J E Reznik1, E Biros2, A C Lamont3,4, Y Sacher5, O Kibrik6, S Milanese7, S Gordon8,9, M P Galea10,11. 1. a College of Healthcare Science and Division of Tropical Health and Medicine. 2. b Queensland Research Centre for Peripheral Vascular Disease. 3. c College of Medicine and Dentistry, James Cook University , Townsville , QLD , Australia. 4. d Department of Radiology , The Townsville Hospital , Townsville , QLD , Australia. 5. e Brain Injury Unit. 6. f Loewenstein Rehabilitation Center, Sackler Faculty of Medicine , Tel Aviv University , Raanana , Israel. 7. g Discipline of Physiotherapy , University of South Australia , Adelaide , SA , Australia. 8. h College of Healthcare Science, James Cook University , Townsville , QLD , Australia. 9. i School of Health Sciences, Flinders University , Bedford Park , SA , Australia. 10. j Department of Medicine, Royal Melbourne Hospital , The University of Melbourne , Melbourne , VIC , Australia. 11. k James Cook University , Townsville , QLD , Australia.
Abstract
INTRODUCTION: Neurogenic heterotopic ossification (NHO) is a complication of a neurological injury following traumatic brain injury (TBI) and may be present around major synovial joints. It is often accompanied by severe pain, which may lead to limitation in activities of daily living. Currently, a common intervention for NHO is surgery, which has been reported to carry many additional risks. This study was designed to assess the effect of extracorporeal shock wave therapy (ESWT) on pain in patients with TBI with chronic NHO. METHODS: A series of single-case studies (n = 11) was undertaken with patients who had TBI and chronic NHO at the hip or knee. Each patient received four applications of high-energy EWST delivered to the affected joint over 8 weeks. Two-weekly follow-up assessments were carried out, and final assessments were made 3 and 6 months post-intervention. Pain was measured using the Faces Rating Scale, and X-rays were taken at baseline and 6-months post-intervention to physiologically measure the size of the NHO. RESULTS: The application of high-energy ESWT was associated with significant overall reduction of pain in patients with TBI and NHO (Tau-0.412, 95% confidence interval -0.672 to -0.159, p = 0.002). CONCLUSIONS: ESWT is a novel non-invasive intervention for reducing pain resulting from NHO in patients with TBI.
INTRODUCTION:Neurogenic heterotopic ossification (NHO) is a complication of a neurological injury following traumatic brain injury (TBI) and may be present around major synovial joints. It is often accompanied by severe pain, which may lead to limitation in activities of daily living. Currently, a common intervention for NHO is surgery, which has been reported to carry many additional risks. This study was designed to assess the effect of extracorporeal shock wave therapy (ESWT) on pain in patients with TBI with chronic NHO. METHODS: A series of single-case studies (n = 11) was undertaken with patients who had TBI and chronic NHO at the hip or knee. Each patient received four applications of high-energy EWST delivered to the affected joint over 8 weeks. Two-weekly follow-up assessments were carried out, and final assessments were made 3 and 6 months post-intervention. Pain was measured using the Faces Rating Scale, and X-rays were taken at baseline and 6-months post-intervention to physiologically measure the size of the NHO. RESULTS: The application of high-energy ESWT was associated with significant overall reduction of pain in patients with TBI and NHO (Tau-0.412, 95% confidence interval -0.672 to -0.159, p = 0.002). CONCLUSIONS: ESWT is a novel non-invasive intervention for reducing pain resulting from NHO in patients with TBI.
Authors: Qizhi Qin; Mario Gomez-Salazar; Masnsen Cherief; Chase A Pagani; Seungyong Lee; Charles Hwang; Robert J Tower; Sharon Onggo; Yuxiao Sun; Abhinav Piplani; Zhao Li; Sowmya Ramesh; Thomas L Clemens; Benjamin Levi; Aaron W James Journal: Bone Res Date: 2022-06-01 Impact factor: 13.362