title: Extra-corporeal pulsed-activated therapy ("EPAT" sound wave) for Achilles tendinopathy: a prospective study.
abstract: Achilles tendinopathy is common and extracorporeal shockwaves have become a popular treatment for this condition, even though previous research has not provided conclusive results regarding its efficacy in cases of Achilles tendinopathy. Our aim was to evaluate 3 weekly shockwave treatments in patients with Achilles tendinopathy, as quantified by the Roles and Maudsley score. A total of 74 tendons in 60 patients were assessed at baseline and at least 1 year posttreatment, including 32 (43.24%) paratendinoses, 23 (31.08%) proximal tendinoses, and 19 (25.68%) insertional tendinoses. The mean age of the participants was 48.6 ± 12.94 years, and patients with paratendinosis (41.44 ± 14.01 years) were statistically significantly younger than those with proximal (53 ± 8.9 years) and insertional (54.26 ± 9.74 years) tendinopathy, and these differences were statistically significant (P = .0012 and P = .0063, respectively). Overall, 58 (78.38%) tendons improved by at least 1 year posttreatment, including 75% in the paratendinosis, 78.26% in the proximal tendinosis, and 84.21% in the insertional tendinosis groups, and no adverse effects were observed. The Roles and Maudsley score improved from 3.22 ± 0.55 to 1.84 ± 1.05 (P < .0001) in the paratendinosis group, 3.39 ± 0.5 to 1.57 ± 0.66 (P < .0001) in the proximal tendinopathy group, and 3.32 ± 0.58 to 1.47 ± 0.7 (P = .0001) in the insertional tendinopathy group. Based on these results, we believe that shockwave therapy serves as a safe, viable, and effective option for the treatment of Achilles tendinopathy.
authors.affiliation: Palo Alto Medical Foundation, Palo Alto, CA 94301, USA. heysax@aol.com
authors.forename: Amol
authors.initials: A
authors.lastname: Saxena
authors.forename: Sona
authors.initials: S
authors.lastname: Ramdath
authors.forename: Patrick
authors.initials: P
authors.lastname: O'Halloran
authors.forename: Ludger
authors.initials: L
authors.lastname: Gerdesmeyer
authors.forename: Hans
authors.initials: H
authors.lastname: Gollwitzer
mesh_terms: D000125:Achilles Tendon / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006305:Health Status Indicators; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013223:Statistics as Topic; D052256:Tendinopathy / Q000175:diagnosis / Q000628:therapy*; D013997:Time Factors; D055815:Young Adult