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Radial Shockwave Therapy (RSWT) for intractable achilles tendinosis: A pilot study
Assessment of Physical Activity in Adolescents and Children. S. G. Trost Senior Research Fellow in Physical Activity and Health School of Human Movement Studies, University of Queensland
Developing valid and reliable tools for quantifying physical activity behaviour in children and adolescents continues to be a priority. Precise yet practical measures of physical activity are a requirement in studies designed to: 1) document the frequency and distribution of physical activity in defined population groups; 2) determine the amount or dose of physical activity required to influence specific health outcomes; 3) identify the biological, psychosocial, and environmental factors that influence physical activity behaviour in young people; and 4) evaluate the efficacy of programs and policies to increase habitual physical activity in young people. This presentation will overview the wide range of methods that have been used to quantify physical activity in children and adolescents. Important methodological issues related to the use of selfreport instruments and objective monitoring devices will be identified and discussed using the latest research as a foundation. Pertinent issues confronting practitioners and field researchers witl be addressed. These include: At what age can children reliably do self-reports? Which objective measure is more valid among children - heart rate monitoring or accelerometery? Are triaxial accelerometers better than single axis accelerometers? Can accelerometer output be used to estimate exercise intensity? Are low-cost electronic pedometers valid among children?
Radial S h o c k w a v e Therapy (RSWT) for intractable Achilles tendinosis: A pilot study H. Lohrer* Sportmedizinisches Institut Frankfurt/Main, Germany
Introduction: No controlled and randomized evidence is available regarding any kind of conservative or surgical therapy for Achilles Tendinosis. 30 % (21/70) of the athletes in the German Olympic track & field team at the Oympic games in Sydney 2000 suffered from Achilles tendinosis. In the last decade extracorporeal shockwave therapy was introduced for effective treatment of insertional tendinoses like tennis elbow or plantar fasciitis (Lohrer et al. 2001, Rompe et al. 2002). The objective of this study was therefore to evaluate the effectiveness of Radial Shockwave Therapy® (RSWT) on Achilles Tendinosis in recreational and professional athletes. Material and methods: 40 athletes with Achilles tendinosis were included in this investigation. These patients had already failed to respond after conservative therapy, with at least 2 different treatment approaches for at least 3 months before proceeding to RSWT. Patients were treated in five sessions with 2,000 impulses each using the Swiss DolorClast® RSWT device. The pain center was localized by biofeedback. Follow up was done at 1,4, 12, 26 and 52 weeks after the end of the treatment. 33 (82,5 %) of the patients finished the study. Results: All evaluation measures improved significantly (Table, p < 0.001). Load induced pain (VAS)
7,8 + 1,7
2,2 + 2,5
0,7 + 1,6
Pain threshold (Newton)
14,1 + 6,6
27,5 + 10,9
41,9 + 11,6
30 Newton pressure pain (VAS)
6,7 + 3,2
2,6 + 3,6
0,9 + 2,8
Pain-free running time (min)
14,4 + 18,5
63,0 + 37,0
90,0 + 43,0
Discussion: RSWT seems to be an effective treatment modality for recalcitrant Achilles tendinosis. Further controlled and randomised trials are mandatory to confirm these results. 103
Developing valid and reliable tools for quantifying physical activity behaviour in children and adolescents continues to be a priority. Precise yet practical measures of physical activity are a requirement in studies designed to: 1) document the frequency and distribution of physical activity in defined population groups; 2) determine the amount or dose of physical activity required to influence specific health outcomes; 3) identify the biological, psychosocial, and environmental factors that influence physical activity behaviour in young people; and 4) evaluate the efficacy of programs and policies to increase habitual physical activity in young people. This presentation will overview the wide range of methods that have been used to quantify physical activity in children and adolescents. Important methodological issues related to the use of selfreport instruments and objective monitoring devices will be identified and discussed using the latest research as a foundation. Pertinent issues confronting practitioners and field researchers witl be addressed. These include: At what age can children reliably do self-reports? Which objective measure is more valid among children - heart rate monitoring or accelerometery? Are triaxial accelerometers better than single axis accelerometers? Can accelerometer output be used to estimate exercise intensity? Are low-cost electronic pedometers valid among children?
Radial S h o c k w a v e Therapy (RSWT) for intractable Achilles tendinosis: A pilot study H. Lohrer* Sportmedizinisches Institut Frankfurt/Main, Germany
Introduction: No controlled and randomized evidence is available regarding any kind of conservative or surgical therapy for Achilles Tendinosis. 30 % (21/70) of the athletes in the German Olympic track & field team at the Oympic games in Sydney 2000 suffered from Achilles tendinosis. In the last decade extracorporeal shockwave therapy was introduced for effective treatment of insertional tendinoses like tennis elbow or plantar fasciitis (Lohrer et al. 2001, Rompe et al. 2002). The objective of this study was therefore to evaluate the effectiveness of Radial Shockwave Therapy® (RSWT) on Achilles Tendinosis in recreational and professional athletes. Material and methods: 40 athletes with Achilles tendinosis were included in this investigation. These patients had already failed to respond after conservative therapy, with at least 2 different treatment approaches for at least 3 months before proceeding to RSWT. Patients were treated in five sessions with 2,000 impulses each using the Swiss DolorClast® RSWT device. The pain center was localized by biofeedback. Follow up was done at 1,4, 12, 26 and 52 weeks after the end of the treatment. 33 (82,5 %) of the patients finished the study. Results: All evaluation measures improved significantly (Table, p < 0.001). Load induced pain (VAS)
7,8 + 1,7
2,2 + 2,5
0,7 + 1,6
Pain threshold (Newton)
14,1 + 6,6
27,5 + 10,9
41,9 + 11,6
30 Newton pressure pain (VAS)
6,7 + 3,2
2,6 + 3,6
0,9 + 2,8
Pain-free running time (min)
14,4 + 18,5
63,0 + 37,0
90,0 + 43,0
Discussion: RSWT seems to be an effective treatment modality for recalcitrant Achilles tendinosis. Further controlled and randomised trials are mandatory to confirm these results. 103