Dalila Scaturro, Domenico Migliorino, Sofia Tomasello, Michele Vecchio, Antimo Moretti, Giovanni Iolascon, Giulia Letizia Mauro
{"title":"体外冲击波疗法和营养补充品治疗外上髁炎的疗效:一项随机对照试验。","authors":"Dalila Scaturro, Domenico Migliorino, Sofia Tomasello, Michele Vecchio, Antimo Moretti, Giovanni Iolascon, Giulia Letizia Mauro","doi":"10.3389/fresc.2025.1593909","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Numerous scientific papers have compared different treatment options in the management of lateral epicondylitis. Our study evaluated the efficacy of focal extracorporeal shock wave treatment (ESWT) combined with an integrative nutraceutical treatment of hyaluronic acid, collagen, vitamin C, and manganese, compared with single treatment in patients with lateral epicondylitis in terms of improvement of pain, functional capacity, muscle strength, and reduction of inflammation on ultrasound images.</p><p><strong>Methods: </strong>A single-center, randomized controlled trial (RCT) was conducted in a population of patients with lateral epicondylitis. Patients were enrolled and randomly divided into 3 groups: Group A, consisting of 15 patients who were treated with twenty sessions of therapeutic exercise and five focal ESWT sessions (one session every six days); Group B, consisting of 15 patients who performed twenty sessions of therapeutic exercise and took daily a dietary supplement consisting of Hyaluronic Acid 200 mg, Collagen 5,000 mg, Vitamin C 250 mg and Manganese 10 mg for thirty days; and Group C, consisting of 15 patients, who received a combined treatment of therapeutic exercise, focal ESWT and nutraceutical supplementation The Numerical Rating Scale (NRS) and Patient-Rated Tennis Elbow Evaluation Scale (PRTEE) were administered during the first physiatric examination (T0), at 15 days after the start of treatment (T1), and at a 30-day follow-up (T2). In addition, muscle strength (Handgrip strength) was analyzed by means of a dynamometer, and common extensor tendon thickness (CET Thickness) by ultrasound examination.</p><p><strong>Results: </strong>Data analysis showed that NRS scale scores decreased significantly only in group B at T1 (<i>P</i> < 0.05), and in the three groups at T2 (<i>P</i> < 0.05). Grip strength increased significantly after 30 days only in group C (<i>P</i> < 0.05), while PRTEE scores and CET Thickness decreased significantly at T2 in the three groups (<i>P</i> < 0.05). The comparison among the various groups also showed that the Group C showed statistically significant improvements of function and grip strength at T2, compared with the other groups (<i>P</i> < 0.05).</p><p><strong>Discussion: </strong>Our study demonstrated that the combination of focal ESWT, therapeutic exercise, and nutraceutical supplementation, represent a viable therapeutic option for the management of lateral epicondylitis; likewise, the proposed treatments resulted in a synergistic effect for pain relief and functional recovery in the short term, providing a decrease in the inflammatory state and an increase in muscle strength.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1593909"},"PeriodicalIF":1.3000,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187671/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy of extracorporeal shock wave therapy and nutraceutical supplementation in the treatment of lateral epicondylitis: a randomized controlled trial.\",\"authors\":\"Dalila Scaturro, Domenico Migliorino, Sofia Tomasello, Michele Vecchio, Antimo Moretti, Giovanni Iolascon, Giulia Letizia Mauro\",\"doi\":\"10.3389/fresc.2025.1593909\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Numerous scientific papers have compared different treatment options in the management of lateral epicondylitis. Our study evaluated the efficacy of focal extracorporeal shock wave treatment (ESWT) combined with an integrative nutraceutical treatment of hyaluronic acid, collagen, vitamin C, and manganese, compared with single treatment in patients with lateral epicondylitis in terms of improvement of pain, functional capacity, muscle strength, and reduction of inflammation on ultrasound images.</p><p><strong>Methods: </strong>A single-center, randomized controlled trial (RCT) was conducted in a population of patients with lateral epicondylitis. Patients were enrolled and randomly divided into 3 groups: Group A, consisting of 15 patients who were treated with twenty sessions of therapeutic exercise and five focal ESWT sessions (one session every six days); Group B, consisting of 15 patients who performed twenty sessions of therapeutic exercise and took daily a dietary supplement consisting of Hyaluronic Acid 200 mg, Collagen 5,000 mg, Vitamin C 250 mg and Manganese 10 mg for thirty days; and Group C, consisting of 15 patients, who received a combined treatment of therapeutic exercise, focal ESWT and nutraceutical supplementation The Numerical Rating Scale (NRS) and Patient-Rated Tennis Elbow Evaluation Scale (PRTEE) were administered during the first physiatric examination (T0), at 15 days after the start of treatment (T1), and at a 30-day follow-up (T2). In addition, muscle strength (Handgrip strength) was analyzed by means of a dynamometer, and common extensor tendon thickness (CET Thickness) by ultrasound examination.</p><p><strong>Results: </strong>Data analysis showed that NRS scale scores decreased significantly only in group B at T1 (<i>P</i> < 0.05), and in the three groups at T2 (<i>P</i> < 0.05). Grip strength increased significantly after 30 days only in group C (<i>P</i> < 0.05), while PRTEE scores and CET Thickness decreased significantly at T2 in the three groups (<i>P</i> < 0.05). The comparison among the various groups also showed that the Group C showed statistically significant improvements of function and grip strength at T2, compared with the other groups (<i>P</i> < 0.05).</p><p><strong>Discussion: </strong>Our study demonstrated that the combination of focal ESWT, therapeutic exercise, and nutraceutical supplementation, represent a viable therapeutic option for the management of lateral epicondylitis; likewise, the proposed treatments resulted in a synergistic effect for pain relief and functional recovery in the short term, providing a decrease in the inflammatory state and an increase in muscle strength.</p>\",\"PeriodicalId\":73102,\"journal\":{\"name\":\"Frontiers in rehabilitation sciences\",\"volume\":\"6 \",\"pages\":\"1593909\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-06-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187671/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in rehabilitation sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3389/fresc.2025.1593909\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in rehabilitation sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/fresc.2025.1593909","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
摘要
简介:许多科学论文比较了治疗外上髁炎的不同治疗方案。我们的研究评估了局点体外冲击波治疗(ESWT)结合透明质酸、胶原蛋白、维生素C和锰的综合营养治疗对外上髁炎患者在改善疼痛、功能能力、肌肉力量和减轻超声图像炎症方面的疗效。方法:对外上髁炎患者进行单中心随机对照试验(RCT)。患者被纳入并随机分为3组:A组,15例患者接受20次治疗性运动和5次焦点ESWT治疗(每6天1次);B组,由15名患者组成,他们进行20次治疗性运动,每天服用由透明质酸200毫克、胶原蛋白5000毫克、维生素C 250毫克和锰10毫克组成的膳食补充剂,持续30天;C组15例患者接受治疗性运动、局灶ESWT和营养补充品的联合治疗。数值评定量表(NRS)和患者评定网球肘评估量表(PRTEE)分别在第一次体格检查(T0)、治疗开始后15天(T1)和30天随访(T2)期间进行。此外,用测力仪分析肌肉力量(握力),超声检查常用伸肌腱厚度(CET厚度)。结果:数据分析显示,只有B组的NRS评分在T1 (P P P P P P P)时显著下降。讨论:我们的研究表明,局灶性ESWT、治疗性运动和营养补充相结合,是治疗外侧上髁炎的可行治疗选择;同样,建议的治疗在短期内对疼痛缓解和功能恢复产生协同效应,提供炎症状态的减少和肌肉力量的增加。
Efficacy of extracorporeal shock wave therapy and nutraceutical supplementation in the treatment of lateral epicondylitis: a randomized controlled trial.
Introduction: Numerous scientific papers have compared different treatment options in the management of lateral epicondylitis. Our study evaluated the efficacy of focal extracorporeal shock wave treatment (ESWT) combined with an integrative nutraceutical treatment of hyaluronic acid, collagen, vitamin C, and manganese, compared with single treatment in patients with lateral epicondylitis in terms of improvement of pain, functional capacity, muscle strength, and reduction of inflammation on ultrasound images.
Methods: A single-center, randomized controlled trial (RCT) was conducted in a population of patients with lateral epicondylitis. Patients were enrolled and randomly divided into 3 groups: Group A, consisting of 15 patients who were treated with twenty sessions of therapeutic exercise and five focal ESWT sessions (one session every six days); Group B, consisting of 15 patients who performed twenty sessions of therapeutic exercise and took daily a dietary supplement consisting of Hyaluronic Acid 200 mg, Collagen 5,000 mg, Vitamin C 250 mg and Manganese 10 mg for thirty days; and Group C, consisting of 15 patients, who received a combined treatment of therapeutic exercise, focal ESWT and nutraceutical supplementation The Numerical Rating Scale (NRS) and Patient-Rated Tennis Elbow Evaluation Scale (PRTEE) were administered during the first physiatric examination (T0), at 15 days after the start of treatment (T1), and at a 30-day follow-up (T2). In addition, muscle strength (Handgrip strength) was analyzed by means of a dynamometer, and common extensor tendon thickness (CET Thickness) by ultrasound examination.
Results: Data analysis showed that NRS scale scores decreased significantly only in group B at T1 (P < 0.05), and in the three groups at T2 (P < 0.05). Grip strength increased significantly after 30 days only in group C (P < 0.05), while PRTEE scores and CET Thickness decreased significantly at T2 in the three groups (P < 0.05). The comparison among the various groups also showed that the Group C showed statistically significant improvements of function and grip strength at T2, compared with the other groups (P < 0.05).
Discussion: Our study demonstrated that the combination of focal ESWT, therapeutic exercise, and nutraceutical supplementation, represent a viable therapeutic option for the management of lateral epicondylitis; likewise, the proposed treatments resulted in a synergistic effect for pain relief and functional recovery in the short term, providing a decrease in the inflammatory state and an increase in muscle strength.