Eficacia de la electrólisis percutánea en tendinopatías del miembro superior: una revisión sistemática
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Resumen
Introducción: Las tendinopatías del miembro superior son una causa frecuente de dolor y discapacidad. La electrólisis percutánea, aplicada bajo guía ecográfica, se propone como técnica invasiva para modular el dolor y apoyar la reparación tisular.
Objetivos: Determinar la eficacia de la electrólisis percutánea para reducir el dolor y sus efectos sobre la función, la fuerza, el rango articular, el umbral de dolor a la presión (UDP), los posibles hallazgos ecográficos y la dosificación.
Métodos: Se realizó una revisión PRISMA en Pubmed, PEDro, Web of Science y Cochrane. Inclusión: adultos con tendinopatía de miembro superior tratados con electrólisis percutánea y que al menos cumpliera con la medida de dolor. Exclusión: estudios en cadáver, miembro inferior, no inclusión de la medición de dolor, publicaciones que no fueran en inglés, francés o español. Se evaluó la calidad mediante el RoB 2 (ECA) y MINORS (no aleatorizados).
Resultados: Se incluyeron 7 estudios (ECA n=32-50; estudio longitudinal n=36), con seguimiento hasta 1 año. La EP mostró una reducción significativa del dolor en todos los estudios, con resultados más consistentes en el hombro. La función mejora de forma significativa en la mayoría de los estudios, con efectos clínicamente relevantes. Se observaron incrementos de fuerza, actividad electromiográfica y ROM, especialmente en hombro. El UDP mostró resultados heterogéneos. La satisfacción fue mayor en los grupos con EP y los cambios ecográficos mostraron mejoras tempranas de la hipervascularización y cambios estructurales posteriores.
Discusión: En adultos con tendinopatías del miembro superior, la electrólisis percutánea es un complemento útil al ejercicio para lograr analgesia temprana, mientras que las ganancias funcionales parecen depender principalmente del programa de ejercicio. La heterogeneidad de protocolos y el riesgo de sesgo aconsejan considerarla adyuvante, no sustitutiva, y priorizar ECA con dosimetría estandarizada, diana anatómica bien definida y seguimiento ≥ 12 meses.
Conclusiones: La electrólisis percutánea puede considerarse un complemento eficaz para modular el dolor en tendinopatías del miembro superior, pero su contribución es secundaria al ejercicio y requiere validación mediante estudios con mayor control metodológico.
Palabras clave
- electrólisis percutánea intratisular
- tendinopatía
- miembro superior
- dolor
- funcionalidad
Referencias
- Gill TK, Mittinty MM, March LM, Steinmetz JD, Culbreth GT, Cross M, et al. Global, regional, and national burden of other musculoskeletal disorders, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023;5(11):e670–e682. doi:10.1016/S2665-9913(23)00232-1.
- Lucas J, van Doorn P, Hegedus E, Lewis J, van der Windt D. A systematic review of the global prevalence and incidence of shoulder pain. BMC Musculoskelet Disord [Internet]. 2022;23(1):1–11. Available from: https://doi.org/10.1186/s12891-022-05973-8
- Manoso-Hernando D, Bailón-Cerezo J, Angulo-Díaz-Parreño S, Reina-Varona Á, Elizagaray-García I, Gil-Martínez A. Shoulder mobility and strength impairments in patients with rotator cuff related shoulder pain: a systematic review and meta analysis. PeerJ. 2024;12:e17604. doi: 10.7717/peerj.17604
- Sims SEG, Miller K, Elfar JC, Hammert WC. Non-Surgical Treatment of Lateral Epicondylitis: A Aystematic Review of Randomized Controlled Trials. HAND. 2014;9(4):419-446. doi: 10.1007/s11552-014-9642-x
- Hodgetts CJ, Leboeuf-Yde C, Beynon A, Walker BF. Shoulder pain prevalence by age and within occupational groups: a systematic review. Archives of Physiotherapy. 2021;11(1). doi: 10.1186/s40945-021-00119-w
- Giri A, O'Hanlon D, Jain NB. Risk factors for rotator cuff disease: A systematic review and meta-analysis of diabetes, hypertension, and hyperlipidemia. Annals of Physical and Rehabilitation Medicine. 2023;66(1):101631. doi: 10.1016/j.rehab.2022.101631
- Virta L, Joranger P, Brox JI, Eriksson R. Costs of shoulder pain and resource use in primary health care: a cost-of-illness study in Sweden. BMC Musculoskeletal Disorders. 2012;13(1). doi: 10.1186/1471-2474-13-17
- Challoumas D, Biddle M, Millar NL. Recent advances in tendinopathy. Faculty Reviews. 2020;9. doi: 10.12703/b/9-16
- Jaworski Ł, Zabrzyńska M, Klimaszewska-Wiśniewska A, Zielińska W, Grzanka D, Gagat M. Advances in Microscopic Studies of Tendinopathy: Literature Review and Current Trends, with Special Reference to Neovascularization Process. Journal of Clinical Medicine. 2022;11(6):1572. doi: 10.3390/jcm11061572
- Thankam FG, Dilisio MF, Gross RM, Agrawal DK. Collagen I: a kingpin for rotator cuff tendon pathology. Am J Transl Res. 2018;10(11):3291–3309.
- Dean BJF, Dakin SG, Millar NL, Carr AJ. Review: Emerging concepts in the pathogenesis of tendinopathy. Surgeon [Internet]. 2017;15(6):349–54. Available from: https://doi.org/10.1016/j.surge.2017.05.005
- Dakin SG, Ly L, Colas RA, Oppermann U, Wheway K, Watkins B, et al. Increased 15-PGDH expression leads to dysregulated resolution responses in stromal cells from patients with chronic tendinopathy. Scientific Reports. 2017;7(1). doi: 10.1038/s41598-017-11188-y
- Dakin SG, Colas RA, Newton J, Gwilym S, Jones N, Reid HAB, et al. 15-Epi-Lxa4 and MaR1 counter inflammation in stromal cells from patients with Achilles tendinopathy and rupture. The FASEB Journal. 2019;33(7):8043-8054. doi: 10.1096/fj.201900196r
- Dakin, S. G., Martinez, F. O., Yapp, C., Wells, G., Oppermann, U., Dean, B. J., Smith, R. D., Wheway, K., Watkins, B., Roche, L., & Carr, A. J. (2015). Inflammation activation and resolution in human tendon disease. Science translational medicine, 7(311), 311ra173. https://doi.org/10.1126/scitranslmed.aac4269
- Yildizgoren MT, Bagcier F. A modern interpretation of traditional galvanic current: percutaneous needle electrolysis therapy. Acupuncture in Medicine. 2023;42(1):56-57. doi: 10.1177/09645284231210569
- De-la-Cruz-Torres B, Barrera-García-Martín I, Valera-Garrido F, Minaya-Muñoz F, Romero-Morales C. Ultrasound-Guided Percutaneous Needle Electrolysis in Dancers with Chronic Soleus Injury: A Randomized Clinical Trial. Evidence-Based Complementary and Alternative Medicine. 2020;2020(1). doi: 10.1155/2020/4156258
- Abat F, Valles S, Gelber P, Polidori F, Stitik T, García-Herreros S et al. Molecular repair mechanisms using the Intratissue Percutaneous Electrolysis technique in patellar tendonitis. Revista Española de Cirugía Ortopédica y Traumatología (English Edition). 2014;58(4):201-205. doi: 10.1016/j.recote.2014.05.005
- Peñin-Franch A, García-Vidal JA, Martínez CM, Escolar-Reina P, Martínez-Ojeda RM, Gómez AI et al. Galvanic current activates the NLRP3 inflammasome to promote Type I collagen production in tendon. eLife. 2022;11. doi: 10.7554/elife.73675
- Sánchez-Sánchez JL, Calderón-Díez L, Herrero-Turrión J, Méndez-Sánchez R, Arias-Buría JL, Fernández-de-las-Peñas C. Changes in Gene Expression Associated with Collagen Regeneration and Remodeling of Extracellular Matrix after Percutaneous Electrolysis on Collagenase-Induced Achilles Tendinopathy in an Experimental Animal Model: A Pilot Study. Journal of Clinical Medicine. 2020;9(10):3316. doi: 10.3390/jcm9103316
- Varela-Rodríguez S, Sánchez-Sánchez JL, Velasco E, Delicado-Miralles M, Sánchez-González JL. Endogenous Pain Modulation in Response to a Single Session of Percutaneous Electrolysis in Healthy Population: A Double-Blinded Randomized Clinical Trial. Journal of Clinical Medicine. 2022;11(10):2889. doi: 10.3390/jcm11102889
- Varela-Rodríguez S, Sánchez-Sánchez JL, Velasco E, Delicado-Miralles M, Sánchez-González JL. Endogenous Pain Modulation in Response to a Single Session of Percutaneous Electrolysis in Healthy Population: A Double-Blinded Randomized Clinical Trial. J Clin Med. 2022 May 1;11(10).
- Rodríguez-Sanz J, Rodríguez-Rodríguez S, López-de-Celis C, Malo-Urriés M, Pérez-Amodio S, Pérez-Antoñanzas R et al. Biological and Cellular Effects of Percutaneous Electrolysis: A Systematic Review. Biomedicines. 2024;12(12):2818. doi: 10.3390/biomedicines12122818
- Sánchez-González JL, Navarro-López V, Cañada-Sánchez P, Juárez-Vela R, Viñaspre-Hernández RRd, Varela-Rodríguez S. Efficacy of different intensities of percutaneous electrolysis for musculoskeletal pain: A systematic review and meta-analysis. Frontiers in Medicine. 2023;10. doi: 10.3389/fmed.2023.1101447
- Belón-Pérez P, Calderón-Díez L, Sánchez-Sánchez JL, Robles-García M, Plaza-Manzano G, Fernández-de-las-Peñas C. Cadaveric and Ultrasound Validation of Percutaneous Electrolysis Approaches at the Arcade of Frohse: A Potential Treatment for Radial Tunnel Syndrome. International Journal of Environmental Research and Public Health. 2022;19(4):2476. doi: 10.3390/ijerph19042476
- Calderón-Díez L, Sánchez-Sánchez JL, Belón-Pérez P, Robles-García M, Pérez-Robledo F, Fernández-de-las-Peñas C. Cadaveric and Ultrasound Validation of Percutaneous Electrolysis Approach at the Distal Biceps Tendon: A Potential Treatment for Biceps Tendinopathy. Diagnostics. 2022;12(12):3051. doi: 10.3390/diagnostics12123051
- Borrella-Andrés, S., Malo-Urriés, M., Pérez-Bellmunt, A., Arias-Buría, J. L., Rodríguez-Sanz, J., Albarova-Corral, M. I., González-Rueda, V., Gallego-Sendarrubias, G. M., Fernández-de-las-Peñas, C., & López-de-Celis, C. (2022). Application of Percutaneous Needle Electrolysis Does Not Elicit Temperature Changes: An In Vitro Cadaveric Study. International Journal of Environmental Research and Public Health, 19(23), 15738. https://doi.org/10.3390/ijerph192315738
- Margalef R, Bosque M, Minaya-Muñoz F, Valera-Garrido F, Santafe MM. Safety analysis of percutaneous needle electrolysis: a study of needle composition, morphology, and electrical resistance. Acupuncture in Medicine. 2021;39(5):471-477. doi: 10.1177/0964528420988007
- de la Cruz Torres B, Albornoz Cabello M, García Bermejo P, Naranjo Orellana J. Autonomic Responses to Ultrasound-Guided Percutaneous Needle Electrolysis of the Patellar Tendon in Healthy Male Footballers. Acupuncture in Medicine. 2016;34(4):275-279. doi: 10.1136/acupmed-2015-010993
- García Bermejo P, De La Cruz Torres B, Naranjo Orellana J, Albornoz Cabello M. Autonomic Responses to Ultrasound-Guided Percutaneous Needle Electrolysis: Effect of Needle Puncture or Electrical Current? The Journal of Alternative and Complementary Medicine. 2018;24(1):69-75. doi: 10.1089/acm.2016.0339
- Asensio-Olea L, Leirós-Rodríguez R, Marqués-Sánchez MP, de Carvalho FO, Maciel LYS. Efficacy of percutaneous electrolysis for the treatment of tendinopathies: A systematic review and meta-analysis. Clinical Rehabilitation. 2022;37(6):747-759. doi: 10.1177/02692155221144272
- Ferreira MHL, Araujo GAS, De-La-Cruz-Torres B. Effectiveness of Percutaneous Needle Electrolysis to Reduce Pain in Tendinopathies: A Systematic Review With Meta-Analysis. Journal of Sport Rehabilitation. 2024;33(5):307-316. doi: 10.1123/jsr.2024-0009
- Fakontis C, Iakovidis P, Lytras D, Kasimis K, Koutras G, Ntinou SR et al. Efficacy of percutaneous needle electrolysis versus dry needling in musculoskeletal pain: A systematic review and meta-analysis. Journal of Back and Musculoskeletal Rehabilitation. 2023;36(5):1033-1046. doi: 10.3233/bmr-220408
- Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al. Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement. Journal of Clinical Epidemiology. 2021;134:103-112. doi: 10.1016/j.jclinepi.2021.02.003
- Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ Journal of Surgery. 2003;73(9):712-716. doi: 10.1046/j.1445-2197.2003.02748.x
- Arias-Buría JL, Truyols-Domínguez S, Valero-Alcaide R, Salom-Moreno J, Atín-Arratibel MA, Fernández-de-las-Peñas C. Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial. Evidence-Based Complementary and Alternative Medicine. 2015;2015:1-9. doi: 10.1155/2015/315219
- Góngora-Rodríguez J, Rosety-Rodríguez MÁ, Rodríguez-Almagro D, Martín-Valero R, Góngora-Rodríguez P, Rodríguez-Huguet M. Structural and Functional Changes in Supraspinatus Tendinopathy through Percutaneous Electrolysis, Percutaneous Peripheral Nerve Stimulation and Eccentric Exercise Combined Therapy: A Single-Blinded Randomized Clinical Trial. Biomedicines. 2024;12(4):771. doi: 10.3390/biomedicines12040771
- de Miguel Valtierra L, Salom Moreno J, Fernández-de-las-Peñas C, Cleland JA, Arias-Buría JL. Ultrasound-Guided Application of Percutaneous Electrolysis as an Adjunct to Exercise and Manual Therapy for Subacromial Pain Syndrome: A Randomized Clinical Trial. The Journal of Pain. 2018;19(10):1201-1210. doi: 10.1016/j.jpain.2018.04.017
- Rodríguez-Huguet M, Góngora-Rodríguez J, Rodríguez-Huguet P, Ibañez-Vera AJ, Rodríguez-Almagro D, Martín-Valero R et al. Effectiveness of Percutaneous Electrolysis in Supraspinatus Tendinopathy: A Single-Blinded Randomized Controlled Trial. Journal of Clinical Medicine. 2020;9(6):1837. doi: 10.3390/jcm9061837
- Rodríguez-Huguet M, Góngora-Rodríguez J, Lomas-Vega R, Martín-Valero R, Díaz-Fernández Á, Obrero-Gaitán E et al. Percutaneous Electrolysis in the Treatment of Lateral Epicondylalgia: A Single-Blind Randomized Controlled Trial. Journal of Clinical Medicine. 2020;9(7):2068. doi: 10.3390/jcm9072068
- Rodríguez-Huguet M, Rodríguez-Almagro D, Rosety-Rodríguez MA, Vinolo-Gil MJ, Molina-Jiménez J, Góngora-Rodríguez J. Pulsed negative pressure myofascial vacuum therapy and percutaneous electrolysis in the treatment of lateral epicondylalgia: A single-blind randomized controlled trial. Journal of Hand Therapy. 2024;37(4):644-652. doi: 10.1016/j.jht.2024.02.003
- Valera-Garrido F, Minaya-Muñoz F, Medina-Mirapeix F. Ultrasound-Guided Percutaneous Needle Electrolysis in Chronic Lateral Epicondylitis: Short-Term and Long-Term Results. Acupuncture in Medicine. 2014;32(6):446-454. doi: 10.1136/acupmed-2014-010619
- Safikhani S, Gries KS, Trudeau JJ, Reasner D, Rüdell K, Coons SJ et al. Response scale selection in adult pain measures: results from a literature review. Journal of Patient-Reported Outcomes. 2018;2(1). doi: 10.1186/s41687-018-0053-6
- Mintken PE, Glynn P, Cleland JA. Psychometric properties of the shortened disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) and Numeric Pain Rating Scale in patients with shoulder pain. Journal of Shoulder and Elbow Surgery. 2009;18(6):920-926. doi: 10.1016/j.jse.2008.12.015
- Augustyn D, Paez A. The effectiveness of intratissue percutaneous electrolysis for the treatment of tendinopathy: a systematic review. South African Journal of Sports Medicine. 2022;34(1). doi: 10.17159/2078-516x/2022/v34i1a12754
- Fernández-Rodríguez T, Fernández-Rolle Á, Truyols-Domínguez S, Benítez-Martínez JC, Casaña-Granell J. Prospective Randomized Trial of Electrolysis for Chronic Plantar Heel Pain. Foot & Ankle International. 2018;39(9):1039-1046. doi: 10.1177/1071100718773998
- Al-Boloushi Z, Gómez-Trullén EM, Arian M, Fernández D, Herrero P, Bellosta-López P. Comparing two dry needling interventions for plantar heel pain: a randomised controlled trial. BMJ Open. 2020;10(8):e038033. doi: 10.1136/bmjopen-2020-038033
- López-Royo MP, Ríos-Díaz J, Galán-Díaz RM, Herrero P, Gómez-Trullén EM. A Comparative Study of Treatment Interventions for Patellar Tendinopathy: A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation. 2021;102(5):967-975. doi: 10.1016/j.apmr.2021.01.073
- Doménech-García V, Pecos-Martín D, Blasco-Abadía J, Bellosta-López P, López-Royo MP. Placebo and nocebo effects of percutaneous needle electrolysis and dry-needling: an intra and inter-treatment sessions analysis of a three-arm randomized double-blinded controlled trial in patients with patellar tendinopathy. Frontiers in Medicine. 2026;13. doi: 10.3389/fmed.2026.1851424
- Muñoz-Fernández AC, Barragán-Carballar C, Villafañe JH, Martin-Pérez S, Alonso-Pérez JL, Díaz-Meco R, et al. Muñoz-Fernández et al. A new ultrasound-guided percutaneous electrolysis and exercise treatment in patellar tendinopathy: three case reports. Frontiers in Bioscience-Landmark. 2021; 26: 1166–1175. Frontiers in Bioscience-Landmark. 2022;27(3). doi: 10.31083/j.fbl2703109
- Blanco-Díaz M, Ruiz-Redondo R, Escobio-Prieto I, De la Fuente-Costa M, Albornoz-Cabello M, Casaña J. A Systematic Review of the Effectiveness of Dry Needling in Subacromial Syndrome. Biology. 2022;11(2):243. doi: 10.3390/biology11020243
- Griswold D, Learman K, Ickert E, Tapp A, Ross O. Dry Needling for Subacromial Pain Syndrome: A Systematic Review with Meta-Analysis. Pain Medicine. 2022;24(3):285-299. doi: 10.1093/pm/pnac131
- Yoon SY, Kim YW, Shin IS, Kang S, Moon HI, Lee SC. The Beneficial Effects of Eccentric Exercise in the Management of Lateral Elbow Tendinopathy: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2021;10(17):3968. doi: 10.3390/jcm10173968
- Ma X, Qiao Y, Wang J, Xu A, Rong J. Therapeutic Effects of Dry Needling on Lateral Epicondylitis: An Updated Systematic Review and Meta-analysis. Archives of Physical Medicine and Rehabilitation. 2024;105(11):2184-2197. doi: 10.1016/j.apmr.2024.02.713
- Yao G, Chen J, Duan Y, Chen X. Efficacy of Extracorporeal Shock Wave Therapy for Lateral Epicondylitis: A Systematic Review and Meta-Analysis. BioMed Research International. 2020;2020(1). doi: 10.1155/2020/2064781
- Wu D, Wen Z, Ke H, Zhang J, Zhong S, Teng J, et al. Specific modes of exercise to improve rotator cuff-related shoulder pain: systematic review and meta-analysis. Frontiers in Bioengineering and Biotechnology. 2025;13. doi: 10.3389/fbioe.2025.1560597
- Paraskevopoulos E, Plakoutsis G, Chronopoulos E, Maria P. Effectiveness of Combined Program of Manual Therapy and Exercise Vs Exercise Only in Patients With Rotator Cuff-related Shoulder Pain: A Systematic Review and Meta-analysis. Sports Health: A Multidisciplinary Approach. 2022;15(5):727-735. doi: 10.1177/19417381221136104
- Naranjo-Cinto F, Cerón-Cordero A, Figueroa-Padilla C, Galindo-Paz D, Fernández-Carnero S, Gallego-Izquierdo T, et al. Real versus Sham Manual Therapy in Addition to Therapeutic Exercise in the Treatment of Non-Specific Shoulder Pain: A Randomized Controlled Trial. Journal of Clinical Medicine. 2022;11(15):4395. doi: 10.3390/jcm11154395
- Spigelman T, Simpkins L, Humphrey C, Vitel Y, Sciascia A. Reliability Analysis of In-person and Virtual Goniometric Measurements of the Upper Extremity. International Journal of Sports Physical Therapy. 2023;18(4). doi: 10.26603/001c.81065
- Bobos P, Ziebart C, Furtado R, Lu Z, MacDermid JC. Psychometric properties of the global rating of change scales in patients with low back pain, upper and lower extremity disorders. A systematic review with meta-analysis. Journal of Orthopaedics. 2020;21:40-48. doi: 10.1016/j.jor.2020.01.047
- Ibáñez JM S. The ultrasound-guided intratissue percutaneous electrolysis (epi®) for the treatment of refractory-neovascular patellar tendinopathy. International Clinical Pathology Journal. 2017;4(1). doi: 10.15406/icpjl.2017.04.00080
- Kannus P. Structure of the tendon connective tissue. Scandinavian Journal of Medicine & Science in Sports. 2000;10(6):312-320. doi: 10.1034/j.1600-0838.2000.010006312.x
- Zhang S, Ju W, Chen X, Zhao Y, Feng L, Yin Z. Bioactive Materials Hierarchical ultrastructure : An overview of what is known about tendons and future perspective for tendon engineering. Bioact Mater [Internet]. 2022;8(June 2021):124–39. Available from: https://doi.org/10.1016/j.bioactmat.2021.06.007
- Benjamin M, Ralphs JR. Fibrocartilage in tendons and ligaments — an adaptation to compressive load. Journal of Anatomy. 1998;193(4):481-494. doi: 10.1017/s0021878298004300
- Buckley MR, Evans EB, Matuszewski PE, Chen Y, Satchel LN, Elliott DM, et al. Distributions of types I, II and III collagen by region in the human supraspinatus tendon. Connective Tissue Research. 2013;54(6):374-379. doi: 10.3109/03008207.2013.847096
- Hrvatin I, Puh U. Measurement properties of the numerical pain rating scale in patients with musculoskeletal impairments of the limbs – a systematic literature review. Zdrav Vestn. 2021;90(9-10):512-20. doi: 10.6016/ZdravVestn.3108
- Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, et al. Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults. JAAOS: Global Research and Reviews. 2018;2(3):e088. doi: 10.5435/jaaosglobal-d-17-00088
- Brindisino F, Venturin D, Bartoli M, Caselli S, Pellicciari L, Poser A. Psychometric properties of the Disability of Arm Shoulder and Hand (DASH) in subjects with frozen shoulder: a reliability and validity study. BMC Musculoskeletal Disorders. 2024;25(1). doi: 10.1186/s12891-024-07371-8
- MacDermid JC, Solomon P, Prkachin K. The Shoulder Pain and Disability Index demonstrates factor, construct and longitudinal validity. BMC Musculoskeletal Disorders. 2006;7(1). doi: 10.1186/1471-2474-7-12
- Sveinall H, Brox JI, Engebretsen KB, Hoksrud AF, Røe C, Johnsen MB. Measurement properties of core outcomes in patients with tennis elbow. Shoulder & Elbow. 2025. doi: 10.1177/17585732251344264
- Bilika P, Kalamatas-Mavrikas P, Vasilis N, Strimpakos N, Kapreli E. Reliability of Pressure Pain Threshold (PPT) and Conditioned Pain Modulation (CPM) in Participants with and without Chronic Shoulder Pain. Healthcare. 2024;12(17):1734. doi: 10.3390/healthcare12171734
- Felici F, Del Vecchio A. Surface Electromyography: What Limits Its Use in Exercise and Sport Physiology?. Frontiers in Neurology. 2020;11. doi: 10.3389/fneur.2020.578504
- Watson J, Barker-Davies RM, Bennett AN, Fong DTP, Wheeler PC, Lewis M et al. Sport and exercise medicine consultants are reliable in assessing tendon neovascularity using ultrasound Doppler. BMJ Open Sport & Exercise Medicine. 2018;4(1):e000298. doi: 10.1136/bmjsem-2017-000298
- Wengert GJ, Schmutzer M, Bickel H, Sora M, Polanec SH, Weber M et al. Reliability of high-resolution ultrasound and magnetic resonance arthrography of the shoulder in patients with sports-related shoulder injuries. PLOS ONE. 2019;14(9):e0222783. doi: 10.1371/journal.pone.0222783
- Fatih BAĞCIER, Duygu GELER KÜLCÜ, Elem YORULMAZ, Elif Çiğdem ALTUNOK. Intra- and Inter-Rater Reliability of Ultrasound Measurements of Supraspinatus Tendon Thickness, Acromiohumeral Distance, and Occupation Ratio in Patients With Shoulder Impingement Syndrome. Archives of Rheumatology. 2020;35(3):385-393. doi: 10.46497/archrheumatol.2020.7515
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