Piezowave for Treatment on Lateral and Medial Elbow Tendinopathies

Johns Hopkins University

Status: Withdrawn

Conditions: Tennis Elbow; Medial Epicondylitis; Golfer's Elbow; Elbow Tendinopathy; Lateral Epicondylitis

Treatments: Device: Piezowave 2

Study type: Interventional

Funder types: Other

Identifiers

NCT04241484

IRB00237364

Details and patient eligibility

About

Within the outpatient rehabilitation clinic, therapists provide therapeutic interventions to treat patients with various tendinopathies, including lateral and medial epicondylosis. Current conservative treatment includes immobilization for forced rest of the inflamed tendons and muscles, as well as mobilizations to focus stimulation of synovial fluid, provide movement to nourish cartilage, promote periarticular extensibility, and provide sensory and proprioceptive input. Musculoskeletal disorders can accompany both local and referred pain patterns that need to be assessed and treated. When an acute trauma or repetitive micro-trauma occurs, that may result in decreased range of motion and increased pain causing the onset of weakness and function of the affected extremity. An alternative approach is through the provision of Piezowave Myofascial Acoustic Compression Therapy (MyACT), which provides mechanical stimuli delivery to improve circulation and provide relief of pain. The focused sound waves produced by the Piezowave MyACT device are classified by a pressure surge, which is followed by a drop in pressure and a brief negative pressure phase low energy/low pressure application. It is this transformation of mechanical stimuli into biochemical signals, or mechanotransduction, which yields the treatment of myofascial and musculoskeletal pain. There is currently limited research to support the benefit in regards to increased function and decreased pain when the Piezowave MyACT is used for the treatment of lateral and medial epicondylosis. Of the limited research available, treatment with non-invasive shock wave therapy, complications are low and effect is achieved in most cases within three to five sessions.

If Piezowave Myofascial Acoustic Compression Therapy (MyACT)) is applied as treatment for symptoms of lateral and medical elbow tendinopathies, then the patient will experience increased function demonstrated by Quick DASH (Disability of the Arm, Shoulder and Hand) score and decreased pain demonstrated by subjective reporting on the numeric pain rating scale.

Sex: All

Ages: 22 to 90 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Tendinopathy symptoms referred for occupational therapy by physician.
• Positive provocation tests

Exclusion criteria

• Contraindications for shock wave

  • Infections
  • Tumor tissue
  • Blood clotting disorder
  • Blood thinning medication use
  • Pregnancy
  • Lung tissue in focal area
  • Head
  • Air-containing organs
  • Elbow fracture

• History of corticosteroid injections less than eight weeks/two months, prior to initiation of occupation therapy treatment for lateral or medial epicondylosis. The goal would be to have elimination of any residual benefit from the injection.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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0 participants in 1 patient group

Piezowave

Experimental group

Description:

* Initiation of Piezowave MyACT treatment to include parameters from the user manual * Set for frequency of five pulses per second * Delivery of 500 to 1000 pulses over multiple injured area sites, not to exceed 4000 pulses per session * Intensity ranging from 0.1 to 18 millijoule per square millimeter. This intensity if energy flux as the rate of transfer of the energy through the surface of the tissue is applied. * Focal transducer * Head size will be variable based on depth of tissue treated. The user manual will be consulted for depth of penetration recommendations

Treatment:

Device: Piezowave 2