From the Graduate Program in Acoustics, The Pennsylvania State University, University Park, Pennsylvania (MS, JCS); Biomedical Engineering, The Pennsylvania State University, University Park, Pennsylvania (SK, MEV, JCS); and Physical Medicine and Rehabilitation, Pennsylvania State College of Medicine, Hershey, Pennsylvania (MEV).
Am J Phys Med Rehabil. 2022 Aug 1;101(8):801-807. doi: 10.1097/PHM.0000000000001894. Epub 2021 Oct 4.
Tendon injury is prevalent and costly in the United States, comprising 45% of the 66 million musculoskeletal injuries and costing $114 billion annually. Surgical and therapeutic methods, such as arthroscopic surgery, dry needling, and physical therapy, produce mixed success in reintroducing a healing response in tendinopathy due in part to inconsistent dosing and monitoring. Ultrasound is one therapeutic modality that has been shown to noninvasively induce bioeffects in tendon that may help promote healing. However, results from this modality have also been mixed. This review compares the current state of the field in therapeutic ultrasound and shockwave therapy, including low-intensity therapeutic ultrasound, extracorporeal shockwave therapy, and radial shockwave therapy, and evaluates the efficacy in treating tendinopathies with ultrasound. We found that the mixed successes may be attributed to the wide variety of achievable parameters within each broader treatment type and the lack of standardization in measurements and reporting. Despite mixed outcomes, all three therapies show potential as an alternative therapy with lower-risk adverse effects than more invasive methods like surgery. There is currently insufficient evidence to conclude which ultrasound modality or settings are most effective. More research is needed to understand the healing effects of these different therapeutic ultrasound and shockwave modalities.
在美国，肌腱损伤很常见且代价高昂，占 6600 万肌肉骨骼损伤的 45%，每年花费 1140 亿美元。由于剂量和监测不一致，手术和治疗方法，如关节镜手术、干针治疗和物理疗法，在重新引入腱病愈合反应方面的成功率参差不齐。超声是一种已被证明可无创地在肌腱中产生生物效应的治疗方式，这可能有助于促进愈合。然而，该方法的结果也参差不齐。本综述比较了治疗性超声和冲击波疗法的当前领域状况，包括低强度治疗性超声、体外冲击波疗法和径向冲击波疗法，并评估了超声治疗腱病的疗效。我们发现，混合成功可能归因于每种更广泛治疗类型中可实现参数的多样性，以及在测量和报告方面缺乏标准化。尽管结果参差不齐，但所有三种疗法都显示出作为替代疗法的潜力，其不良影响的风险低于手术等更具侵入性的方法。目前没有足够的证据可以得出哪种超声模式或设置最有效。需要更多的研究来了解这些不同的治疗性超声和冲击波模式的愈合效果。
