A PROSPECTIVE, COMPARATIVE, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY ON THE EFFICACY OF RADIAL SHOCKWAVES IN THE TREATMENT OF MYOFASCIAL PAIN SYNDROME OF THE LUMBAR/GLUTEAL REGIONS
Notice bibliographique
Résumé
BACKGROUND: Extracorporeal shockwave therapy (ESWT) has been used successfully in different musculoskeletal conditions, including pseudarthrosis and tendinopathies. However no randomized controlled trial are available about its use for chronic low back pain with myofascial pain syndrome (MPS). AIMS: The aim of the study was to evaluate the efficacy of radial ESWT (r - ESWT) in the treatment of MPS in the lumbar and gluteal regions. METHODS: The study was prospective, randomized, double-blind and placebo controlled. A total of 121 patients were enrolled and 46 patients were considered eligible based on inclusion and exclusion criteria (chronic low back pain, MPS lasting more than six months, DN4 < 4, VAS u2265 4). In the first phase, all patients were treated with a standard multidisciplinary protocol for six weeks (tricyclic antidepressant associated with physical therapy). After this phase, patients were reassessed with previously used questionnaires, 31 patients had VAS u2265 4 and moved to the r - ESWT phase. In the 2nd phase, they were randomized into 2 groups: active (n = 14) and control (n = 17). The patients underwent six ESWT sessions with an interval of one week between them. The parameters used in the radial shockwave device were: pulses = 1000 per trigger point or 2500 per muscle; frequency = 5 to 7 hertz; pressure = 3 bar (1st and 2nd sessions), 3.5 bar (3rd and 4th sessions), 4 bar (5th and 6th sessions). Evaluations were made after the first phase of conservative treatment and after ESWT (1.5, 3, 6 and 12 months). Pain intensity and functional disability were assessed using the VAS, Roland Morris Disability Questionnaire (RDQ), Oswestry Disability Index (ODI), Short-form McGill Pain Questionnaire (SF-MPQ). Trigger points were documented through thermography. RESULTS: Baseline characteristics of age, gender, VAS, RDQ, ODI, SF-MPQ were similar between groups. However, the duration of low back pain was significantly longer in the active r - ESWT group (p < 0.05).Three, six and 12 months after r - ESWT, the percentage of patients who had greater than 50% improvement in VAS in the active group was significantly higher than in the control group (Fig. 2). At the 12nd months of follow-up, the active group had significantly improvement in the functional disability of low back pain according to ODI (Fig. 3). CONCLUSIONS: The r - ESWT provided a significant and lasting reduction in pain intensity from the third until 12th month of follow up, finding that suggests that its analgesic effect settles late and has long duration. Additionally, r - ESWT pro-vided improvement of the functionality according to the ODI at the 12th month follow up.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,006 | 0,002 |
| Bibliométrie | 0,013 | 0,015 |
| Études des sciences et des technologies | 0,001 | 0,007 |
| Communication savante | 0,002 | 0,003 |
| Science ouverte | 0,015 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».