The Clinical Efficacy of Extracorporeal Shock Wave Therapy Combined With Platelet-Rich Plasma and Exercise for Lateral Epicondylitis: Prospective Randomized Sham-Controlled Ultrasonographic Study.

IF 3.6 2区 医学 Q1 REHABILITATION Archives of physical medicine and rehabilitation Pub Date : 2025-01-20 DOI:10.1016/j.apmr.2025.01.420
Ali İzzet Akçin, Nuran Eyvaz, Ümit Dündar, Hasan Toktaş, Hilal Yeşil, Selma Eroğlu, Sevda Adar
{"title":"The Clinical Efficacy of Extracorporeal Shock Wave Therapy Combined With Platelet-Rich Plasma and Exercise for Lateral Epicondylitis: Prospective Randomized Sham-Controlled Ultrasonographic Study.","authors":"Ali İzzet Akçin, Nuran Eyvaz, Ümit Dündar, Hasan Toktaş, Hilal Yeşil, Selma Eroğlu, Sevda Adar","doi":"10.1016/j.apmr.2025.01.420","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the combined effect of 2 different regenerative therapies, extracorporeal shock wave therapy (ESWT) and platelet-rich plasma (PRP), along with therapeutic exercise, in patients with lateral epicondylitis (LE).</p><p><strong>Design: </strong>Prospective, randomized, sham-controlled trial.</p><p><strong>Settings: </strong>Outpatient clinic.</p><p><strong>Participants: </strong>Ninety-one patients (N=91) with LE for >3 months were randomly allocated into 3 groups.</p><p><strong>Interventions: </strong>Participants were assigned to PRP+ESWT, Sham PRP+ESWT, or ESWT only treatment group. All groups received exercise therapy.</p><p><strong>Main outcome measures: </strong>The primary outcome was the visual analog scale (VAS) pain score. Secondary outcomes included handgrip strength, Patient-rated Tennis Elbow Evaluation (PRTEE), Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH), Short Form 36, ultrasonographic assessments (common extensor tendon [CET] measurement and total ultrasonography scale score [TUSS]), and isokinetic evaluation. Participants were evaluated 3 times: pre-treatment (T0), after 4 weeks (T1), and after 12 weeks (T2).</p><p><strong>Results: </strong>The PRP group showed superiority over other groups in terms of VAS (activity and night) scores at follow-ups. With regard to the secondary outcomes, in the short term, the PRP group demonstrated a statistically significant difference in the PRTEE-function. In the 12th week, PRP outperformed only against ESWT in all PRTEE parameters, and also showed superior Quick DASH scores to the other groups. In handgrip strength, the PRP group demonstrated superiority over the Sham PRP group at T1 and over both groups at T2. In the isokinetic evaluation, PRP group showed superiority over the Sham PRP group in both wrist flexion/extension peak torque scores during follow-ups. No significant differences were found in any of the ultrasonographic parameters, including CET thickness and TUSS scores, between the groups at the 4th and 12th week.</p><p><strong>Conclusions: </strong>The combined application of ESWT and PRP in the management of LE has demonstrated superior efficacy, as evidenced by significant improvements in clinical parameters.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.apmr.2025.01.420","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives: To evaluate the combined effect of 2 different regenerative therapies, extracorporeal shock wave therapy (ESWT) and platelet-rich plasma (PRP), along with therapeutic exercise, in patients with lateral epicondylitis (LE).

Design: Prospective, randomized, sham-controlled trial.

Settings: Outpatient clinic.

Participants: Ninety-one patients (N=91) with LE for >3 months were randomly allocated into 3 groups.

Interventions: Participants were assigned to PRP+ESWT, Sham PRP+ESWT, or ESWT only treatment group. All groups received exercise therapy.

Main outcome measures: The primary outcome was the visual analog scale (VAS) pain score. Secondary outcomes included handgrip strength, Patient-rated Tennis Elbow Evaluation (PRTEE), Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH), Short Form 36, ultrasonographic assessments (common extensor tendon [CET] measurement and total ultrasonography scale score [TUSS]), and isokinetic evaluation. Participants were evaluated 3 times: pre-treatment (T0), after 4 weeks (T1), and after 12 weeks (T2).

Results: The PRP group showed superiority over other groups in terms of VAS (activity and night) scores at follow-ups. With regard to the secondary outcomes, in the short term, the PRP group demonstrated a statistically significant difference in the PRTEE-function. In the 12th week, PRP outperformed only against ESWT in all PRTEE parameters, and also showed superior Quick DASH scores to the other groups. In handgrip strength, the PRP group demonstrated superiority over the Sham PRP group at T1 and over both groups at T2. In the isokinetic evaluation, PRP group showed superiority over the Sham PRP group in both wrist flexion/extension peak torque scores during follow-ups. No significant differences were found in any of the ultrasonographic parameters, including CET thickness and TUSS scores, between the groups at the 4th and 12th week.

Conclusions: The combined application of ESWT and PRP in the management of LE has demonstrated superior efficacy, as evidenced by significant improvements in clinical parameters.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
6.20
自引率
4.70%
发文量
495
审稿时长
38 days
期刊介绍: The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.
期刊最新文献
Cluster Analysis of Outpatient Prescription Medications Following Combat-Related Amputations: A Retrospective Study. The reporting of sex and gender in rehabilitation randomized clinical trials: a commentary. Individualized Physiotherapy and Activity Coaching in Multiple Sclerosis (IPAC-MS): Results of a Randomized Controlled Trial. Comparative Cost Analysis of Neck Pain Treatments for Medicare Beneficiaries. Corrigendum.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1