Extracorporeal Shockwave Therapy of Healthy Achilles Tendons Results in a Conditioned Pain Modulation Effect: A Randomised Exploratory Cross-Over Trial

P. Vallance, P. Malliaras
Original Article, 262-271
doi: 10.32098/mltj.02.2019.16
Full text PDF

Background. This study investigated whether ESWT applied to healthy Achilles tendons results in a conditioned pain modulation (CPM) effect.
Methods. 3000 and 6000-shock dose radial ESWT was performed on dominant side Achilles tendon (random order over 5-9 days) among 20 healthy participants (75% male). Pressure was modulated throughout, producing >4/10 pain (10=worst imaginable). Bilateral pressure-pain thresholds (PPT) were assessed pre-post ESWT at Achilles tendon, tibialis anterior and elbow lateral epicondyle (random order). PPT change per site and PPT change scores for each site were compared between doses (repeated ANOVA), PPT reliability (intraclass correlation coefficients [ICC]), and PPT change variability (each site, coefficient of variation) were investigated. Dose order was investigated (first vs second) (t-tests, each site).
Results. Test-retest reliability was good for all sites (ICC [3,2]=0.76-0.89). PPT increased significantly (p<0.05) at all sites bilaterally following 3000-shock dose, and at bilateral Achilles tendon, and left sided tibialis anterior and lateral epicondyle following 6000-shock dose (right 6000-shock tibialis anterior, lateral epicondyle p>0.05). Dose order wasn’t associated with outcome (p>0.05).
Conclusion. ESWT produces immediate CPM effect when applied to Achilles tendon in healthy populations. This appears more consistent at 3000-shock dose. Determining if this mechanism occurs in Achilles tendinopathy will inform appropriate modality use.

Keywords: Achilles tendon, conditioned pain modulation, endogenous pain modulation, extracorporeal shock wave therapy,

Table of Content: Vol.9 (No.2) 2019 April/June

  1. Ligamentum capitis femoris: first written mentions

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  2. The anatomical characteristics of Vietnamese adult hip joint: a multiplanar reconstruction computer tomographic study

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  3. Evolution of isokinetic strength and return to sport after proximal hamstring rupture without surgical repair: a retrospective series of cases

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  4. Iliotibial Band Friction Syndrome: A Systematic Review and Meta-analysis to evaluate lower-limb biomechanics and conservative treatment

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  6. Repair of antero lateral ligament injuries in acute anterior cruciate ligament tears: an in vivo study using navigation

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  7. Isokinetic strength profile of subjects with proximal patellar tendinopathy

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  8. Histological alterations to the hamstring tendon caused by cleaning during autograft preparation

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  10. Fifth metatarsal tuberosity avulsion fractures: a new surgical technique without metal implant

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  12. Comparison of distal versus proximal-distal kinesio taping effects on gait initiation profile in athletes with functional ankle instability

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  13. Effects of supraphysiological doses of nandrolone decanoate in Achilles tendon of rats

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    doi: 10.32098/mltj.02.2019.15
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  14. Extracorporeal Shockwave Therapy of Healthy Achilles Tendons Results in a Conditioned Pain Modulation Effect: A Randomised Exploratory Cross-Over Trial

    P. Vallance, P. Malliaras
    Original Article, 262-271
    doi: 10.32098/mltj.02.2019.16
    Full text PDF

  15. Which leg immobilized patient gains the most from Intermittent Pneumatic Compression in DVT-prevention?

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  16. The efficacy of knee orthoses following anterior cruciate ligament injury. Review of literature

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  18. Retraction

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