title: Focused low-energy extracorporeal shock waves with distally symmetric polyneuropathy (DSPNP): a pilot study.
abstract: BACKGROUND
  Incidental observations led to the question whether ESWT could alleviate the still difficult-to-improve symptoms of DSPNP.
  
  
  METHODS
  In a pilot study, out of an original 24 patients with DSPNP, 10 patients with diabetes mellitus were excluded because of their inhomogeneous performances. Of the 14 patients remaining, 6 received one sham treatment at the beginning. All 14 patients were then treated with ESWT to the soles of the feet using the Duolith® shock wave generator (Storz Medical) 3 times weekly for 2 weeks. The assessments were carried out before and after the sham treatment, the first ESWT (question: before and after the first ESWT or only after?) and after 2, 4 and 8 weeks.
  
  
  RESULTS
  The placebo treatment did not influence pain or paraesthesia. After the 2 weeks of ESWT, intensity decreased from 100% to 23.6%, rising again after 8 weeks to 45.7% of the original state (p < 0.01). The placebo treatment did however have a great effect on walking abilities. The results of ESWT did not become significant until the 8th week. Step length improved by 14.6% (p < 0.001), walking speed by 24.8% (p < 0.001) and time of dual support during the stance phase of the gait declined by 12.2% (p < 0.009).
  
  
  CONCLUSIONS
  Despite the small number of cases, it appears that ESWT can alleviate some of the symptoms of DSPNP.
authors.affiliation: Outpatient Department for Manual Medicine - Movement Disorder Center Rheintalklinik, Bad Krozingen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Lohse-Busch
authors.affiliation: Storz Medical AG, Tägerwilen, Switzerland.
authors.forename: E
authors.initials: E
authors.lastname: Marlinghaus
authors.affiliation: Outpatient Department for Manual Medicine - Movement Disorder Center Rheintalklinik, Bad Krozingen, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Reime
authors.affiliation: Outpatient Department for Manual Medicine - Movement Disorder Center Rheintalklinik, Bad Krozingen, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Möwis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D005260:Female; D005534:Foot Diseases / Q000534:rehabilitation*; D005684:Gait; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010865:Pilot Projects; D010919:Placebos; D011115:Polyneuropathies / Q000150:complications / Q000534:rehabilitation*; D020127:Recovery of Function; D016896:Treatment Outcome
chemical_list: D010919:Placebos
keywords: Extracorporeal shock wave therapy; pain; paraesthesia; polyneuropathy; walking kinematics