Biomedizinische Technik. Biomedical engineering
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Randomized Controlled Trial
Extracorporeal shock wave therapy for non-calcific supraspinatus tendinitis - 10-year follow-up of a randomized placebo-controlled trial.
Evidence for the efficacy of extracorporeal shock wave therapy (ESWT) in supraspinatus tendinopathy without calcification is sparse, and therefore this treatment option is often controversial. Patients of a randomized placebo-controlled study to analyze the effects of ESWT on function and pain were revisited 10 years after the initial consultation. The former verum group received 6000 impulses (energy flux density, 0.11 mJ/mm²) in three sessions after local anesthesia between 1999 and 2000. ⋯ No significant changes (p>0.05) in relative Constant scores, pain at rest, or pain during activity could be found after a 10-year follow-up between the placebo and verum groups after ESWT. The treatment of non-calcific supraspinatus tendinopathy with ESWT does not seem to have an effect on function or pain improvement in the long run. The results of the present study cannot advise the use of ESWT in cases of non-calcific supraspinatus tendinopathy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Auto-CPAP therapy based on the forced oscillation technique.
Autoadjusting CPAP devices (APAP) are designed to continuously adjust the positive pressure to the required levels, and thus increase treatment quality and patient compliance. The results of APAP treatment strongly depend on the control mechanism of the respective APAP device. In agreement with other working groups, we have recently shown that the forced oscillation technique (FOT) is capable of detecting incipient upper airway obstruction prior to physiological reactions such as the onset of increasing esophageal pressure swings or microarousals. ⋯ The mean treatment pressure during APAP was significantly lower than during CPAP treatment (6.0 +/- 2.0 vs. 9.0 +/- 1.8 mbar; p < 0.001). There were no significant differences between APAP and CPAP treatment in any parameter of efficacy or acceptance. APAP treatment with this device controlled exclusively by FOT is well accepted by the patients and permits an adequate treatment of OSAS without the need for invidiual CPAP titration.