Abstract
Objectives
To investigate the effect of hypertonic dextrose injection on pain and disability
in patients with chronic supraspinatus tendinosis. The secondary aim was to evaluate
its effect on the tendon range of motion (ROM) and morphology.
Design
Randomized double-blind placebo-controlled trial.
Setting
Outpatient clinic.
Participants
Individuals (N=57) with symptomatic chronic supraspinatus tendinosis.
Interventions
Participants were randomly administered ultrasound-guided injections of 20% hypertonic
dextrose (study group, n=29) or 5% normal saline (control group, n=28).
Main Outcome Measures
The primary outcome measure was visual analog scale (VAS) scores for pain and Shoulder
Pain and Disability Index (SPADI) scores. Secondary outcomes included the ROM and
ultrasound examination findings of the supraspinatus tendon at baseline and at 2,
6, and 12 weeks postintervention.
Results
The study group exhibited significant improvements in the VAS (mean difference [MD],
−2.1; 95% confidence interval [CI], −2.7 to −1.4; P<.001) and SPADI (MD, −11.6; 95% CI, −16.5 to −6.7; P<.001) scores compared with baseline scores at week 2. However, the effect was not
sustained to week 6. Flexion ROM increased at weeks 2 (MD, 14.1; 95% CI, 5.7-22.5;
P<.001) and 6 (MD, 8.9; 95% CI, 2.4-15.4; P=.003) compared with baseline. The thickness of the supraspinatus tendon improved
at weeks 6 (MD, .50; 95% CI, .26-.74; P<.001) and 12 (MD, .61; 95% CI, .37-.84; P<.001) compared with baseline. The ratio of histograms also improved at weeks 6 (MD,
.19; 95% CI, .06-.32; P=.002) and 12 (MD, .26; 95% CI, .10-.41; P<.001) compared with baseline.
Conclusion
Hypertonic dextrose injection could provide short-term pain and disability relief
in patients with chronic supraspinatus tendinosis. Ultrasound imaging at week 6 revealed
changed tendon morphology.
Keywords
List of abbreviations:
AROM (active range of motion), DPT (dextrose prolotherapy), ER (external rotation), ICC (intraclass correlation coefficient), IR (internal rotation), MD (mean difference), ROI (region of interest), ROM (range of motion), SPADI (Shoulder Pain and Disability Index), TRPV1 (transient receptor potential vanilloid-1), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 02, 2021
Accepted:
July 27,
2021
Received:
July 26,
2021
Footnotes
This work was supported by the Ministry of Science and Technology of Taiwan under grants MOST 105-2314-B-038-040, MOST 106-2314-B-038-027, and TMU108-AE1-B01.
This study was approved by TMU-Joint Institutional Review Board (N201605022).
Disclosures: none.
Clinical trial registration number (ClinicalTrials.gov): NCT03000205.
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
