Category | General Articles

Current Clinical Considerations in the Use of Dextrose Prolotherapy in Sport and Exercise Medicine

28 Jul 2022 published by: Mark Wilson, Anna Topping, Nirmala Perera, Richard Saw, David Hughes & Stephan Praet

Together with colleagues from the Australian Institute of Sport, Dr. Praet has published a narrative review article entitled
‘ Current Clinical Considerations in the Use of Dextrose Prolotherapy in Sport and Exercise Medicine’ in Acta Scientific Orthopaedics.

Based on an extensive review of the medical and scientific literature it's concluded that 'Prolotherapy is an injection-based therapy for acute and chronic musculoskeletal pain and has a long history of clinical use. The two main forms of dextrose prolotherapy utilise isotonic or hypertonic preparations and are considered to work via different mechanisms. Hypertonic dextrose is the most commonly used injectate and has an excellent safety profile. Isotonic dextrose can provide reliable and reproducible analgesia, given the correct patient and indication. Indeed, the application of isotonic dextrose in a perineural injection technique fashion has proven benefit for myofascial disorders, including small and large nerve entrapment syndromes. As a therapeutic intervention, dextrose prolotherapy is a powerful tool in the sports medicine armamentarium. Further investigation with high-quality randomised controlled trials with non-injection control arms in studies specific to sports injuries is needed to determine the efficacy of prolotherapy in achieving good long-term outcomes.'

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Oral Supplementation of Specific Collagen Peptides Combined with Calf-Strengthening Exercises Enhances Function and Reduces Pain in Achilles Tendinopathy Patients

21 May 2020 published by: Dr Stephan Praet et al.

The current pilot study, published in the peer-reviewed journal Nutrients 2019, 11(1), 76; https://doi.org/10.3390/nu11010076, investigated whether oral supplementation of specific collagen peptides improves symptoms and tendon vascularisation in patients with chronic mid-portion Achilles tendinopathy in combination with structured exercise. Participants were given a placebo or specific collagen peptides (TENDOFORTE^®) in combination with a bi-daily calf-strengthening program for 6 months. Group AB received specific collagen peptides for the first 3 months before crossing over to placebo. Group BA received placebo first before crossing over to specific collagen peptides. At baseline (T1), 3 (T2) and 6 (T3) months, Victorian Institute of Sports Assessment–Achilles (VISA-A) questionnaires and microvascularity measurements through contrast-enhanced ultrasound were obtained in 20 patients. Linear mixed modeling statistics showed that after 3 months, VISA-A increased significantly for group AB with 12.6 (9.7; 15.5), while in group BA VISA-A increased only by 5.3 (2.3; 8.3) points. After crossing over group AB and BA showed subsequently a significant increase in VISA-A of, respectively, 5.9 (2.8; 9.0) and 17.7 (14.6; 20.7). No adverse advents were reported. Microvascularity decreased in both groups to a similar extent and was moderately associated with VISA-A (R_c²:0.68). We conclude that oral supplementation of specific collagen peptides may accelerate the clinical benefits of a well-structured calf-strengthening and return-to-running program in Achilles tendinopathy patients. View Full-Text

Keywords: achilles tendon; microvessels; contrast-enhanced ultrasound; hydrolysed collagen supplementation