Efficacy of ultrasound-guided galvanic electrolysis technique and physical therapy in patients with Achilles’ tendinopathy: A pilot randomised controlled trial

Article type: Research Article

Authors: Di Gesù, Marco^a | Alito, Angelo^b | Borzelli, Daniele^{b; c} | Romeo, Domenico^d | Bonomolo, Fabio^a | Calafiore, Dario^e | de Sire, Alessandro^{f; g; *}

Affiliations: [a] Health Center Mya Salute, Palermo, Italy | [b] Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy | [c] Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy | [d] Physiocare: Physiotherapy Rehabilitation Center, Augusta, Italy | [e] Department of Neurosciences, Physical Medicine and Rehabilitation Unit, ASST Carlo Poma, Mantova, Italy | [f] Department of Medical and Surgical Sciences, Physical and Rehabilitative Medicine, University of Catanzaro “Magna Graecia”, Catanzaro, Italy | [g] Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, Catanzaro, Italy

Correspondence: [*] Corresponding author: Alessandro de Sire, Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy. E-mail: alessandro.desire@unicz.it.

Abstract: BACKGROUND: Ultrasound-guided galvanic electrolysis technique (USGET) is an innovative mini-invasive intervention with the potential to optimise outcomes in the treatment of Achille’s tendinopathy (AT). OBJECTIVE: The aim of this pilot study is to evaluate the efficacy of adding USGET to conventional eccentric exercise treatment in patients with chronic AT. METHODS: Inclusion criteria were patients with unilateral non-insertional AT, pain lasting > 3 months, aged 25–60 years. Patients were randomised in two groups receiving the same physiotherapy treatment (2 sessions per week for 8 weeks). In addition, the experimental group received three USGET stimulations, one every 15 days. Outcome measures were assessment of Achilles tendinopathy severity using the Victorian Institute of Sport Assessment-Achilles (VISA-A) and pain intensity using the Visual Analogue Scale (VAS). Assessment points occurred at the onset of treatment (T0), its conclusion (T1), and subsequent follow-ups at one (T2) and two months (T3). RESULTS: Out of the 52 patients who met the study inclusion criteria, two participants withdrew from the study, resulting in a total of 50 subjects who completed the research. None of the parameters showed a different distribution at T1 (p> 0.337). At T2, there was a statistical difference in VISA-A (p= 0.010) and its subscales and VAS (p= 0.002) in the USGET group. At T3, both groups improved with a statistical difference observed in VISA-A (p< 0.001) and its subscales Pain (p= 0.004), Function (p= 0.003) and Sport (p= 0.002), but the EG patients showed a greater improvement. No adverse events were reported. CONCLUSION: The effect of USGET combined with eccentric exercise appears to be a safe and effective technique for achieving pain relief and functional recovery in the medium term, supporting the integrated use of USGET as a rehabilitative treatment option for patients with chronic AT.

Keywords: Achilles tendon, exercise therapy, interventional ultrasound, physical and rehabilitation medicine, tendinopathies

DOI: 10.3233/BMR-230255

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 5, pp. 1177-1188, 2024