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European Journal of Physical and Rehabilitation Medicine 2019 December;55(6):862-4

DOI: 10.23736/S1973-9087.18.05498-9

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

High-energy focused extracorporeal shockwave therapy relieved pain in Dupuytren’s disease: a series of seven hands

Ahmad J. ABDULSALAM ¹ ✉, Dia SHEHAB ², Adlia A. ELHADY ³, Mini ABRAHAM ²

¹ Physical Medicine and Rehabilitation Hospital, Ardiya, Kuwait; ² Department of Medicine, Faculty of Medicine, Kuwait University, Jabriya, Kuwait; ³ Department of Physical Medicine, Jahra Hospital, Al Jahra, Kuwait

BACKGROUND: Dupuytren’s disease of the hand is characterized by progressive thickening and shortening of palmar fascia resulting in flexion deformities of the digits and hence limitation of hand function. The objective of this study was to evaluate the effectiveness of shock-wave therapy on patients with Dupuytren’s disease of the hand.
CASE REPORT: A case series study observed a total of four patients with Dupuytren’s disease of the hand. All 4 patients had diabetes. Three patients had bilateral hand involvement. Two patients had flexion deformity. High-energy focused extracorporeal shockwave therapy was applied using a Storz Duolith SD1 (2000 impulses, 3 Hz, 1.24 mJ/mm2) in 5 sessions with 7 days between. Outcome measured included pain score, tender score, hand grip, and nodule size from the Michigan Hand Outcome Questionnaire, JAMAR hand held dynamometer, and ultrasonography. Data was collected at the entry and conclusion of the study at 0 and 8 weeks.
CLINICAL REHABILITATION IMPACT: Significant statistical improvement was observed for pain score 8.7±0.5 vs. 2.0±0.9, P<0.001 and for tender score 8.5±0.5 vs. 2.5±0.9, P<0.009 after the therapy. Decrease in size of nodules with improvement of flexion deformity was observed in one patient who had multiple bilateral nodules. No adverse effects were noted. Extracorporeal shockwave therapy was beneficial in relieving symptoms in Dupuytren’s disease of the hand.

KEY WORDS: Dupuytren’s contracture; Extracorporeal shockwave therapy; Hand; Pain