Русский
Shock wave therapy: Possibilities and perspectives for application in clinical practice for diabetic foot patients
DOI: https://dx.doi.org/10.18565/therapy.2024.4.91-97
Teltevskaya I.I., Ivanova S.V., Yushchuk E.N., Mkrtumyan A.M., Melekhina I.V.
1) Russian University of Medicine of the Ministry of Healthcare of Russia, Moscow; 2) A.S. Loginov Moscow Clinical Scientific and Practical Center of the Department of Healthcare of Moscow
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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About the Autors
Inna I. Teltevskaya, MD, postgraduate student of the Department of clinical functional diagnostics, Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.
E-mail: inna.teltevskaia@yandex.ru
ORCID: https://orcid.org/0000-0002-2305-7937
Svetlana V. Ivanova, MD, Dr. Sci. (Medicine), associate professor, professor of the Department of clinical functional diagnostics, Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.
E-mail: svivanova@rambler.ru
ORCID: https://orcid.org/0000-0001-7370-9297
Elena N. Yushchuk, MD, Dr. Sci.(Medicine), professor, head of the Department of clinical functional diagnostics, Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.
E-mail: ndlena@mail.ru
ORCID: https://orcid.org/0000-0003-0065-5624
Ashot M. Mkrtumyan, MD, Dr. Sci. (Medicine), professor, head of the Department of endocrinology and diabetology, Russian University of Medicine of the Ministry of Healthcare of Russia, head of the Scientific Department of endocrine and metabolic disorders, A.S. Loginov Moscow Clinical Scientific and Practical Center of the Department of Healthcare of Moscow. Address: 127006, Moscow, 4 Dolgorukovskaya St.
E-mail: vagrashot@mail.ru
ORCID: https://orcid.org/0000-0003-1316-5245
Inna V. Melekhina, MD, postgraduate student of the Department of clinical functional diagnostics, Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.
E-mail: melekhinaiv@yandex.ru
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