Shock wave therapy: possibilities and perspectives for application in clinical practice for diabetic foot patients
- Authors: Teltevskaya I.I.1, Ivanova S.V.1, Yushchuk E.N.1, Mkrtumyan A.M.1,2, Melekhina I.V.1
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Affiliations:
- Russian University of Medicine of the Ministry of Healthcare of Russia
- A.S. Loginov Moscow Clinical Scientific and Practical Center of the Department of Healthcare of Moscow
- Issue: Vol 10, No 4 (2024)
- Pages: 91-97
- Section: ORIGINAL STUDIES
- URL: https://journal-vniispk.ru/2412-4036/article/view/260522
- DOI: https://doi.org/10.18565/therapy.2024.4.91-97
- ID: 260522
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Abstract
Diabetic foot syndrome (DFS) is one of the most dangerous complications of diabetes mellitus (DM). According to the State register, in Russia the frequency of limb amputations in patients with type 2 diabetes mellitus (DM 2) is 10.9 cases per 10 thousand adult patients. Averting of ulcers formation can prevent up to 85% of lower limb amputations.
The aim: to evaluate the efficacy of extracorporeal shock wave therapy (SWT) for DFS treatment in patients with DM 2.
Material and methods. Pilot study included 17 patients with DM2 and DFS without a peptic ulcer. The average age of the participants was 64.9 ± 9.0 years, duration of DM 2 existence was 12.6 [10.0; 15.0] years. All patients underwent clinical examination, laboratory and instrumental examination: electrocardiography, volumetric sphygmography with analysis of the ankle-brachial (ABI) and finger-brachial (FBI) indexes, and assessment of sensory peripheral sensitivity. Neuropathy screening diagnostic scales and SF-36 quality of life questionnaire were used. SWT treatment sessions were performed using CARDIOSPEC system (Medispec, Israel).
Results. Initially, the average ABI value was within the normative values (right – 1.01 ± 0.14, left – 1.05 ± 0.07). Patients with type 2 diabetes, DFS and a decrease in FBI of less than 0.65 received a 3-week course of shock wave therapy. A significant increase in FBI on the side exposed to SWT was fixed after 3 weeks, maintaining a statistically significant difference comparatively to baseline values after 6, 9 and 12 weeks. On the opposite foot, which was the control, the average PPI value at all stages of observation did not change significantly. All patients showed recovery of vibration and tactile sensitivity after a course of shock wave therapy. A significant improvement of life quality in all components of physical health of SF-36 questionnaire also took place.
Conclusion. Use of a 3-week course of shock wave therapy in patients with type DM 2 and diabetic foot syndrome without an ulcer defect contributed to the improvement of perfusion of the lower limb on the affected side, which was accompanied by a significant increase in FBI, improvement in sensory peripheral sensitivity and life quality of patients.
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##article.viewOnOriginalSite##About the authors
Inna I. Teltevskaya
Russian University of Medicine of the Ministry of Healthcare of Russia
Author for correspondence.
Email: inna.teltevskaia@yandex.ru
ORCID iD: 0000-0002-2305-7937
MD, postgraduate student of the Department of Clinical Functional Diagnostics
Russian Federation, MoscowSvetlana V. Ivanova
Russian University of Medicine of the Ministry of Healthcare of Russia
Email: svivanova@rambler.ru
ORCID iD: 0000-0001-7370-9297
MD, Dr. Sci. (Medicine), associate professor, professor of the Department of Clinical Functional Diagnostics
Russian Federation, MoscowElena N. Yushchuk
Russian University of Medicine of the Ministry of Healthcare of Russia
Email: ndlena@mail.ru
ORCID iD: 0000-0003-0065-5624
MD, Dr. Sci. (Medicine), professor, head of the Department of Clinical Functional Diagnostics
Russian Federation, MoscowAshot M. Mkrtumyan
Russian University of Medicine of the Ministry of Healthcare of Russia; A.S. Loginov Moscow Clinical Scientific and Practical Center of the Department of Healthcare of Moscow
Email: vagrashot@mail.ru
ORCID iD: 0000-0003-1316-5245
MD, Dr. Sci. (Medicine), professor, head of the Department of Endocrinology and Diabetology; head of the Scientific Department of Endocrine and Metabolic Disorders
Russian Federation, Moscow; MoscowInna V. Melekhina
Russian University of Medicine of the Ministry of Healthcare of Russia
Email: melekhinaiv@yandex.ru
MD, postgraduate student of the Department of Clinical Functional Diagnostics
Russian Federation, MoscowReferences
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