The effectiveness of treatment Achilles tendinopathy with extracorporeal shock wave therapy

Uvod: Ahilova tetiva je najdaljša in ena izmed najmočnejših tetiv v človeškem telesu. Pogosta okvara, ki nastane zaradi prekomernih ponavljajočih se obremenitev, je Ahilova tendinopatija. Ahilova tendinopatija je stanje, povezano z izgubo mišične moči, prisotnostjo bolečine, otekline, povečane občutljivosti in togostjo okoliških tkiv. Zdravljenje je najprej konservativno, nato se v primeru neuspešnosti konservativne terapije lahko zdravi kirurško. Ena izmed novejših konservativnih metod zdravljenja so udarni globinski valovi. Namen: Namen diplomskega dela je bil na podlagi pregleda strokovne in znanstvene literature predstaviti učinkovitost zdravljenja Ahilove tendinopatije z udarnimi globinskimi valovi. Metode dela: Za izdelavo je bila uporabljena opisna metoda. Literatura je bila zbrana iz podatkovnih zbirk PEDro, PubMed in Conchrane Library. Uporabljeni so bili naslednji vključitveni kriteriji: prosto dostopni članki v polnem obsegu v angleškem jeziku, randomizirane kontrolne raziskave, objavljene med letoma 2005 in 2019, raziskave, kjer so proučevali vpliv udarnih globinskih valov pri pacientih z Ahilovo tendinopatijo. Rezultati: Na podlagi vključitvenih kriterijev je bilo v pregled vključenih sedem raziskav. Za ocenjevanje učinkovitosti vpliva na bolečino in funkcijo so uporabili različne lestvice, vprašalnike in točkovalnike. Rezultati so pokazali, da so tako nizko kot visoko energetski udarni globinski valovi učinkoviti pri izboljšanju bolečine in funkcije pri pacientih z Ahilovo tendinopatijo. Razprava in zaključek: Kljub temu da so rezultati pokazali, da je terapija z udarnimi globinskimi valovi varna in učinkovita za zdravljenje Ahilove tendinopatije, so potrebne še dodatne raziskave. Predvsem raziskave, kjer bi med seboj primerjali različno veliko gostoto energijskega toka in s tem pripomogli k določitvi standardnega protokola zdravljenja. Prav tako raziskave, kjer bi spremljali stanje pacientov tudi po enem letu po končanem zdravljenju in s tem opredelili dolgoročne učinke udarnih globinskih valov.Introduction: The Achilles tendon is the longest and one of the strongest tendons in the human body. One of common failure, that occurs because of the repetitive overload, is Achilles tendinopathy. Achilles tendinopathy is a condition where the main symptoms are loss of muscular strength, pain, swelling, increased sensitivity and stiffness of surrounding soft tissues. The treatment is first conservative, then in case of failure they perform surgery. Extracorporeal shock waves are one of the newest conservative methods of treatment. Purpose: The purpose of dissertation is to, based on review of professional and scientific literature, present the efficiency of treating Achilles tendinopathy with extracorporeal shock wave therapy. Methods: Literature was searched using PEDro, PubMed and Conchrane Library. The following inclusion criteria were used: free access texts with full text in English language, randomized controlled trials published between 2005 and 2019, studies which studied the efficiency of treatment of Achilles tendinopathy with extracorporeal shock waves. Results: Based on our inclusion criteria, seven studies were included in the review. They used different scores and questionnaires to evaluate the efficiency of influence on pain and function. The results show that both, low energy and high energy extracorporeal shock waves are effective in reducing pain and improving function in patients with Achilles tendinopathy. Discussion and conclusion: Despite positive results that extracorporeal shock wave therapy is safe and effective method for treatment of Achilles tendinopathy, further studies are needed. Especially studies, where they will compare different amount of energy flux density in order to determine a standard protocol for treatment. Further more studies, with follow up are needed in order to explain the long-term effects of extracorporeal shock waves