Radial or Focal Extracorporeal Shock Wave Therapy in Lateral Elbow Tendinopathy: A Real-Life Retrospective Study

Raffaello Pellegrino, Angelo Di Iorio (), Serena Filoni, Paolo Mondardini, Teresa Paolucci, Eleonora Sparvieri, Domiziano Tarantino, Antimo Moretti and Giovanni Iolascon
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Raffaello Pellegrino: Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano, Switzerland
Angelo Di Iorio: Antalgic Mini-Invasive and Rehab-Outpatients Unit, Department of Innovative Technologies in Medicine & Dentistry, University “G. d’Annunzio”, 66100 Chieti, Italy
Serena Filoni: Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
Paolo Mondardini: Department of Sport Science, Università di Bologna, 40100 Bologna, Italy
Teresa Paolucci: Physical Medicine and Rehabilitation, Department of Oral Medical Science and Biotechnology, University “G. d’Annunzio”, 66100 Chieti, Italy
Eleonora Sparvieri: Internal Medicine Unit, Ospedale S. Liberatore, 64100 Teramo, Italy
Domiziano Tarantino: Department of Public Health, University Federico II of Naples, 80131 Naples, Italy
Antimo Moretti: Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Giovanni Iolascon: Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy

IJERPH, 2023, vol. 20, issue 5, 1-11

Abstract: Lateral elbow tendinopathy (LET) is characterized by pain, poor muscle strength of the wrist ex-tensors, and disability. Among the conservative rehabilitative approaches, focal as well as radial extracorporeal shock wave therapy (ESWT), are considered effective in LET management. The objective of this study was to compare the safety and effectiveness of focal (fESWT) and radial (rESWT) in terms of LET symptoms and the strength of wrist extensors, taking into account potential gender differences. This is a retrospective longitudinal cohort study of patients with LET treated with ESWT that had received a clinical and functional evaluation, including visuo-analogic scale (VAS), muscle strength using an electronic dynamometer during Cozen’s test, and the patient-rated tennis elbow evaluation (PRTEE) questionnaire. Follow-ups were carried out weekly in four visits after enrollment, and at 8 and 12 weeks. During the follow-ups, the VAS score decreased in both treatments, even if patients receiving fESWT reported early pain relief compared to those treated with rESWT (time for treatment p -value < 0.001). Additionally, peak muscle strength increased independently of the device used, and again more rapidly in the fESWT group (time for treatment p -value < 0.001). In the stratified analysis for sex and for the type of ESWT, rESWT appears to be less effective in female participants in terms of mean muscle strength and PRTEE scores, without differences according to the type of device used. The rESWT group reported a higher rate of minor adverse events (i.e., discomfort, p = 0.03) compared to fESWT. Our data suggest that both fESWT and rESWT might be effective in improving LET symptoms, even if the higher rate of painful procedures were reported in patients treated with rESWT.

Keywords: extracorporeal shock wave therapy; lateral elbow tendinopathy; muscle strength; gender effect; rehabilitation; minimally invasive (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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