Clinical Interventions in Aging (Oct 2019)
The Effectiveness Of Radial Extracorporeal Shock Wave Therapy In Patients With Chronic Low Back Pain: A Prospective, Randomized, Single-Blinded Pilot Study
Abstract
Karolina Walewicz,1 Jakub Taradaj,2,3 Katarzyna Rajfur,1 Kuba Ptaszkowski,4 Michał Tomasz Kuszewski,2 Mirosław Sopel,5 Robert Dymarek5 1Faculty of Physiotherapy, Opole Medical School, Opole, Poland; 2Institute of Physiotherapy and Health Sciences, Academy of Physical Education, Katowice, Poland; 3College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada; 4Department of Physiotherapy, Wroclaw Medical University, Wroclaw, Poland; 5Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, PolandCorrespondence: Robert DymarekDepartment of Nervous System Diseases, Faculty of Health Sciences, Wroclaw Medical University, Bartla 5, Wroclaw 51-618, PolandTel +48 71 784 18 05Fax +48 71 341 95 33Email [email protected]: This prospective, randomized and single-blinded study assesses the influence of radial extracorporeal shock wave therapy (rESWT) in patients with low back pain (LBP).Methods: A total of 52 patients with LBP were enrolled in the study, out of which a homogeneous group of 40 patients with mean age of 53.45±4.9 years was included. Patients were randomized into group A (n=20) treated with rESWT (2000 pulses; 2.5 bars; 5 Hz, 7 mins) performed twice a week for five weeks (10 sessions) and stabilization training, as well as group B (n=20) treated with sham rESWT and stabilization training. To analyze the therapeutic progress, the following tests were performed (before and after therapy; 1 and 3 months follow-up) to assess pain and functional efficiency: (1) Visual Analog Scale (VAS), (2) Laitinen Pain Scale (LPS), and (3) Oswestry Disability Index (ODI).Results: The control group had a statistically significant advantage over the rESWT group (4.4 vs. 3.1 points on the VAS; p=0.039). However, in long-term observations, group A gradually experienced more pain relief than group B (2.7 vs. 3.5 points, p>0.05, at one month and 2.0 vs. 4.4 points at three months after treatment; p<0.0001). Similar findings can be seen in the analysis of changes in pain sensations measured with the LPS. The functional state (ODI) was better in rESWT group, especially in follow-up observation (9.3 vs. 14.6 points, p=0.033, at one month and 9.3 vs. 17.8 points, p=0.004, at three months after treatment).Conclusion: The rESWT combined with stabilization training is particularly effective in the long-term and achieves a stable beneficial effect for patients with LBP. The use of rESWT has a significant long-term influence on the reduction of pain and the improvement of the general functional state in relation to the conventional motor improvement program.Keywords: shock waves, ESWT, low back pain, functional state, physical therapy
