An attempt at using focused shockwave therapy to treat selected orthopedic diseases – a preliminary report

Andrzej Franek, Damian Kusz, Jacek Durmała, Piotr Król, Robert Wilk, Ewa Detko, Bartosz Wnuk, Paweł Dolibog, Edward Błaszczak, Patrycja Dolibog, Lidia Wiercigroch, Jakub Taradaj

Andrzej Franek, Damian Kusz, Jacek Durmała, Piotr Król, Robert Wilk, Ewa Detko, Bartosz Wnuk, Paweł Dolibog, Edward Błaszczak, Patrycja Dolibog, Lidia Wiercigroch, Jakub Taradaj – An attempt at using focused shockwave therapy to treat selected orthopedic diseases – a preliminary report. Fizjoterapia Polska 2012; 12(2); 147-158

Abstract
Background. Focused shockwaves have been successfully used in orthopaedics and physiotherapy for over twenty years. The aim of this study was to evaluate the usefulness of focused shockwaves in treating patients with osteonecrosis of the femoral head (OFH), as well as their effectiveness as a therapy for tennis elbow and symptomatic heel spurs.Material and methods. The study has covered to date 6 patients with osteonecrosis of the femoral head (OFH) (stages I, II and III on the ARCO scale), 10 patients with tennis elbow (TE) and 6 patients with symptomatic heel spurs (HS). The patients were treated using focused shockwaves.Results. After treatment ended, pain intensity was noted to be statistically significantly lower in all groups of patients. In the OFH patients functional improvement could also be observed, as well as increased strength of wrist flexors and extensors and of finger flexors in the TE patients. The OFH and HS patients obtained better results in tests carried out on the tensometric platform. Conclusion. Focused shockwave is an effective and safe physical modality for treating early stages of osteonecrosis of the femoral head, tennis elbow and symptomatic calcaneal spurs; its main advantage is good analgesic effect right after treatment. However, the delayed effects of the therapy need to be investigated to confirm its effectiveness.
Key words:
focused shockwave, necrosis of the femoral head, tennis elbow, calcaneal spurz
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Evaluation of the effect of ultrasound therapy on pressure ulcer healing

Anna Polak, Marzena Dzikiewicz, Jakub Taradaj, Cezary Kucio, Agnieszka Nawrat-Szołtysik, Lidia Wiercigroch, Piotr Król

Anna Polak, Marzena Dzikiewicz, Jakub Taradaj, Cezary Kucio, Agnieszka Nawrat-Szołtysik, Lidia Wiercigroch, Piotr Król – Evaluation of the effect of ultrasound therapy on pressure ulcer healing. Fizjoterapia Polska 2012; 12(4); 363-378

Abstract
As well as being a long process, the treatment of pressure ulcers involves the application of different therapeutic methods. In treating soft tissue defects, including pressure ulcers, physical modalities are increasingly used.The experiment involved 24 patients (16 women and 8 men) with chronic stage II-IV pressure ulcers, who were distributed between two comparative groups, A and B. Group A consisted of 12 subjects (8 women and 4 men) whose mean age was 75.27 years (±19.24). The mean wound surface area in the group was 4.71 (±3,42 cm2). Group B (control) contained 12 subjects (8 women and 4 men) whose mean age was 77.21 (±10.32) years. The mean wound surface area in group B was 4.51 (±3,73 cm2). In addition to standard treatment for pressure ulcers that both groups received, group A patients were additionally administered ultrasound therapy (1 MHz; 0.5 W/cm2; 20%; 1 min/cm2). Healing processes were observed in both groups for 6 weeks. The wound surface area, diameter and linear measurements were found to decrease statistically significantly. Treatment results in the ultrasound group were somewhat better, but healing rates derived from changes in pressure ulcer surface areas, lengths, widths and diameters did not show the groups to be statistically significantly different (respectively 85.23% (±10.23), 78.21% (±18.16), 74.78% (±22.88), 80.23% (±7.88) in group A and 84.11% (±8.45), 74.98% (±13.12), 73.54% (±21.66), 79.01% (±8.11) in group B).Ultrasound therapy does not make pressure ulcers heal significantly faster, nor does it significantly reduce their surface areas, diameters and linear measurements.
Key words:
focused shockwave, radial shockwave, calcaneal spur
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Focused and radial shockwave therapies in the treatment of symptomatic calcaneal spur

Piotr Król, Andrzej Franek, Paweł Dolibog, Jacek Durmała, Ewa Detko, Bartosz Wnuk, Krzysztof Ficek, Edward Błaszczak, Tomasz Król, Patrycja Dolibog, Lidia Wiercigroch, Jakub Taradaj, Magdalena Piecha, Grzegorz Sobota

Piotr Król, Andrzej Franek, Paweł Dolibog, Jacek Durmała, Ewa Detko, Bartosz Wnuk, Krzysztof Ficek, Edward Błaszczak, Tomasz Król, Patrycja Dolibog, Lidia Wiercigroch, Jakub Taradaj, Magdalena Piecha, Grzegorz Sobota – Focused and radial shockwave therapies in the treatment of symptomatic calcaneal spur. Fizjoterapia Polska 2012; 12(4); 341-354

Abstract
Pain experienced in the plantar part of the heel is the most common cause of its dysfunction in adults. In many cases the underlying reason is a calcaneal spur. This study aimed to assess and compare focused and radial shockwave therapies in terms of their efficacy in treating a symptomatic calcaneal spur. Twenty patients with a symptomatic calcaneal spur were enrolled in the experiment. The pa­tients were divided into 2 comparative groups A and B (each consisting of 10 patients) that received focused shockwave and radial shockwave therapies, respectively. Each patient was given 5 treatments at weekly intervals. Immediately after treatment ended a statistically significant reduction in all types of pain considered in the experiment was noted in both comparative groups. A further reduction in pain was observed after another three weeks. The comparative groups were similar in terms of relative changes in all types of pain. Additionally, focused shockwave therapy was found to have significantly affected patients’ stabilographic parameters. Both focused shockwave therapy and radial shockwave therapy are physical modalities that can be safely and effectively used to treat a symptomatic calcaneal spur. Their main advantage is good analgesic effect directly after treatment. This effect is even more distinct after another 3 weeks.
Key words:
focused shockwave, radial shockwave, calcaneal spur
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