Focused electromagnetic high-energetic extracorporeal shockwave (ESWT) reduces pain levels in the nodular state of Dupuytren's disease-a randomized controlled trial (DupuyShock)

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064203%3A_____%2F22%3A10420905" target="_blank" >RIV/00064203:_____/22:10420905 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11130/22:10420905

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=nzGM8aofFi" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=nzGM8aofFi</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s10103-021-03254-9" target="_blank" >10.1007/s10103-021-03254-9</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Focused electromagnetic high-energetic extracorporeal shockwave (ESWT) reduces pain levels in the nodular state of Dupuytren's disease-a randomized controlled trial (DupuyShock)

Popis výsledku v původním jazyce

Dupuytren&apos;s disease is a progressive fibroproliferative disorder of the hand. In the nodular stage of Dupuytren&apos;s disease, pain might limit daily hand activities and progress to finger contractures. Focused electromagnetic high-energetic extracorporeal shockwave therapy (ESWT) may reduce pain in Dupuytren&apos;s nodules (Tubiana N). In this prospective, randomized, blinded, placebo-controlled single center trial, we enrolled 52 patients (mean age, 58.2 +- 9.2) with painful nodular Dupuytren disease Tubiana N. Randomization was done to either (group A) 3 treatments with focused electromagnetic high-energetic ESWT (2000 shots, 3 Hz, 0.35 mmJ/mm(2)/hand, Storz Duolith SD1, n = 27) or (group B) placebo ESWT (2000 shots, 3 Hz, 0.01 mJ/mm(2)/hand, n = 25) in a weekly interval. Primary outcome was the level of pain on a visual analogue scale (VAS 0-10) at 3/6/12/18 months, secondary outcomes were patient-related outcome measures (DASH score, MHQ score, URAM scale), grip strength, patient&apos;s satisfaction, and Dupuytren&apos;s disease progression over 18 months follow-up. Focused ESWT significantly improved outcomes. Pain was reduced from 3.6 +- 1.8 to 1.9 +- 1.2 at three, to 1.4 +- 0.7 at six, to 1.7 +- 1.6 after 12 months and 1.9 +- 0.8 after 18 months in the intervention group (47% reduction, p &lt; 0.05). In the placebo group, pain on VAS increased from 2.2 +- 1.4 to 3.4 +- 1.7 at three, to 3.4 +- 1.8 at six, to 3.4 +- 1.4 at 12 and 3.1 +- 1.1 at 18 months (35% increase, p &lt; 0.05). Quality-of-life score tended to improve in the intervention group (MHQ, 77 +- 19 to 83 +- 12; DASH, 12 +- 18 to 10 +- 9) while it deteriorated in the placebo group as Dupuytren&apos;s disease was progressing (MHQ, 79 +- 15 to 73 +- 17; DASH, 6 +- 10 to 14 +- 13). The strength of the affected hand and fingers did not change significantly in either of the groups. Patients&apos; satisfaction was higher in the intervention group for symptom improvement (56% vs. 12%) and reduction of disease progression (59% vs. 24%). Any Dupuytren-related intervention was performed in 26% in the intervention group and in 36% in the placebo group within 18 months of follow-up (n.s.). Focused electromagnetic high-energetic ESWT can significantly reduce pain in painful nodules in Dupuytren&apos;s disease in an 18-month perspective. ( ClinicalTrials.gov Identifier: NCT01184586).

Název v anglickém jazyce

Focused electromagnetic high-energetic extracorporeal shockwave (ESWT) reduces pain levels in the nodular state of Dupuytren's disease-a randomized controlled trial (DupuyShock)

Popis výsledku anglicky

Dupuytren&apos;s disease is a progressive fibroproliferative disorder of the hand. In the nodular stage of Dupuytren&apos;s disease, pain might limit daily hand activities and progress to finger contractures. Focused electromagnetic high-energetic extracorporeal shockwave therapy (ESWT) may reduce pain in Dupuytren&apos;s nodules (Tubiana N). In this prospective, randomized, blinded, placebo-controlled single center trial, we enrolled 52 patients (mean age, 58.2 +- 9.2) with painful nodular Dupuytren disease Tubiana N. Randomization was done to either (group A) 3 treatments with focused electromagnetic high-energetic ESWT (2000 shots, 3 Hz, 0.35 mmJ/mm(2)/hand, Storz Duolith SD1, n = 27) or (group B) placebo ESWT (2000 shots, 3 Hz, 0.01 mJ/mm(2)/hand, n = 25) in a weekly interval. Primary outcome was the level of pain on a visual analogue scale (VAS 0-10) at 3/6/12/18 months, secondary outcomes were patient-related outcome measures (DASH score, MHQ score, URAM scale), grip strength, patient&apos;s satisfaction, and Dupuytren&apos;s disease progression over 18 months follow-up. Focused ESWT significantly improved outcomes. Pain was reduced from 3.6 +- 1.8 to 1.9 +- 1.2 at three, to 1.4 +- 0.7 at six, to 1.7 +- 1.6 after 12 months and 1.9 +- 0.8 after 18 months in the intervention group (47% reduction, p &lt; 0.05). In the placebo group, pain on VAS increased from 2.2 +- 1.4 to 3.4 +- 1.7 at three, to 3.4 +- 1.8 at six, to 3.4 +- 1.4 at 12 and 3.1 +- 1.1 at 18 months (35% increase, p &lt; 0.05). Quality-of-life score tended to improve in the intervention group (MHQ, 77 +- 19 to 83 +- 12; DASH, 12 +- 18 to 10 +- 9) while it deteriorated in the placebo group as Dupuytren&apos;s disease was progressing (MHQ, 79 +- 15 to 73 +- 17; DASH, 6 +- 10 to 14 +- 13). The strength of the affected hand and fingers did not change significantly in either of the groups. Patients&apos; satisfaction was higher in the intervention group for symptom improvement (56% vs. 12%) and reduction of disease progression (59% vs. 24%). Any Dupuytren-related intervention was performed in 26% in the intervention group and in 36% in the placebo group within 18 months of follow-up (n.s.). Focused electromagnetic high-energetic ESWT can significantly reduce pain in painful nodules in Dupuytren&apos;s disease in an 18-month perspective. ( ClinicalTrials.gov Identifier: NCT01184586).

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30103 - Neurosciences (including psychophysiology)

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2022

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Lasers in Medical Science

ISSN

0268-8921

e-ISSN

1435-604X

Svazek periodika

37

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

11

Strana od-do

323-333

Kód UT WoS článku

000611102800001

EID výsledku v databázi Scopus

2-s2.0-85099994664