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KMID : 0361420140380040523
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Journal of Korean Academy of Rehabilitation Medicine
2014 Volume.38 No. 4 p.523 ~ p.533
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Outcomes of Ultrasound-Guided Extracorporeal Shock Wave Therapy for Painful Stump Neuroma
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Jung Yun-Jae
Park Won-Yong
Jeon Jong-Hyun
Mun Jeong-Hyeon
Cho Yoon-Soo
Jun Ah-Young
Jang Ki-Un
Seo Cheong-Hoon
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Abstract
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Objective: To investigate the effect of extracorporeal shock wave therapy (ESWT) on painful stump neuroma.
Methods: Thirty patients with stump neuroma at the distal end of an amputation site were assigned randomly to the ESWT group (n=15) and the transcutaneous electrical nerve stimulation (TENS)+desensitization+pharmacological treatment group (n=15). For 3 weeks, the ESWT group received a weekly session involving 1,500 pulses at 0.10 mJ/mm2, while the control group was treated 10 times each, 40 minutes per day with TENS and desensitization treatment, and daily medication for 3 weeks. ESWT stimulation was given by focusing on the area at the neuroma site clearly identified by ultrasound.
Results: The changes in the McGill pain questionnaire were 38.8±9.0 prior to treatment and 11.8±3.1 following the treatment. The corresponding values for the control group were 37.2±7.7 and 28.5±10.3. The changes between groups were significantly different (p=0.035). The change in visual analog scale prior to and after treatment was 7.0±1.5 and 2.8±0.8 in the ESWT group, respectively, and 7.2±1.4 and 5.8±2.0 in the control group. These changes between the groups were also significantly different (p=0.010). The outcome in the pain rating scale also showed significant differences between groups (p<0.001). Changes in neuroma size and pain pressure threshold (lb/cm2) were not significantly different between groups (p>0.05).
Conclusion: The study findings imply that ESWT for stump neuroma is superior to conventional therapy.
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KEYWORD
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Amputation stumps, Neuroma, Extracorporeal shock wave therapy, Ultrasonography, Visual analogue scale
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