Radial pressure wave or extracorporeal Shockwave therapy and foot pain: is there any evidence of efficacy?

摘要

Extracorporeal Shockwave therapy (ECSWT) and radial pressure wave therapy (RPWT) have been used in a variety of circumstances, but there is limited evidence of documented efficacy, especially related to conditions of the foot. Sixteen horses with 'navicular syndrome' were treated using ECSWT using 1000 pulses through the frog and 1000 pulses from between the heel bulbs under general anaesthesia at 0.89 mJ/mm (Bar etal. 2001). Video recordings from before and 6 months after treatment were analysed blindly. 56% of horses improved at least 1 lameness grade (AAEP grading scale of 0-5) (McClure ef al. 2004). Owners reported that 69% of the horses returned to the previous level of activity. There was no comparative control group. No horse underwent magnetic resonance imaging (MRI) and therefore the precise cause(s) of pain and lameness were not clear. The degree and duration of lameness prior to treatment were poorly defined. In another study of horses with navicular syndrome, all 26 horses treated undergeneral anaesthesia with 3000 pulses at 0.56 mJ/mm (Bar ef al. 2001) were free of lameness at 6 months (Bar ef al. 2001). Once again, horses did not undergo MRI and the cause of pain was ill-defined.