwave therapy used at the functional and structural disordes of locomotive system are presented here. Methods: Manual medicine techniques allow to relieve painful muscle spasm for follow up dynamic aplication of radial ESWT. This affects not only painful muscle spasm but also referred pain and peripheral pain perception itself. Results: Combination of manual therapy and dynamic aplication ESWT is very effective in the acute and chronic disorders of locomotive system with prompt pain relieve.Best effect was observed in non-specific cervical and low back pain and radial epicondylitis. Discussion: Manual therapy and dynamic aplication of ESWT has been much more effective than static one. This technique is enabling to affect multisegmental disorders of spine,fascias, joints. Conclusion: Authors are presenting own technique of treatment concered in musculoskeletal system. Optimal combination seems to be manual therapy according Prague´s school and dynamic application of ESWT....
محمد رضا جودکی

The Effects of Radial Extracorporeal Shockwave Therapy on Function, Range of Motion, Strength and Pain in Patients with Chronic Rotator Cuff Tendinosis: A Prospective Pre-Test Post-Test Design Paolo Sanzo Institution: Lakehead University, Thunder Bay, Canada Device and producing company: D Actor 100 Radial Shockwave Unit; Storz Medical Introduction: Shoulder pain is the third most common cause of musculoskeletal pain. 16-34% of the population suffers from shoulder pain with rotator cuff tendinosis (RCT) comprising a good portion of this subpopulation. Many treatments exist for RCT but few are supported by strong scientific evidence. Much needs to be learned about the etiology, pathophysiology, and management of RCT. As a result, the purpose of this investigation was to assess the effects of ECSWT on shoulder pain, function, ROM and strength in patients with RCT. Methods: ROM, strength, functional status via the Upper Extremity Functional Scale (UEFS), and pain was measured with the P4 Scale pre- and 3 months post-treatment. 24 subjects received 3 treatments (2000 shockwaves, 2.5 bars, 10-15 Hz, 11.5 Mp) completed over the painful site (clinical focusing) and insertion of the painful tendon (anatomical focusing). A Wilcoxen Test and dependent t-Test was used to analyze the data. Results: A significant improvement was found in UEFS scores (p=.0001); P4 scores (p=.0001); ROM for shoulder flexion (p=.013); abduction (p=.002); internal rotation (p=.02); and external rotation (p=.001); and strength for shoulder abduction (p=.01); and external rotation (p=.002). Discussion: not applicable Radial ECSWT has been reported to be an effective treatment in some trials and ineffective in others, but the evidence and efficacy remains controversial. The results add to the merit and body of literature supporting its use. Conclusion: Radial ECSWT is an effective treatment for patients diagnosed with RCT and is able to decrease shoulder pain, and improve shoulder function, ROM, and strength....
محمد رضا جودکی

Combination of Shockwave Therapy with Exercise in Shoulder Tendinopathy: Preliminary Results on Percieved Functional Outcome Gianluca Ruggiero, Elisabetta Tibalt, Maria Cristina D’Agostino, Stefano Respizzi Institution: Humanitas Research Hospital, Milan, Italy Device and producing company: SLK STORZ MEDICAL Introduction: Purpose of the study was to investigate whether association of exercise therapy with ESWT, resulted in better and early functional outcome in patients with rotator cuff tendinopathy. Methods: Eighteen patients (average age 57.4, 12 female, 8 male) with rotator cuff tendinopathy, were randomly assigned into two groups. Both groups (A and B) were treated with ESWT. Patients in Group B were even instructed, by a Physiotherapist, with a self-assisted exercise program and provided with a therapy kit for home exercise. A weekly session of supervised physiotherapy was scheduled in order to verify and update the exercise program. Patients were evaluated at baseline and 1 and 2 months after beginning of treatment. Clinical assessment included pain and R.O.M. Subjective functional assessment included SST and D.A.S.H. Results: At 2 months follow-up the average Pain score (assessed with V.A.S.) improved 16.5% with non significant difference between two groups (16.7% in Group A and 16.4% in Group B), confirming an overall benefit in pain relief even in short term results. Subjective functional assessment increased 3.3 (SST) and 13.6 (DASH) average points in Group A (52.3% for SST and 19.8% for DASH); Group B increased 1.8 (SST) and 12.3 (DASH) average points (28.9% for SST and 18.4% for DASH). All patients completed exercise program but one patient in Group B but one patient in Group B didn't participate at final assessment at follow-up. Discussion: There is no significative evidence that association of exercise with ESWT for patients with rotator cuff tendinopathy seems to result in better functional improvement. However results in Group B (patients instructed with a home based, self- assisted rehabilitation program with PT supervising) seem to achieve better functional results in a shorter period. Conclusion: Further investigations are needed to assess long term-results and different ESWT-exercise combination modalities. Updated data will be presented....
محمد رضا جودکی

Extracorporeal Shockwave Therapy in Calcific Tendinosis of the Rotator Cuff: Comparision of Radial and Focal Treatment Edson Serrano, Karim Flores, Jean Carlos Criado Institution: Neomedica Shockwave Unit; Lima, Peru Device and producing company: ORTHOGOLD 100, MTS; BTL 5000, BTL 6000 Introduction: Calcific tendinosis of the shoulder is often associated with chronic pain and impairment of function. Extracorporeal shockwave therapy (ESWT) is considered to be a treatment option. We compared the effects of two different ESWT technologies: focal and radial. Methods: Forty eight shoulders were followed in 2 groups of twenty-four each. The treatment was weekly consisted of 3 x 2000 focal electrohidraulic shockwave with an energy flux density of 0.14-0.2 mJ/mm2 without anesthesia (group A) and 5 x 6000 impulses of radial impulses with progresive protocol (group B). The patients were examined at a 4 weeks, 3 and 6 months after treatment. X-rays were performed at each visit. Results: In six months of folllowing after treatment the Constant Score improved from 52.5 to 78.4 in group A and from 54.2 to 72.6 in group B (p < 0.05). The values on the visual analog scale which ranges from 0 (no pain) to 10 (maximal pain) improved from 7.7 to 3.1 (group A) and from 7.4 to 3.3 (group B) before and 6 months after treatment respectively. X-rays showed a complete or subtotal calcific resorption in 56% in group A, and 38% in group B of patients. Discussion: This is a preliminary study indicates that three sessions of extracorporeal electrohidraulic focal shockwave therapy with energy flux density of 0.14-0.2 mJ/mm2 may be as effective as five applications of a radial extracorporeal shockwave therapy with progressive protocol for calcific tendinosis of rotator cuff. Focal technology shortens the treatment time, but the radial treatment is more accessible to people. Conclusion: Both technologies of ESWT (focal and radial) had successful and comparable result in the treated patients with calcific tendinosis of rotator cuff of the shoulder. No complications seen in six months of following. Subjectively, 84% of group A and 76% of group B judged the treatment to be successful....
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