Treatment of Spasticity in Patients with Brain Damage with the Association of Focused Shock Waves and Botulinum Toxin
Abstract | Volume 2 | Issue 2 | JRS Jul – Dec 2022 | Page 26 | Antonio Déniz Cáceres, Pedro Saavedra Santana, María Isabel Marrero Arencibia, Jaime Hernández Alemán ,Almudena Hernández
DOI: 10.13107/jrs.2022.v02.i02.65
Author: Antonio Déniz Cáceres [1], Pedro Saavedra Santana [2], María Isabel Marrero Arencibia [3], Jaime Hernández Alemán [4], Almudena Hernández [4]
[1] Rehabilitation Service, Hospital Universitario de Gran Canaria Dr. Negrín, Spain.
[2] Department of Mathematics, Universidad de Las Palmas de Gran Canaria, Spain.
[3] Department of Biochemestry and Molecular Biology, Universidad de Las Palmas de Gran Canaria, Spain.
[4] Universidad de Las Palmas de Gran Canaria, Spain.
Address of Correspondence
Dr. Antonio Déniz Cáceres, MD, PhD,
Rehabilitation Service, Hospital Universitario de Gran Canaria Dr. Negrín, Spain.
E-mail: antonio.deniz@ulpgc.es
Abstract
Introduction: Spasticity is a common complication in patients with brain damage secondary to stroke and multiple sclerosis, generating
disability and reducing the quality of life. In cases of muscles spasticity, we usually use Botulinum toxin injections (BTI) associated with
physiotherapy. Extracorporeal shock wave therapy (ESWT) is a safe, effective, and non-invasive treatment in these patients. Both methods are highly effective but currently are applied separately. Scientific evidence of the combined use of both techniques is scarce. The aim of this study is to assess the results of the association of both treatments (ESWT and BTI). On spasticity in patients secondary to stroke or multiple sclerosis.
Materials and Methods: This is a prospective study, with 6-month follow-up, including 10 adult patients with stroke or multiple sclerosis. ESWT was added to the usual treatment with BTI weekly for 3 weeks. The patients received rehabilitation during the treatment period and during the follow-up period. For statistical analysis in each of the follow-up weeks, the markers analyzed (spasticity and gait speed) were summarized in medians, which were plotted as a weekly function and the paired data were compared with the Wilcoxon test. The data were analyzed with an statistical program version 3.6.1 (R Development Core Team, 2019).
Results and Conclusions: We observed a statistically significant improvement in spasticity that was correlated with an increase in walking speed. The effectiveness of the combined treatment was superior and lasted longer than BTI alone.
Keywords: Shockwaves, Spasticity, Brain damage, Botulinum Toxin
| How to Cite this article: Deniz A, Saavedra P, Marrero I, Hernández J, Hernández A | Treatment of Spasticity in Patients with Brain Damage with the Association of Focused Shock Waves and Botulinum Toxin. | Journal of Regenerative Science | Jul – Dec 2022; 2(2): 26. |
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2022 Chinese Expert Consensus Statement on the Management of Extracorporeal Shockwave Therapy in Musculoskeletal Disorders during Novel Coronavirus Pandemic Prevention and Control
Review Article | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 27-31 | Fuqiang Gao , Xiangwei Ma , Wei Sun , Zirong Li , Jike Lu
DOI: 10.13107/jrs.2022.v02.i01.41
Author: Fuqiang Gao [1,2], Xiangwei Ma [3], Wei Sun [1,4], Zirong Li [1,2], Jike Lu [5]
[1] Shockwave Center, Department of Orthopedics, China-Japan Friendship Hospital, Chaoyang, Beijing, China.
[2] Beijing Key Laboratory of Immune Inflammatory Disease, China-Japan Friendship Hospital, Chaoyang, Beijing, China.
[3] Department of Rehabilitation Medicine, China-Japan Friendship Hospital, Chaoyang, Beijing, China.
[4] Department of Orthopaedic Surgery, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
[5] Department of Orthopedics, Beijing United Family Hospital, Chaoyang, Beijing, China.
Address of Correspondence
Dr. Wei Sun, Shockwave Centers,
Department of Orthopedics, China-Japan Friendship Hospital, Chaoyang, Beijing, China.
E-mail: sun887@163.com
Abstract
Novel coronavirus pneumonia (corona virus disease 2019, [COVID-19]) is a novel respiratory infectious disease that has rapidly spread in many countries or regions around the world [1, 2, 3] . With the approval of the State Council, COVID-19 was included in the category B infectious diseases under the Law of the People’s People’s Republic of China on the Prevention and Control of Infectious Diseases, and the preventive and control measures for category A infectious diseases were adopted. Given the severity of the COVID-19 epidemic, the wide spread of transmission, and the human-to-human transmission, some patients with musculoskeletal disorders visiting hospitals and health care
workers engaged in medical shockwave technology are at potential risk of COVID-19 infection. The 2022 Chinese expert consensus statement on the Management of Musculoskeletal Disease Extracorporeal Shock Wave during the Prevention and Control of Novel Coronavirus Epidemic is formulated..
Keywords: Chinese expert consensus, Extracorporeal shockwave, Management, Musculoskeletal disorders, Novel coronavirus pandemic.
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20. Shockwave Medicine Professional Committee of China Research Hospital Association. Guidelines for extracorporeal shockwave therapy for musculoskeletal diseases in China. Chin J Med Front 2019;11:1-10.
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| How to Cite this article: Gao F, Ma X, Sun W, Li Z, Lu J | 2022 Chinese Expert Consensus Statement on the Management of Extracorporeal Shockwave Therapy in Musculoskeletal Disorders during Novel Coronavirus Pandemic Prevention and Control. | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 27-31. |
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Shock Waves in Scaphoid Pseudarthrosis: A Case Series
Technical | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 39-42 | Paul German Terán1, Fidel Ernesto Cayon1, Estefania Anabel Lozada1, Alvaro Santiago Le Mari2
DOI: 10.13107/jrs.2022.v02.i01.47
Author: Paul German Terán [1], Fidel Ernesto Cayon [1], Estefania Anabel Lozada [1], Alvaro Santiago Le Marie [2]
[1] Department of Traumatology and Orthopedics, Orthopedic Specialties Center, Quito, Ecuador.
[2] Department of General and Laparoscopic Surgery, Universidad Internacional del Ecuador, Quito, Ecuador.
Address of Correspondence
Dr. Paul German Terán,
Department of Traumatology and Orthopedics, Orthopedic Specialties Center, Quito, Ecuador.
E-mail: paulteranmd@gmail.com
Abstract
Scaphoid fracture accounts for 60% of carpal fractures. The mechanism of fracture occurs after a fall with the hand extended, in pronation and radial or ulnar deviation in addition to the importance, they gain for their frequency; clinically, their problem lies in the high possibility of non-consolidation, due to the type of vascularization that it has, fractures located mainly in the waist and in the proximal pole are a high-risk factor. Most of the up-to-date papers available confirm a positive outcome of the use of focused extracorporeal shock wave therapy (ESWT-F) in pseudarthrosis. According to the literature, the success rate is between 50% and 91%. Complications when ESWT-F are performed by qualified personnel and following the standards established by international scientific organizations, are limited to petechiae and local hematomas having as a requirement, to be performed by trained personnel. This manuscript will discuss a series of cases treated in a certified center for the application of Focal Shock Waves between 2018 and 2021 to patients with scaphoid fracture with a diagnosis of Fracture Consolidation Delay and pseudarthrosis of scaphoids, which subjected to treatment with high-intensity focal shock waves under ultrasound guidance. We analyzed six male patients with an average age of 31.3 years who were treated with ESWT-F. About 33.3% were taken to osteosynthesis as initial management without achieving satisfactory bone consolidation; hence, ESWT-F was performed. About 0% complications were reported, bone consolidation occurred in 100% of patients on average of 6 weeks from the last session of ESWT-F. The results were clinically evaluated, where 100% of patients manifested a decrease in pain by an average of 75% at 2 weeks of the last session of ESWT-F and 100% at 12 weeks. In the imaging evaluation, the six patients (100%) showed signs of bone consolidation in the complete radiological assessment at 12 weeks and the Disabilities of the Arm, Shoulder, and Hand scale applied revealed improvement in their functional capacity.
Keywords: Scaphoid non-union, Delayed union, Extracorporeal shockwave therapy, Extracorporeal shock wave therapy, Pseudarthrosis, Disabilities of the arm, shoulder and hand
References:
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12. Fallnhauser T, Wilhelm P, Priol A, Windhofer C. High-energy extracorporeal shock wave therapy in delayed healing of scaphoid fractures and non-unions: Aretrospective analysis of the consolidation rate and factors relevant to therapy decisions. Handchir Microchir Plast Chir 2019;51:164-70.
13. Terán Vela P, Abarca WI, Martínez Asnalema D. Extracorporeal shock waves as a non-surgical treatment of delay of consolidation and non-bone union in diaphyseal fracture of the humerus associated with axonotmesis of the radial nerve, clinical case and literature review. Rev Ecu Med EUGENIO ESPEJO 2019;5:52-66.
14. Moya D, Ramón S, Guiloff L, Terán P, Eid J, Serrano E. Poor results and complications in the use of focal shock waves and radial pressure waves in musculoskeletal pathology. Rehabilitation 2021;4:13-18.
15. D’Agostino MC, Craig K, Tibalt E, Respizzi S. Shock wave as biological therapeutic tool: From mechanical stimulation to recovery and healing, through mechanotransduction. Int J Surg 2015;24:147-53.
16. Wang CJ, Cheng JH, Huang CC, Yip HK, Russo S. Extracorporeal shockwave therapy for avascular necrosis of femoral head. Int J Surg 2015;24:184-7.
17. Cheng JH, Wang CJ. Biological mechanism of shockwave in bone. Int J Surg 2015;24:143-6.
18. Wang CJ. Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res 2012;7:11.
19. Balius R, Jimenez F. Interventional Ultrasound in Sports Traumatology. I. Madrid; 2015. p. 2-4.
| How to Cite this article: Teran PG, Cayon FE, Lozada EA, Le Marie AS | Shock Waves in Scaphoid Pseudarthrosis: A Case Series. | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 39-42. |
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Treatment of a Femoral Shaft Non-union in a Pediatric Patient with Focused Shock Waves
Case Report | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 36-38 | Sebastián Senes1, Gerardo Staudacher2, Santiago Iglesias1, Daniel Moya1, Rodolfo Goyeneche2
DOI: 10.13107/jrs.2022.v02.i01.45
Author: Sebastián Senes [1], Gerardo Staudacher [2], Santiago Iglesias [1], Daniel Moya[1], Rodolfo Goyeneche [2]
[1] Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires, Argentina.
[2] Servicio de Ortopedia y Traumatología Infantil, Hospital de Pediatría Garrahan, Buenos Aires, Argentina.
Address of Correspondence
Dr. Daniel Moya, MD,
Hospital Británico de Buenos Aires, Perdriel 74, C1280 AEB, CABA, Argentina.
E-mail: drdanielmoya@yahoo.com.ar
Abstract
Non-unions of the femur in children are not frequent, but when they do occur they can be very difficult to manage. Shock wave therapy has emerged as an effective option for well-chosen pseudoarthrosis cases, however there are no reports of pediatric cases. We report a 12-year-old male patient with a history of pathological fracture due to mid-diaphyseal osteomyelitis of the right femur at 8 years of age. After several surgical procedures the integrity of the femur was restored but an area of non-unions persisted at mid-diaphyseal level. He was treated with 3 sessions of focused shock waves with an electrohydraulic generator. He presented a rapid consolidation, avoiding a new endomedullary nailing surgery with bone graft.
Focused shock waves may be a useful therapeutic option in children with nonunions in well-selected cases.
Keywords: Pediatric, Fracture non-unions, Shock Waves
References:
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2. Rockwood, Charles A., Kaye E. Wilkins, James H. Beaty, and James R. Kasser. Rockwood and Wilkins’ Fractures in Children. Philadelphia: Lippincott Williams & Wilkins, 2001
3. Valchanou VD, Michailov P. High energy shock waves in the treatment of delayed and nonunion of fractures. Int Orthop. 1991;15(3):181-4. doi: 10.1007/BF00192289. PMID: 1743828.
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12. Cacchio A, Giordano L, Colafarina O, Rompe JD, Tavernese E, Ioppolo F, Flamini S, Spacca G, Santilli V. Extracorporeal shock-wave therapy compared with surgery for hypertrophic long-bone nonunions. J Bone Joint Surg Am. 2009 Nov;91(11):2589-97. doi: 10.2106/JBJS.H.00841. Erratum in: J Bone Joint Surg Am. 2010 May;92(5):1241. PMID: 19884432.
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15. W. Schaden, M. Pusch, C. Schwab, R. Mittermayr, H. Kuderna. Grundlagen der extrakorporalen Stoßwellentherapie (ESWT) bei Pseudarthrosen. Quality for the treated and practitioners. 47th Annual Meeting, Salzburg, Austria, 2011.
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| How to Cite this article: Senes S, Staudacher G, Iglesias S, Moya D, Goyeneche R | Treatment of a femoral shaft non-union in a pediatric patient with focused shock waves | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 36-38. |
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Novel Extracorporeal Magnetotransduction Therapy with Magnetolith® and Focused Electromagnetic Extracorporeal Shockwave Therapy in Medial Meniscal Tear – A Case Report
Case Report | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 32-35 | Karsten Knobloch
DOI: 10.13107/jrs.2022.v02.i01.43
Author: Karsten Knobloch [1]
[1] Sport Praxis Prof. Knobloch, Hannover, Germany.
Address of Correspondence
Prof. Dr. Karsten Knobloch,
Heiligerstr. 3, Hannover – 30159, Germany.
E-mail: professor.knobloch@sportpraxis-knobloch.de
Abstract
The case report describes a non-invasive combination of novel extracorporeal magnetotransduction therapy (EMTT) with focused extracorporeal shockwave therapy for symptomatic medial meniscal tear in a 41-year-old gentleman. Ultra-high-frequency 33 MHz ultrasound revealed a complex medial meniscal tear with a ganglion confirmed by subsequent magnetic resonance imaging. Non-invasive treatment with combined novel Magnetolith® EMTT with focused electromagnetic extracorporeal shockwave therapy for three sessions on a weekly interval. Shear wave elastography at 6 months demonstrated comparable stiffness of the healed and the healthy contralateral meniscus. The healing of the meniscal tear could be depicted by multiparametric ultra-high-frequency ultrasound (33 MHz) with novel stress testing and shear wave elastography.
Keywords: Magnetic field, Extracorporeal shockwave therapy, Extracorporeal shockwave therapy, Meniscal, Ultrasound, Pain
References:
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9. Knobloch K. Novel extracorporeal magnetotransduction therapy with Magnetolith and high-energy focused electromagnetic extracorporeal shockwave therapy as bone stimulation therapy for scaphoid nonunion – A case report. Med Case Rep Study Protoc 2020;2:1.
10. Knobloch K. Extracorporeal magnetotransduction therapy (EMTT) and high-energetic focused extracorporeal shockwave therapy (ESWT) as bone stimulation therapy for metacarpal non-union – A case report. Handchir Mikrochir Plast Chir 2021;53:82-6.
11. Knobloch K. Bone stimulation 4.0 – Combination of EMTT & EMTT in humerus nonunion. Unfallchirurg 2022;125:323-6.
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| How to Cite this article: Knobloch K | Novel Extracorporeal Magnetotransduction Therapy with Magnetolith® and Focused Electromagnetic Extracorporeal Shockwave Therapy in Medial Meniscal Tear – A Case Report | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 32-35. |
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Extracorporeal Shockwave Treatment for Managing Biofilm-mediated Infections in Dentistry: Current Knowledge and Future Perspectives
Review Article | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 22-26 | Antonia Olivares, Christina M A P Schuh, Sebastian Aguayo
DOI: 10.13107/jrs.2022.v02.i01.39
Author: Antonia Olivares [1], Christina M A P Schuh [2], Sebastian Aguayo [1,3]
[1] School of Dentistry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
[2] Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.
[3] Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile.
Address of Correspondence
Dr. Sebastian Aguayo,
School of Dentistry and Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile.
E-mail: sebastian.aguayo@uc.cl
Abstract
At present, chronic non-communicable diseases are becoming more prevalent across the world. Among these pathologies, oral diseases such as dental caries and periodontitis are some of the most frequently observed in populations worldwide. These biofilm-mediated infections are produced as a consequence of a series of factors that modify the oral microenvironment and lead to dysbiosis among residing biofilms, which are particularly difficult to treat with pharmacological approaches due to their structural and anatomical characteristics. Furthermore, the recent sharp increase in antimicrobial resistance has potentiated the need for the development of novel techniques to effectively treat biofilm-mediated diseases in the mouth. One option that has recently shown promising results in vitro is the use of focused high-energy extracorporeal shockwave therapy (fhESWT) for the control of microbial growth and biofilm formation. Several studies have shown the effect of fhESWT on the treatment of biofilm-mediated infections associated with bone fractures and orthopedic implant infection, although the mechanisms behind this effect are still unknown. Regarding the oral cavity, there remains a lack of clinical studies but there are some limited in vitro and in vivo investigations that shed light on the potential of fhESWT for biofilm control. Therefore, the objective of this review is to discuss the most relevant available literature regarding the in vitro and in vivo effects of fhESWT over biofilm control, as well as the potential use of fhESWT for the treatment of oral biofilm-mediated diseases in the future.
Keywords: Bacteria, Biofilms, Extracorporeal shockwave therapy, Focused high-energy extracorporeal shockwave therapy, Fungi, Microorganisms.
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| How to Cite this article: Olivares A, Schuh CMAP, Aguayo S | Extracorporeal Shockwave Treatment for Managing Biofilm-mediated Infections in Dentistry: The Current Knowledge and Future Perspectives | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 22-26. |
