Traitement du conflit antérolatéral de la cheville par ondes de choc extra-corporelles : étude préliminaire sur un échantillon de patients sportifs à Bordeaux

Abstract : Objective. To describe the clinical effects observed after extracorporeal shock wave therapy in patients with anterolateral ankle impingement. Method. A prospective interventional non-comparative study was performed. Diagnosis of anterolateral ankle impingement was primarily based on clinical findings in our study, according to the presence of Liu criteria (sensibility 94 %, specificity 75 %) after lateral ankle sprain. The therapeutic protocol consisted of 3 sessions of low energy radial shock wave treatment (3 000 shocks/session, 12/s) performed with a one-week interval. Ankle joint function (Karlsson scoring system), rest pain and activity-related pain (numeric pain scale) and measurement of ankle dorsiflexion were evaluated at baseline and 1 and 6 weeks after treatment. Results. Eight patients ranging in age from 20 to 55 were included. The average duration of symptoms was 6.3 months (3–14). All patients previously received a conventional medical treatment and physiotherapy for at least 3 months. The following clinical outcomes were significantly improved (p < 0,05) at the last follow-up, performed 6 weeks after the last shock wave session : the average Karlsson ankle score increased from 38.63/100 (25–55) to 83.38/100 (42–100), the average activity-related pain decreased from 6.5/10 (5–8) to 2.63/10 (1–6) and the average rest pain decreased from 2.88/10 (0–5) à 0.38/10 (0–3) after treatment. Adverse events related were not constant and always minor. Conclusion. Extracorporeal shock wave therapy might be an interesting treatment for anterolateral ankle impingement. It could be a complement to conventional medical treatment, physiotherapy, and before surgery. Larger randomized controlled trials are required to confirm our results.
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Master Thesis
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Submitted on : Friday, December 8, 2017 - 12:24:12 PM
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Guillaume Messina. Traitement du conflit antérolatéral de la cheville par ondes de choc extra-corporelles : étude préliminaire sur un échantillon de patients sportifs à Bordeaux. Médecine humaine et pathologie. 2017. ⟨dumas-01659348⟩

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