Ultrasound-guided application of percutaneous electrolysis as an adjunct to exercise and manual therapy for tibialis posterior tendinopathy: A randomized clinical trial

Abstract

Percutaneous electrolysis has been advocated as a therapeutic strategy for tendinopathies; however, no previous trials have investigated the effects of percutaneous electrolysis on the treatment of tibialis posterior tendinopathy. The aim of this study was to investigate the effects on pain and disability of adding percutaneous electrolysis to a manual therapy and exercise program in individuals with tibialis posterior tendinopathy. A randomized clinical trial (clinical registry: NCT05370092) was conducted. Forty-six (n=46) patients with tibialis posterior tendinopathy were randomized into manual therapy/exercise (n=23) or manual therapy/exercise and percutaneous electrolysis (n=23) group. All participants received the same manual therapy/exercise protocol (one session/week, 4 weeks). Those allocated to electrolysis group also received this intervention US-guided at each treatment session. Pain intensity (Numerical Pain Rate Scale) as primary outcome and disability as secondary outcome (Foot and Ankle Ability Measure, FAAM) were assessed at baseline, post-treatment and at 3- and 6- months. Patients receiving percutaneous electrolysis had significantly greater improvements in pain (post: Δ-3.4, 95%CI −4.8 to −2.0; 3months: Δ-3.4, −5.0 to −1.8; 6months: Δ-2.6, −4.2 to −1.0) and disability (post: FAAM/Sports Δ49.6, 95%CI 34.6–64.6 - FAAM/ADL Δ26.9, 14.6–39.2; 3months: FAAM/Sports Δ31.6, 14.8–48.4 - FAAM/ADL Δ4.9, 2.0–7.8; 6months: FAAM/Sports Δ17.4, 2.0–32.8 – FAAM/ADL Δ2.4, 1.0–3.8) than those receiving just manual therapy/exercise alone. This clinical trial found that adding US-guided percutaneous electrolysis to a manual therapy/exercise program was more effective for improving pain and disability than the application of just manual therapy/exercise in people with tibialis posterior tendinopathy at short-term and mid-term follow-ups.