HIGHLIGHTS
- •Clinical effectiveness of extracorporeal shockwave therapy (ESWT) for trigger finger (TF) remains unclear.
- •Wide-focused ESWT could be safe and effective for pain relief and functional improvement in TF.
- •Dose-related effectiveness of wide-focused ESWT may exist in treatment of TF.
Abstract
Objectives
To determine the efficacy of extracorporeal shockwave therapy (ESWT) and to determine
the ideal energy flux density of wide-focused ESWT in the treatment of trigger finger
(TF).
Design
Double-blind randomized controlled trial.
Setting
A university hospital.
Participants
A total of 60 patients (N=60) with grade II TF according to the Quinnell classification
were randomly and evenly allocated to 3 treatment groups.
Interventions
Three treatment groups included a high-energy ESWT (HS) group (energy flux density
of 0.01 mJ/mm2, 5.8 bar, 1500 impulses, once per week for 4wk), a low-energy ESWT (LS) group (energy
flux density of 0.006 mJ/mm2, 3 bar, 1500 impulses, once per week for 4wk), and a sham intervention group (sham
group). All participants received 6 months of follow-up after intervention when only
painkillers were allowed as concomitant treatment.
Main Outcome Measures
Clinical outcomes were followed at baseline and 1, 3, and 6 months after intervention,
including pain score, frequency of triggering, severity of triggering, functional
impact of triggering, and quick Disabilities of the Arm, Shoulder, and Hand questionnaire
(qDASH).
Results
All groups showed significant improvements from baseline in all clinical parameters,
except for functional impact of triggering, 6 months after the interventions. However,
the HS group demonstrated a higher magnitude of improvement than the LS and sham groups.
In addition, the HS group reported significantly lower pain (P=.01) and lower qDASH (P=.008) than the sham group 6 months after the interventions. No adverse effects were
reported in the HS and LS groups within 6 months of follow-up.
Conclusions
Wide-focused ESWT is a safe and effective but dose-dependent alternative facilitating
pain relief and functional improvement in the treatment of grade II TF according to
the Quinnell classification.
Keywords
List of abbreviations:
ANOVA (analysis of variance), ESWT (extracorporeal shockwave therapy), HS (high-energy ESWT), LS (low-energy ESWT), NSAID (nonsteroidal anti-inflammatory drug), qDASH (quick Disabilities of the Arm, Shoulder, and Hand questionnaire), RCT (randomized controlled trial), TF (trigger finger)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 20, 2021
Accepted:
April 28,
2021
Received in revised form:
April 19,
2021
Received:
December 7,
2020
Footnotes
Supported by Wan Fang Hospital (grant no. 108-wf-phd-02); the Ministry of Science and Technology (grant nos. MOST 109-2926-I-010-501, MOST 107-2314-B-010-015-MY3, MOST 109-2926-I-010-502, MOST 109-2321-B-010-005, MOST 108-2923-B-010-002-MY3, MOST 109-2823-8-010-003-CV, MOST 109-2622-B-010-006, MOST 109-2321-B-010-006); the “Development and Construction Plan” of the School of Medicine, National Yang-Ming University, now known as National Yang Ming Chiao Tung University (grant no. 107F-M01-0504); and Aiming for the Top University Plan, a grant from Ministry of Education.
Clinical Trial Registration No.: NCT03928873.
Disclosures: none.
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
