Jarit Paddy, Klyve Dominic, Walters Rod
Department of Sport & Orthopaedic Physical Therapy, Fairfield, CT, USA.
Department of Mathematics, Central Washington University, Ellensburg, WI, USA.
Glob J Orthop Res. 2023;4(2). Epub 2023 Jan 20.
The use of long duration sonophoresis (LDS) for musculoskeletal injuries is a new and emerging treatment option for patients undergoing rehabilitation. The treatment is non-invasive, provides multi-hour mechanical stimulus expediating tissue regeneration and deep tissue heat along with local application of therapeutic compound for improved pain relief. The objective of this prospective case study was to evaluate real-world application of diclofenac LDS as an add-on intervention for patients non-responsive to physical therapy alone.
Patient who failed to respond to at least 4 weeks of physical therapy were treated with the addition of 2.5% diclofenac LDS daily for 4 weeks. The numerical rating scale, global health improvement score, functional improvement, and treatment satisfaction index were measured to assess pain reduction and quality of life improvement from treatment. Patient outcome data was organized by injury type and patient age groups, and statistically analyzed with ANOVA to assess treatment differences within and between groups. The study was registered on clinicaltrails.gov NCT05254470.
The study included (n=135) musculoskeletal injury LDS treatments with no adverse events. Patients reported a mean pain reduction from baseline of 4.44 points (p<0.0001) and a 4.85point health improvement score after 4-week of daily sonophoresis treatment. There were no age-related differences in pain reduction, and 97.8% of patients in the study reported functional improvement with the addition of LDS treatment. Significant pain relief was observed in injuries related to tendinopathy, sprain, strain, contusion, bone fracture, and post-surgical recovery.
The use of LDS significantly reduced pain and improved musculoskeletal function and quality of life for patients. Clinical findings suggest that LDS with 2.5% diclofenac is a viable therapeutic option for practitioners and should be further investigated.
对于正在接受康复治疗的患者，长时间超声透入疗法（LDS）用于肌肉骨骼损伤是一种新出现的治疗选择。该治疗是非侵入性的，能提供数小时的机械刺激以加速组织再生和深部组织加热，同时局部应用治疗性化合物以更好地缓解疼痛。本前瞻性病例研究的目的是评估双氯芬酸LDS作为单独物理治疗无反应患者的附加干预措施在实际中的应用。
对至少4周物理治疗无反应的患者，每日加用2.5%双氯芬酸LDS治疗4周。采用数字评分量表、整体健康改善评分、功能改善和治疗满意度指数来评估治疗后疼痛减轻情况和生活质量改善情况。患者结局数据按损伤类型和患者年龄组进行整理，并采用方差分析进行统计学分析，以评估组内和组间的治疗差异。该研究已在clinicaltrails.gov上注册，注册号为NCT05254470。
该研究包括135例肌肉骨骼损伤的LDS治疗，无不良事件发生。患者报告每日超声透入治疗4周后平均疼痛较基线减轻4.44分（p<0.0001），健康改善评分为4.85分。疼痛减轻方面无年龄相关差异，研究中97.8%的患者报告加用LDS治疗后功能改善。在与肌腱病、扭伤、拉伤、挫伤、骨折和术后恢复相关的损伤中观察到显著的疼痛缓解。
LDS的使用显著减轻了患者的疼痛，改善了肌肉骨骼功能和生活质量。临床研究结果表明，2.5%双氯芬酸的LDS对从业者来说是一种可行的治疗选择，应进一步研究。
