| Abstract | Cilj: Ovaj sustavni pregledni rad (scoping review) ima za cilj istražiti i evaluirati sigurnost i učinak udarnog vala u liječenju adhezivnog kapsulitisa ramena.
Metode: Pretražuju se, računalnom obradom, svi objavljeni znanstveni radovi na engleskom i hrvatskom jeziku, zaključno do 1.7.2019.god. na pretraživačima: PubMed, MEDLINE, Web of Science, Google Scholar, Cochrane Central Register of Control Trials i EMBASE. Sastav pokusne i kontrolne skupine čine osobe koje imaju potvrđenu dijagnozu adhezivnog kapsulitisa ramena. Kroz specijalizirane pretraživače i pojmovnike navedenih baza podataka pretražuju se riječi: adhesive capsulitis, frozen shoulder, shoulder, extracorporeal shock wave therapy, shock wave therapy, physical therapy, shock wave treatment. Analiziraju se primarni ishodi (bol i pokretljivost) i sekundarni ishodi (funkcija ramena u aktivnostima svakodnevnog života). Za svaku pronađenu studiju izdvajaju se podaci, procjenjuje se rizik pristranosti, te se procjenjuje kvaliteta i kvantiteta dobivenih podataka koji se odnose na temu rada.
Rezultati: Pronađeno je 10 studija (RCT, nerandomizirane, kohortna, nekontrolirana opservacijska) koje su ukupno uključivale 410 ispitanika, u periodima od 2006.god. do 2018.god. Tri studije izravno se odnose na dijabetičare. Studije su koristile različite udarne valove (fokusirane ili radijalne), s različitom gustoćom energije (od 0.06 mJ/mm² - 0.6 mJ/mm²), različitim vremenskim intervalima aplikacije, različitim brojem udara u aplikaciji, različitim pritiskom (1.5 – 3.5 bar), različitim anatomskim pristupom. Također su koristile različita mjerenja, procjene i upitnike (VAS, ROM, CSS, DASH, QuickDASH, PSFS, OSS, SPADI, PNRS) u različitim vremenskim točkama mjerenja. Pokusne skupine su koristile udarni val samostalno ili u kombinaciji s nekim drugim fizikalnim ili farmakološkim tretmanaima, a kontrolna skupina ima „lažni“ udarni val, ili drugi farmakološki ili fizikalni tretman. Udarni val, samostalno ili u kombinaciji, je pokazao značajna klinička i statistička poboljšanja u primarnim i sekundarnim ishodima.
Zaključak: Ovaj rad procjenjuje da je kratkoročno (6 mjeseci) statistički značajna, sigurna i učinkovita upotreba udarnog vala u liječenju adhezivnog kapsulitisa ramena (kod dijabetičara i nedijabetičara) na smanjenje boli, povećanje opsega pokreta i funkcionalnost ramena u aktivnostima svakodnevnog života. Potrebna su daljnja istraživanja kako bi se potvrdilo isto, te dokazala srednjeročna i dugoročna učinkovitost liječenja istoga na strukturu i funkciju ramena. |
| Abstract (english) | Diploma thesis title: Rehabilitation with extracorporeal shock wave therapy (ESWT) in patients with shoulder adhesive capsulitis (SAC).
Objective: This systematic review (scoping review) aims to explore and evaluate safety and effectiveness of ESWT treatment of SAC.
Methods: With computer processing is searched all published scientific articles on english and croatian language, inclusive until 1. July 2019. on database and sources: PubMed, MEDLINE, Web of Science, Google Scholar, Cochrane Central Register of Control Trials i EMBASE. Structure of intervention and control groups make patients with dignosed SAC by expert doctor. With specialised glossary and searching through those database and sources are exploring words: adhesive capsulitis, frozen shoulder, shoulder, extracorporeal shock wave therapy, shock wave therapy, physical therapy, shock wave treatment. The primary outcomes (pain and ROM) and secondary outcomes (function of shoulder in activity of everyday life) are analysed. For every found article are separated data, assessed risk of partiality, and assessed quality and quantity obtained data which is purpose of this diploma thesis title.
Results: It is found 10 trials (RCT, non-randomised CT, cohort, non-control opservation) which involved 410 subjects, in period from 2006. – 2018. Three trials directly related on subject with diabetes mellitus (DM). Trials used different shock waves (focused and radilal), with different energy flux density (from 0.06 mJ/mm² - 0.6 mJ/mm²), with different time interval of aplication, different impulses shock per session, different pressure (1.5 – 3.5 bar), different direction. Also were used different outcome primary and secondary measures (VAS, ROM, CSS, DASH, QuickDASH, PSFS, OSS, SPADI, PNRS) in different time point of measures. Intervention groups are treated with ESWT only or with combination with some other physical or pharmacological treatment, while control groups are treated with fake ESWT or some other physical or pharmacological treatment. ESWT, only or with combination, has resulted in significant clinical and and statistical improvement in primary and secundary outcomes in patients with SAC.
Conclusion: This systematic review assessed that ESWT in treatment SAC in short – term is statisticaly significant, safety and effectiveness (on diabetic or non-diabetic patients) on decrease pain, increase ROM and increase funcionality of the shoulder in everyday activities |
