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1.
Radiol Clin North Am ; 57(5): 1073-1082, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31351537

RESUMO

Ultrasound has been reported to be a quick, cheap, and effective imaging modality to guide the interventional procedures in the musculoskeletal system. The use of ultrasound results in increased accuracy of needle placement associated with a reduction of complications. In the upper limb, ultrasound-guided procedures are applied to joints and soft tissues around the shoulder, elbow, wrist, and hand. This article reviews the clinical and technical aspects of the most common procedures performed in this anatomic area.


Assuntos
Tendinopatia/diagnóstico por imagem , Tendinopatia/terapia , Ultrassonografia de Intervenção/métodos , Extremidade Superior/diagnóstico por imagem , Humanos , Extremidade Superior/lesões
3.
Zhongguo Gu Shang ; 32(6): 504-507, 2019 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-31277531

RESUMO

OBJECTIVE: To explore the method and effect of ultrasound-guided suprascapular nerve block combined with acupuncture in the treatment of calcified tendinitis of rotator cuff. METHODS: From January 2015 to December 2017, total 30 patients with calcified tendinitis, including 23 cases of supraspinatus tendon, 5 cases of infraspinatus tendon and 2 cases of subscapular tendon, were treated with ultrasound-guided suprascapular nerve block combined with acupuncture. There were 7 males and 23 females, ranging in age from 36 to 71 years old, with an average of 51.6 years old. There were 17 cases on the right and 13 cases on the left. VAS pain score, Constant-murley score, UCLA score and X-ray examination were used to evaluate the clinical results before and after surgery. RESULTS: The mean follow-up was 14.3 months (6 to 30 months). The preoperative VAS score was 3.82±1.13, Constant-Murley score was 36.91±7.95 and UCLA score was 11.35±2.17. The final follow-up scores were 1.32±1.06, 90.61±2.89 and 33.22±1.51, respectively. The final follow-up scores were improved significantly(P<0.05). CONCLUSIONS: Conservative treatment of calcified rotator cuff tendinitis is ineffective. Suprascapular nerve block guided by ultrasound combined with acupuncture has a good therapeutic effect. It is a minimally invasive, economic, safe and effective method, which is worth promoting.


Assuntos
Terapia por Acupuntura , Bloqueio Nervoso , Lesões do Manguito Rotador , Tendinopatia , Adulto , Idoso , Artroscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Manguito Rotador , Tendinopatia/terapia , Resultado do Tratamento
4.
Bone Joint J ; 101-B(6_Supple_B): 116-122, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31146555

RESUMO

AIMS: The aims of this study were to assess the exposure and preservation of the abductor mechanism during primary total hip arthroplasty (THA) using the posterior approach, and to evaluate gluteus maximus transfer to restore abductor function of chronically avulsed gluteus medius and minimus. PATIENTS AND METHODS: A total of 519 patients (525 hips) underwent primary THA using the posterior approach, between 2009 and 2013. The patients were reviewed preoperatively and at two and five years postoperatively. Three patients had mild acute laceration of the gluteus medius caused by retraction. A total of 54 patients had mild chronic damage to the tendon (not caused by exposure), which was repaired with sutures through drill holes in the greater trochanter. A total of 41 patients had severe damage with major avulsion of the gluteus medius and minimus muscles, which was repaired with sutures through bone and a gluteus maximus flap transfer to the greater trochanter. RESULTS: Abductor strength was maintained in the normal hips, but lateral hip pain progressed significantly, five years postoperatively (p < 0.0001). In the 54 patients with mild abductor tendon damage treated with simple repair, lateral hip pain also increased significantly during follow-up (p = 0.002). In the 35 patients with severe avulsion but good muscle repaired using a gluteus maximus flap transfer, abductor function was restored. The six patients with complete avulsion and poor muscle did not regain strong abductor power, but lateral hip pain decreased. CONCLUSION: The posterior approach offered excellent exposure and preservation of the abductor mechanism during primary THA. Augmentation of the repair with a gluteus maximus flap provided stable reconstruction of the abductor muscles and seemed to restore function in the hips with functioning muscles. Cite this article: Bone Joint J 2019;101-B(6 Supple B):116-122.


Assuntos
Artroplastia de Quadril/efeitos adversos , Tendinopatia/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia de Quadril/métodos , Feminino , Humanos , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Músculo Esquelético/lesões , Músculo Esquelético/fisiopatologia , Complicações Pós-Operatórias/etiologia , Técnicas de Sutura , Tendinopatia/fisiopatologia , Traumatismos dos Tendões/etiologia , Traumatismos dos Tendões/fisiopatologia
5.
Cuad. Hosp. Clín ; 60(1): 11-16, jun. 2019. ilus.
Artigo em Espanhol | LILACS, LIBOCS | ID: biblio-1006566

RESUMO

INTRODUCCIÓN: una gran parte de la población adulta padece dolor de hombro en algún momento de su vida. Dejando aparte las enfermedades neoplásicas, sistémicas y traumáticas directas, una de las causas de dolor de hombro es la patología inflamatoria o degenerativa del manguito rotador, que puede ser responsable de una limitación funcional importante adulto. OBJETIVO: determinar el grado de correlación clínica y ultrasonográfica con los hallazgos intra-operatorios en pacientes con diagnóstico de ruptura de manguito rotador en el servicio de Traumatología del Hospital Obrero Nº 1, durante el periodo 2010 ­ 2014. MATERIAL Y MÉTODOS: estudio descriptivo transversal y analítico. Se estudiaron 56 pacientes de ambos sexos, internados en el servicio de Traumatología y Ortopedia del Hospital Obrero Nº1, durante el periodo del 1° de enero del 2010 al 31 de diciembre del año 2014. Se realizó la valoración clínica (maniobra de Jobe y manobra de Yocum) y ultrasonográfica y se compararon los resultados con los hallazgos intra-operatorios, para determinar la validez y la seguridad de la clínica y la ecografía. RESULTADOS: se determina que el test diagnóstico clínico tiene mayor validez (Sensibilidad: 92,7-87,8% y Especificidad: 73,3-60%) y seguridad (Valor Predictivo Positivo: 90,5-85,7% y Valor Predictivo Negativo: 78,6-64,3%) que el test diagnóstico ultrasonográfico (Sensibilidad: 85,4%, Especificidad: 66,7%, Valor Predictivo Positivo: 87,5% y Valor Predictivo Negativo: 62,5%). CONCLUSIÓN: se determina que existe una correlación clínica y ultrasonográfica con los hallazgos intra-operatorios en pacientes con diagnóstico de ruptura de manguito rotador en el servicio de Traumatología del Hospital Obrero Nº 1


INTRODUCTION: a great part of the adult population suffers shoulder pain at some moment of life. Leaving aside direct neoplastic systems and traumatic diseases, one of the causes of pain of shoulder is the inflammatory or degenerative pathology of the muff rotator, which can result in an important functional limitation. OBJECTIVE: determining the degree of clinical and ultrasonographic correlation with the intra-operative findings in patients with yielding-point diagnosis of muff rotator in the service of Traumatology of the Hospital Obrero Nº 1, during the period 2010 ­ 2014. MATERIAL AND METHODS: cross-sectional descriptive and analytical study. 56 patients of both sexes were surveyed, inpatients in the service of Traumatology y Orthopedic of the Hospital Obrero Nº 1, during the period January 1 of 2010 to December 31 of 2014. The clinical assessment was carried out (maneuver of Jobe and maneuver of Yocum) and ultrasonographic and the results were compared with the intra operative findings, in order to determine the value and security of the clinic and the echography. RESULTS: it is determined that the diagnostic test has higher validity (Sensitivity: 92,7-87,8% and specificity: 73,3-60%) and certainty (Positive Predictive Value: 90,5-85,7% and Negative Predictive Value: 78,6-64,3%) than the diagnostic ultrasonographic test (Sensitivity: 85.4%, Specificity: 66.7%, Positive Predictive Value: 87.5% and Negative Predictive Value: 62.5%). CONCLUSIONS: it is determined that there is a clinical and ultrasonographic correlation with the intra operative findings in patients with yielding-point diagnosis of muff rotator at the service of Traumatology of the Hospital Obrero Nº 1


Assuntos
Humanos , Animais , Masculino , Ultrassonografia/instrumentação , Manguito Rotador/diagnóstico por imagem , Traumatologia/métodos , Tendinopatia
6.
Harefuah ; 158(6): 395-397, 2019 Jun.
Artigo em Hebraico | MEDLINE | ID: mdl-31215193

RESUMO

INTRODUCTION: Platelet rich plasma (PRP) intra-articular injections are gaining popularity worldwide. Albeit its vast application, its efficacy has not been proven unequivocally. This position statement was conducted for the Israeli Shoulder and Elbow Society and is intended to guide practitioners on treatment with PRP injections. Platelets secrete growth factors as part of their function which stimulates angiogenesis, cellular proliferation and tissue repair. Four main PRP subtypes exist: activated, non-activated, leucocyte-rich and leukocyte-poor. The function of leukocytes in PRP is not yet clearly understood and may locally cause harm. There are 3 main pathologies involving the shoulder and elbow in which PRP is being used: rotator cuff tendinopathy, rotator cuff tears and epicondylitis. Contraindications to PRP injection are infection, systemic disease presenting at the injection site, bone marrow pathology, thrombocytopenia, systemic steroids use and anticoagulant therapy. Most studies that explored the efficacy of PRP for rotator cuff tendinopathy failed to demonstrate any clinical benefit when compared to other non-operative treatments. Research shows that PRP injection improves rotator cuff tear healing when used as an augmentation to surgical repair, irrespective of tear size. Furthermore, high quality studies reported less pain in the early postoperative period with PRP augmentation in rotator cuff repair surgery but no significant changes to post-operative shoulder function. Larger studies were conducted on PRP injection to various joints which reported no side effects and approved its safety.


Assuntos
Plasma Rico em Plaquetas , Lesões do Manguito Rotador , Tendinopatia , Artroplastia , Artroscopia , Humanos , Manguito Rotador , Lesões do Manguito Rotador/terapia , Resultado do Tratamento
7.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46490

RESUMO

Lesão ou inflamação das estruturas que estão em volta das articulações, resultando em bursites, tendinites, entesites e dor miofascial.


Assuntos
Doenças Reumáticas , Reumatologia , Bursite , Tendinopatia , Dor Facial
8.
Managua; s.n; maio 2019. 59 p. ilus, tab, graf.
Tese em Espanhol | LILACS | ID: biblio-1015449

RESUMO

OBJETIVO: Caracterizar al personal con tendinopatía del Manguito Rotador de industrias cárnicas de Juigalpa y Nandaime atendido en la Clínica de Medicina Laboral "Oscar Benavides Lanuza", Enero 2014 - Diciembre 2016. METODOLOGÍA: Estudio descriptivo, corte transversal, constituido por una muestra de 48 personas, se obtuvo del registro de los expedientes médicos suministrados por la oficina de Archivo. La recolección de la información se realizó a partir del llenado de ficha elaborada por el autor, se recolectó datos según los objetivos, para el procesamiento de la información se empleó programa estadístico SPSS versión 21, se hizo gráficos en Excel, el texto en Microsoft Word y la presentación en Power Point. RESULTADOS: El personal con tendinopatía del Manguito Rotador fue más numeroso en mayores de 41 años con 21 casos (44%), con predominio en hombres 45 casos (94%), cumpliendo una jornada laboral de 8 horas 26 casos (54%), con más de 16 años de laborar en la empresa 20 casos, (42%), no se realiza rotación de puesto de trabajo 38 casos, (79%), el personal afectado labora en ambiente térmico que oscila entre 10 ­ 28 grados centígrados. CONCLUSIONES: Las características más frecuentes en el personal estudiado fueron lesión bilateral de hombros, mayoría son hombres, no hacen rotación de puesto de trabajo, usan herramientas cortantes, laboran 8 horas o más la mayoría tuvo manejo medico conservador y la mayoría tiene una pensión parcial otorgada por la Comisión Médica de Invalidez (CMI)


Assuntos
Humanos , Indústria da Carne , Saúde do Trabalhador , Manguito Rotador , Tendinopatia , Doenças Profissionais , Epidemiologia Descritiva , Estudos Transversais , Saúde do Trabalhador
10.
Clin Plast Surg ; 46(3): 317-327, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31103076

RESUMO

Tendinopathy and tendinitis are some of the most frequently encountered disorders in hand and upper extremity surgery. Patients often present with progressively increasing pain over a subacute or chronic period. In most cases it is a clinical diagnosis, with confirmation via advanced imaging. First-line treatment consists of conservative measures such as activity modification, splints, and injections. After a 3- to 6-month trial of nonoperative treatment, surgery usually involves decompression of the involved tendons and debridement of any inflammatory tissue. Patient and anatomic factors can affect the outcomes of both nonoperative and operative treatments.


Assuntos
Procedimentos Ortopédicos/métodos , Tendinopatia/terapia , Antebraço/cirurgia , Mãos/cirurgia , Humanos , Contenções , Tendinopatia/cirurgia , Punho/cirurgia
12.
Sensors (Basel) ; 19(9)2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31052554

RESUMO

PURPOSE: The goal of the present study was to assess, by ultrasound imaging (USI), the thickness of the plantar fascia (PF) at the insertion of the calcaneus, mid and forefoot fascial locations, and the calcaneal fat pad (CFP) in patients with Achilles tendinopathy (AT). METHODS: An observational case-control study. A total sample of 143 individuals from 18 to 55 years was evaluated by USI in the study. The sample was divided into two groups: A group composed of the chronic non-insertional AT (n = 71) and B group comprised by healthy subjects (n = 72). The PF thicknesses at insertion on the calcaneus, midfoot, rearfoot and CFP were evaluated by USI. RESULTS: the CFP and PF at the calcaneus thickness showed statistically significant differences (P < 0.01) with a decrease for the tendinopathy group with respect to the control group. For the PF midfoot and forefoot thickness, no significant differences (P > 0.05) were observed between groups. CONCLUSION: The thickness of the PF at the insertion and the CPF is reduced in patients with AT measured by USI.


Assuntos
Tendão do Calcâneo/diagnóstico por imagem , Placa Plantar/diagnóstico por imagem , Tendinopatia/diagnóstico , Ultrassonografia , Tendão do Calcâneo/fisiopatologia , Adolescente , Adulto , Fáscia/diagnóstico por imagem , Fáscia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Placa Plantar/patologia , Tendinopatia/diagnóstico por imagem , Tendinopatia/fisiopatologia , Adulto Jovem
13.
Georgian Med News ; (288): 15-20, 2019 Mar.
Artigo em Russo | MEDLINE | ID: mdl-31101768

RESUMO

Aim of investigation - the assessment of opportunities of ultrasound (US) imaging for visualization of the shoulder joint pathological changes. 100 patients with the pathologies of shoulder joint have been investigated, they included traumatic, degenerative -dystrophic and inflammatory pathologies (tendinitis, tendinosis, tendinopathy, subacromial-subdelatoid bursitis).Ultrasound study performed on ultrasound TOSHIBA xario XG by high linear probe (7,5-12.0 MHz) with dopplerography(color, energetic), transverse and sagittal planes. It has been evaluated the thickness(diffuse, local), echostructure, continuity of contours of main shoulder joint tendons in above mentioned pathologies, in order to study their diagnostic values. 23 patients have been investigated by MRI which was used as "gold standard". The thickness, structure and continuity of contours of tendons have been evaluated by MRI in following regimes: T1, T2 and PDFs. In the study group the comparative results of ultrasound and MRI research were compared to determine the high diagnostic reliability of US, which is important for timely and effective treatment. The evaluation of US diagnostic accuracy for tendon thickness showed that the sensitivity was 95.00%, specificity - 66.67%, and diagnostic accuracy - 91.30%. It should be noted that negative likelihood ratio (NLR) is significant and equals to 0.08 (95% CI - 0.01÷0.60). The assessment of US diagnostic accuracy for tendon echostructure showed that the sensitivity was 94.74%, specificity - 50.00%, and diagnostic accuracy - 86.96%. It should be noted that negative likelihood ratio (NLR) is significant and equals to 0.11 (95% CI - 0.01÷0.60). The sensitivity of the evaluation of continuity of contours by US was 95.00%, specificity - 66.67%, diagnostic accuracy - 91.30%. It should be noted that negative likelihood ratio (NLR) is significant and equals to 0.08 (95% CI - 0.01÷0.60). On the basis of obtained results we can conclude that US may be characterized by high sensitivity, moderate specificity and high diagnostic accuracy for diagnostics of shoulder joint pathologies. It should be noted that mainly NLR is significant features for this imaging technique. US can be used in primary outpatient diagnostics, MRI and MR-arthrography should be performed in the hospital, to reveal the accompanying anomalies when planning surgical and/or other interventions.


Assuntos
Articulação do Ombro , Tendinopatia , Artrografia , Humanos , Imagem por Ressonância Magnética , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Articulação do Ombro/diagnóstico por imagem , Tendinopatia/diagnóstico por imagem , Ultrassonografia
14.
Medicine (Baltimore) ; 98(16): e15278, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31008973

RESUMO

BACKGROUND: Platelet-rich plasma (PRP) is used as an alternative therapy to reduce pain and improve functional restoration in patients with Achilles tendinopathy (AT). We evaluated the current evidence for the efficacy of PRP as a treatment for chronic AT. METHODS: The PubMed, Embase, Web of Science, and The Cochrane Library databases were searched for articles on randomized controlled trials (RCTs) that compared the efficacy of PRP with that of with placebo injections plus eccentric training as treatment for AT. The articles were uploaded over the establishment of the databases to May 01, 2018. The Cochrane risk of bias (ROB) tool was used to assess methodological quality. Outcome measurements included the Victorian Institute of Sports Assessment-Achilles (VISA-A), visual analog scale (VAS) and Achilles tendon thickness. Statistical analysis was performed with RevMan 5.3.5 software. RESULTS: Five RCTs (n = 189) were included in this meta-analysis. Significant differences in the VISA-A were not observed between the PRP and placebo groups after 12 weeks [standardized mean difference (SMD) = 0.2, 95% confidence interval (95% CI): 0.36 to 0.76, I = 71%], 24 weeks (SMD = 0.77, 95% CI: -0.10-1.65, I = 85%) and 1 year (SMD = 0.83, 95% CI: -0.76-2.42, I = 72%) of treatment. However, PRP exhibited better efficacy than the placebo treatment after 6 weeks (SMD = 0.46, 95% CI: 0.15-0.77, I = 34%). Two studies included VAS scores and tendon thickness. VAS scores after 6 weeks (SMD = 1.35, 95% CI: -0.1.04-3.74, I = 93%) and 24 weeks (SMD = 1.48, 95% CI: -0.1.59-4.55, I = 95%) were not significantly different. However, VAS scores at the 12th week (SMD = 1.10, 95% CI: 0.53-1.68, I = 83%) and tendon thickness (SMD = 1.51, 95% CI: 0.39-2.63, I = 53%) were significantly different. CONCLUSION: PRP injection around the Achilles tendon is an option for the treatment of chronic AT. Limited evidence supports the conclusion that PRP is not superior to placebo treatment. These results still require verification by a large number of well designed, heterogeneous RCT studies.


Assuntos
Tendão do Calcâneo , Plasma Rico em Plaquetas , Tendinopatia/terapia , Doença Crônica , Humanos , Injeções
15.
Zhongguo Gu Shang ; 32(4): 377-382, 2019 Apr 25.
Artigo em Chinês | MEDLINE | ID: mdl-31027418

RESUMO

As a common soft tissue disease, the mechanism of tendinopathy has not been clarified and is lack of effective treatment method. Change of tissue fibrosis is the one of the main pathological features. Transforming growth factor beta 1 (TGF-ß1), which is one of the important factor, participated in fibrosis. Inconsonant expressions of TGF-ß1 could be found in tendinopathy. The studies are still controversial, but the vast majority of studies had showed that TGF-ß1 was abnormal, and it is given priority to increase, which means that TGF-ß1 plays an important role in the process of tendinopathy. In the process of tendon injuries and repairs, the time of TGF-ß1 increasing is inconsistent. The time for TGF-ß1 plays a significant role has not been determined. TGF-ß1 has abnormal expressions in both tendinopathy and tendon repairs, which are two opposite processes. Thus, it may not be a one-way adjustment factor, but has a pleiotropic. Recent studies showed that TGF-ß1 was considered as binding to receptor and transferring signal into the cell. Now there are three different receptors are found. The classical pathway of TGF-ß1 in intracellular signal transduction is mainly through activation of Smad pathway. In the same time, there are also some non-classical pathways. TGF-ß1 could break balance of extracellular matrix, which may be a reason to cause tendinopathy. But the regulations of TGF-ß1 on the extracellular matrix are complex and diverse, further studies are required. Existing researches showed that the performance of treatments on tendinopathy is unsatisfied by blocking TGF-ß1 downstream pathway. Therefore, it is a good way to study the upstream mechanism of produce TGF-ß1. It may be an effective method to find new targets to inhibit the development of tendinopathy better by finding the original source of TGF-ß1.


Assuntos
Tendinopatia , Fibrose , Humanos , Transdução de Sinais , Fator de Crescimento Transformador beta1
16.
J Sports Med Phys Fitness ; 59(5): 839-845, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30936418

RESUMO

Plantaris muscle (lat. musculus plantaris) is a fusiform muscle of the superficial posterior leg compartment, characterized with a small muscle belly and very long and slender tendon. Many anatomical variations of plantaris muscle have been reported previously, including its inconstancy. Evolutional studies strongly suggest that plantaris muscle is a rudimentary muscle that plays minor role in gait biomechanics. However, plantaris muscle seems to have very important proprioceptive role since it has very high density of muscle spindles. Clinically, plantaris muscle is involved in differential diagnosis of posterior leg pain and several pathological entities such as: plantaris muscle rupture, non-insertional Achilles tendinopathy and popliteal artery compression syndrome. Different surgical specialties have recognized plantaris muscle tendon as a valuable graft. However, literature on plantaris muscle tendon biomechanical properties is rather scant and inconsistent with several limitations for proper data comparison and interpretation. Further comparative studies are needed to properly define biomechanical properties of plantaris muscle tendon grafts for various ligament and tendon reconstructive procedures.


Assuntos
Tendão do Calcâneo/transplante , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/fisiologia , Fenômenos Biomecânicos , Diagnóstico Diferencial , Humanos , Músculo Esquelético/lesões , Propriocepção , Ruptura , Tendinopatia
17.
J Foot Ankle Res ; 12: 20, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30949243

RESUMO

Background: Mid-portion Achilles tendinopathy is a common musculoskeletal condition characterised by degeneration of the Achilles tendon, which causes pain and disability. Multiple non-surgical treatments have been advocated for this condition including calf muscle eccentric exercise and in-shoe heel lifts. Although adherence is challenging, there is evidence to suggest that calf muscle eccentric exercise is effective in decreasing pain and improving function in people with Achilles tendinopathy. Heel lifts reduce ankle joint dorsiflexion and Achilles tendon strain, however their efficacy in the management of Achilles tendinopathy is unclear. This article describes the design of a parallel-group randomised trial comparing the efficacy of heel lifts to calf muscle eccentric exercise for Achilles tendinopathy. Methods: Ninety-two participants with Achilles tendinopathy will be randomised to one of two groups: (i) a heel lift group that will receive pre-fabricated 12 mm in-shoe heel lifts (Clearly Adjustable®), or (ii) an exercise group that will be advised to carry out a calf muscle eccentric exercise program (twice a day, 7 days a week, for 12 weeks). Outcome measures will be obtained at baseline, 2, 6 and 12 weeks; the primary endpoint for assessing efficacy being 12 weeks. The primary outcome measure will be the total score of the Victorian Institute of Sport Assessment - Achilles (VISA-A) questionnaire. Secondary outcome measures will include thickness and integrity of the Achilles tendon (using ultrasound tissue characterisation [UTC]), participant perception of treatment effect on pain and function (using the 7-point Patient Global Impression of Change scale), severity of pain at the Achilles tendon (using a 100 mm visual analogue scale) in the previous week, health status (using the EuroQol-5D-5L™ questionnaire), physical activity levels (using the 7-day Recall Physical Activity Questionnaire) and calf muscle function (using the standing heel rise test). Data will be analysed using the intention to treat principle. Discussion: The HEALTHY trial (Heel lifts versus calf muscle eccentric Exercise for AchiLles TendinopatHY) is the first randomised trial to compare the efficacy of heel lifts to calf muscle eccentric exercise in reducing pain and improving function in people with Achilles tendinopathy. A pragmatically designed trial was developed to ensure that if the interventions are found to be effective, the findings can be readily implemented in clinical practice. Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12617001225303. Registered on August 22nd, 2017.


Assuntos
Tendão do Calcâneo/fisiopatologia , Terapia por Exercício/métodos , Calcanhar/fisiopatologia , Músculo Esquelético/fisiopatologia , Tendinopatia/reabilitação , Interpretação Estatística de Dados , Terapia por Exercício/efeitos adversos , Humanos , Cooperação do Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Projetos de Pesquisa , Tendinopatia/fisiopatologia , Resultado do Tratamento
18.
Biomed Res Int ; 2019: 2958251, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31001553

RESUMO

Background: Extracorporeal shock wave therapy (ESWT) had been proved to be beneficial in calcific tendinosis; however, the treatment efficacy in noncalcific tendinosis of rotator cuff still remains controversial. The present study was to compare the outcomes ESWT among the noncalcific rotator cuff tendinosis and different types of calcific tendinosis on the basis of similar shoulder functional status. Methods: A retrospective, comparative study was conducted with the enrollment of 20 patients in each group through propensity score matching in a 1:1:1 ratio from 291 patients who underwent single ESWT for painful shoulder tendinosis. The patients were divided into three groups which included noncalcified tendinosis (NCTS), type I dense calcified tendinosis of shoulder (DCTS), and type II and type III translucent calcified tendinosis of shoulder (TCTS) according to Gartner and Heyer classification. The clinical evaluation included the subjective pain score with visual analog scale (VAS) and functional outcome with Constant and Murley score (CMS). Results: Twelve months after ESWT, the VAS in TCTS (1.5 ± 2.48) was statistically significant lower than NCTS (2.9 ± 2.86) and DCTS (3.8 ± 2.46) (p=.011). For the functional outcome, the overall CMS was superior in TCTS than the NCTS and DCTS (86.9 ± 19.7 versus 78.7 ± 18.3 and 71.1 ± 17.8, p=.014). Besides, the subscales of pain score, strength, and range of motion in TCTS improved significantly better than NCTS and DCTS. 70% of patients were complaint-free in TCTS group, which was higher than the NCTS group (15%) and DCTS group (25%) (p<0.05). Conclusion: The present study indicated that the high-dose ESWT posed superior clinical efficacy in type II/III calcification tendinosis rather than type I calcification and noncalcific shoulder tendinosis.


Assuntos
Tratamento por Ondas de Choque Extracorpóreas , Ombro , Tendinopatia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Amplitude de Movimento Articular , Estudos Retrospectivos , Manguito Rotador/patologia , Manguito Rotador/fisiopatologia , Ombro/patologia , Ombro/fisiopatologia , Tendinopatia/patologia , Tendinopatia/fisiopatologia , Tendinopatia/terapia , Resultado do Tratamento
19.
Agri ; 31(2): 107-110, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30995330

RESUMO

Rotator cuff calcific tendinitis is a common shoulder disorder that usually subsides spontaneously. Some patients, however, do not show any improvement in the pain after conservative treatment for an extended period of time. The aim of this report was to demonstrate the improvement in a patient with calcific tendinitis of infraspinatus following treatment with platelet-rich plasma (PRP). Although the efficacy of PRP therapy in this condition is uncertain, it can be an effective treatment option in refractory cases.


Assuntos
Osteoartrite/tratamento farmacológico , Plasma Rico em Plaquetas , Manguito Rotador , Dor de Ombro/tratamento farmacológico , Tendinopatia/tratamento farmacológico , Feminino , Humanos , Injeções Intra-Articulares , Pessoa de Meia-Idade , Medição da Dor
20.
Pain Res Manag ; 2019: 2823401, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30863472

RESUMO

Objective: To compare the safety and efficacy of 2 transcutaneous stimulation techniques, transcutaneous pulsed radiofrequency (TPRF) versus transcutaneous electrical nerve stimulation (TENS), in chronic shoulder tendonitis. Design: A prospective, randomized, and double-blind clinical trial. Setting: Academic pain service of a city hospital. Subjects: Fifty patients with sonography-confirmed shoulder tendonitis. Methods: Fifty patients were randomly allocated into two groups for electrical stimulation treatment with 3-month follow-ups: Group 1 (n=25), TENS and Group 2 (n=25), TPRF. Both groups underwent either treatment for 15 minutes every other day, three times total. Our primary goals were to find any treatment comfort level, adverse event, and changes in Constant-Murley shoulder (CMS) scores. The secondary goals were finding the changes in pain, enjoyment of life, and general activity (PEG) scores. Results: For primary goals, no adverse events were noted throughout this study. No differences were found between groups for treatment tolerability (3.20 + 0.87 vs. 2.16 + 0.75). Statistically significant lower PEG scores were noticeable with the TPRF group after the course (12.73 + 5.79 vs. 24.53 + 10.21, p=0.013). Their statistical significance lasted for 3 months although the difference gap diminished after 1 month. CMS scores were significantly higher in the TPRF group (70.84 + 6.74 vs. 59.56 + 9.49, p=0.007) right after treatment course but the significance did not last. Conclusions: In treating chronic shoulder tendinitis using two transcutaneous stimulation techniques, both TPRF and TENS are safe and effective. TPRF is superior to TENS.


Assuntos
Tratamento por Radiofrequência Pulsada/métodos , Dor de Ombro/terapia , Tendinopatia/terapia , Estimulação Elétrica Nervosa Transcutânea/métodos , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Manejo da Dor , Projetos Piloto , Estudos Prospectivos , Dor de Ombro/etiologia , Tendinopatia/complicações
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