Fan Yifei, Feng Ziyan, Cao Jun, Fu Weili
West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
West China School of Preclinical Medicine and Forensic Medicine, Sichuan University, Chengdu, Sichuan, China.
Orthop J Sports Med. 2020 Feb 27;8(2):2325967120903430. doi: 10.1177/2325967120903430. eCollection 2020 Feb.
Achilles tendinopathy is a frequent sports injury, and extracorporeal shock wave therapy (ESWT) has been proposed as a treatment.
To compare outcomes between ESWT and other nonsurgical intervention (including sham shock wave therapy) in Achilles tendinopathy patients.
Systematic review; Level of evidence, 2.
We included 5 randomized controlled trials and 3 case-control studies published between 2005 and 2018. We analyzed pain scores and other outcomes that were reported in more than 3 of the 8 studies.
ESWT was associated with significantly better scores than comparison therapy on the visual analog scale for pain ( < .01), American Orthopaedic Foot & Ankle Society scale ( = .01), Likert scale for satisfaction ( = .03), Roles and Maudsley scale ( < .01), Victorian Institute of Sports Assessment-Achilles questionnaire ( < .01), and numerical rating scale ( = .02). The 2 patient groups did not differ significantly in tenderness ( = .34) or pain threshold ( = .24). Subgroup analysis showed that ESWT led to better VAS pain scores than comparison treatments at both low-energy level (0.06-0.11 mJ/mm) and medium-energy level (0.12-0.25 mJ/mm) and at both shorter (<6 months) and longer (≥6 months) follow-up.
ESWT improves pain and functional outcomes in patients with Achilles tendinopathy. Further research is needed to determine the optimal energy level.
跟腱病是一种常见的运动损伤，体外冲击波疗法（ESWT）已被提议作为一种治疗方法。
比较跟腱病患者中ESWT与其他非手术干预措施（包括假冲击波疗法）的治疗效果。
系统评价；证据等级，2级。
我们纳入了2005年至2018年间发表的5项随机对照试验和3项病例对照研究。我们分析了8项研究中超过3项所报告的疼痛评分和其他结果。
在视觉模拟疼痛量表（P<0.01）、美国矫形足踝协会量表（P = 0.01）、满意度李克特量表（P = 0.03）、罗尔斯和莫兹利量表（P<0.01）、维多利亚运动评估-跟腱问卷（P<0.01）以及数字评分量表（P = 0.02）方面，ESWT的评分显著优于对照疗法。两组患者在压痛（P = 0.34）或疼痛阈值（P = 0.24）方面无显著差异。亚组分析表明，在低能量水平（0.06 - 0.11 mJ/mm）和中等能量水平（0.12 - 0.25 mJ/mm）以及较短（<6个月）和较长（≥6个月）随访期时，ESWT在视觉模拟疼痛量表上的疼痛评分均优于对照治疗。
ESWT可改善跟腱病患者的疼痛和功能结局。需要进一步研究以确定最佳能量水平。
