Physical Therapy Post-Platelet Rich Plasma
Description: Physical Therapy Post-Platelet Rich Plasma Treatment Keerat Chawla, SPT Objectives The audience will be able to understand about injuries and soft tissue structures in the body that respond well to PRP injections The audience will learn
Related Topics
Download Presentation
"Physical Therapy Post-Platelet Rich Plasma" is the property of its rightful owner. Permission is granted to download and print the materials on this website for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Presentation Transcript
slide1. Physical Therapy Post-Platelet Rich Plasma Treatment Keerat Chawla, SPT<br>
slide2. Objectives The audience will be able to understand about injuries and soft tissue structures in the body that respond well to PRP injections
The audience will learn about which patient populations would be appropriate for and may benefit from a PRP injection with continues PT after.
The audience will learn about the implications that PRP treatment will have on a patient’s course of therapy.<br>
slide3. 1<br>
slide4. PRP Treatment is appropriate for 2,3:<br>
slide5. TMJ Osteoarthritis 4 Effect of platelet- rich plasma injection combined with individualized comprehensive physical therapy on temporomandibular joint osteoarthritis: A prospective cohort study (Liu SS, et al.): Findings:
Pain intensity, maximum mouth opening, & TMJ sounds improved in both groups
Mouth opening better in combined group
TMJ sounds better in PRP only group
Pain improvement was greater in the combined group at 3 & 6 months
JFLS scores were higher in the combined group at 6 months Assessed:
Pain intensity
Maximum mouth opening
TMJ sounds
Jaw Functional Limitation Scale (JFLS)
Imaging<br>
slide6. Surgical Rotator Cuff Repair 5 Supporting PRP use:
(Randelli et al.): Utilized a PRP group vs no PRP application
VAS pain score was lower in the PRP group at 3, 7, 14, & 30 days post-surgery
PRP group had higher SST scores and greater external rotation strength at 3 months post-surgery
Not Supporting:
No significant difference in outcome measures at 6, 12, & 24 months post-surgery<br>
slide7. Hamstring injury 6,7 Platelet-rich plasma injections for the treatment of hamstring injuries: a randomized controlled trial (MSA Hamid): Assessed:
Effectiveness of a PRP injection to treat grade 2 hamstring injury
Methods:
28 patients with acute hamstring injury randomly given either PRP + rehab or only a rehab program Findings:
1 PRP injection + rehab program was significantly more effective in treating the injuries than a rehab program along
Return to play:
26.7 ± 7.0 days (PRP group)
42.5 ± 20.6 days (Rehab group)
PRP group reported lower pain severity throughout the study.<br>
slide8. Conservative treatment approaches:
Physical therapy: eccentric and concentric loading of quadriceps
Bracing
Transdermal nitroglycerin patches
Heat therapy
*Many studies have been done of the effectiveness of PRP injections in treating patellar tendinopathy
Difficult to draw conclusions due to conflicting evidence
Some studies show improvement in pain with PRP therapy
Some showed no profound benefit from treatment with a PRP injection + PT program; and others did Patellar Tendinopathy 8 Chronic tendinopathy occurs from repetitive loading of a tendon crossing a joint
May result in increased pain with loading and impact activities, which can negatively effect performance<br>
slide9. Rehab guidelines post- PRP injection 9<br>
slide10. Rehab guidelines post- PRP injection 9<br>
slide11. Possible side effects 12 Pain
Infection
Allergic reaction
Nerve injuries and tissue damage Possible Contraindications 10,11,13 Anemia, hemodynamic instability
Unstable angina, Sepsis
Infection
Systemic disease
Bone marrow pathology
Thrombocytopenia
Systemic steroid use
Anticoagulation therapy<br>
slide12. Informing Patients<br>
slide13. SUMMARY 2, 14,15 Many cases have positive outcomes from PRP injections
Increased healing rates are not guaranteed
Many unanswered questions remain:
Dosing, timing, frequency of injections, optimal physiologic conditions for injections, location of delivery, age of individual, etc.
Thus, deeming the procedure as “experimental” and not covered by insurance.
There is ongoing research on this topic with new evidence being found
Prevent/ treat infections
Promote nerve regeneration<br>
slide14. Questions?<br>
slide15. Resources Platlete Rich Plasma (PRP) – Integrative Health & Wellness. Accessed June 8, 2022. https://integrative-health.com/functional-medicine/platlete-rich-plasma-prp/.
Middleton KK, Barro V, Muller B, Terada S, Fu FH. Evaluation of the effects of platelet-rich plasma (PRP) therapy involved in the healing of sports-related soft tissue injuries. Iowa Orthop J. 2012;32:150-163.
Cole BJ, Seroyer ST, Filardo G, Bajaj S, Fortier LA. Platelet-rich plasma: where are we now and where are we going? Sports Health. 2010;2(3):203-210. doi:10.1177/1941738110366385
Liu S-S, Xu L-L, Fan S, et al. Effect of platelet-rich plasma injection combined with individualised comprehensive physical therapy on temporomandibular joint osteoarthritis: A prospective cohort study. J Oral Rehabil. 2022;49(2):150-159. doi:10.1111/joor.13261
Schneider A, Burr R, Garbis N, Salazar D. Platelet-rich plasma and the shoulder: clinical indications and outcomes. Curr Rev Musculoskelet Med. 2018;11(4):593-597. doi:10.1007/s12178-018-9517-9
A Hamid MS, Mohamed Ali MR, Yusof A, George J, Lee LPC. Platelet-rich plasma injections for the treatment of hamstring injuries: a randomized controlled trial. Am J Sports Med. 2014;42(10):2410-2418. doi:10.1177/0363546514541540
Poudel B, Pandey S. Hamstring Injury. In: StatPearls. StatPearls Publishing; 2021.
Jeong DU, Lee CR, Lee JH, et al. Clinical applications of platelet-rich plasma in patellar tendinopathy. Biomed Res Int. 2014;2014:249498. doi:10.1155/2014/249498
Clare D, Desai M. Platelet-Rich Plasma Protocol. Accessed June 8, 2022. https://releasept.com/wp-content/uploads/2019/05/PRP-Protocol_Release-final-.pdf
Luzo ACM, Fávaro WJ, Seabra AB, Durán N. What is the potential use of platelet-rich-plasma (PRP) in cancer treatment? A mini review. Heliyon. 2020;6(3):e03660. doi:10.1016/j.heliyon.2020.e03660
Jain NK, Gulati M. Platelet-rich plasma: a healing virtuoso. Blood Res. 2016;51(1):3-5. doi:10.5045/br.2016.51.1.3
Latalski M, Walczyk A, Fatyga M, et al. Allergic reaction to platelet-rich plasma (PRP): Case report. Medicine. 2019;98(10):e14702. doi:10.1097/MD.0000000000014702
Yaari L, Dolev A, Haviv B. [platelet rich plasma injection as treatment for rotator cuff tendinopathy and as an augmentation for rotator cuff repair]. Harefuah. 2019;158(6):395-397.
Zhang W, Guo Y, Kuss M, et al. Platelet-Rich Plasma for the Treatment of Tissue Infection: Preparation and Clinical Evaluation. Tissue Eng Part B Rev. 2019;25(3):225-236. doi:10.1089/ten.TEB.2018.0309
Yu W, Wang J, Yin J. Platelet-rich plasma: a promising product for treatment of peripheral nerve regeneration after nerve injury. Int J Neurosci. 2011;121(4):176-180. doi:10.3109/00207454.2010.544432<br>
slide2. Objectives The audience will be able to understand about injuries and soft tissue structures in the body that respond well to PRP injections
The audience will learn about which patient populations would be appropriate for and may benefit from a PRP injection with continues PT after.
The audience will learn about the implications that PRP treatment will have on a patient’s course of therapy.<br>
slide3. 1<br>
slide4. PRP Treatment is appropriate for 2,3:<br>
slide5. TMJ Osteoarthritis 4 Effect of platelet- rich plasma injection combined with individualized comprehensive physical therapy on temporomandibular joint osteoarthritis: A prospective cohort study (Liu SS, et al.): Findings:
Pain intensity, maximum mouth opening, & TMJ sounds improved in both groups
Mouth opening better in combined group
TMJ sounds better in PRP only group
Pain improvement was greater in the combined group at 3 & 6 months
JFLS scores were higher in the combined group at 6 months Assessed:
Pain intensity
Maximum mouth opening
TMJ sounds
Jaw Functional Limitation Scale (JFLS)
Imaging<br>
slide6. Surgical Rotator Cuff Repair 5 Supporting PRP use:
(Randelli et al.): Utilized a PRP group vs no PRP application
VAS pain score was lower in the PRP group at 3, 7, 14, & 30 days post-surgery
PRP group had higher SST scores and greater external rotation strength at 3 months post-surgery
Not Supporting:
No significant difference in outcome measures at 6, 12, & 24 months post-surgery<br>
slide7. Hamstring injury 6,7 Platelet-rich plasma injections for the treatment of hamstring injuries: a randomized controlled trial (MSA Hamid): Assessed:
Effectiveness of a PRP injection to treat grade 2 hamstring injury
Methods:
28 patients with acute hamstring injury randomly given either PRP + rehab or only a rehab program Findings:
1 PRP injection + rehab program was significantly more effective in treating the injuries than a rehab program along
Return to play:
26.7 ± 7.0 days (PRP group)
42.5 ± 20.6 days (Rehab group)
PRP group reported lower pain severity throughout the study.<br>
slide8. Conservative treatment approaches:
Physical therapy: eccentric and concentric loading of quadriceps
Bracing
Transdermal nitroglycerin patches
Heat therapy
*Many studies have been done of the effectiveness of PRP injections in treating patellar tendinopathy
Difficult to draw conclusions due to conflicting evidence
Some studies show improvement in pain with PRP therapy
Some showed no profound benefit from treatment with a PRP injection + PT program; and others did Patellar Tendinopathy 8 Chronic tendinopathy occurs from repetitive loading of a tendon crossing a joint
May result in increased pain with loading and impact activities, which can negatively effect performance<br>
slide9. Rehab guidelines post- PRP injection 9<br>
slide10. Rehab guidelines post- PRP injection 9<br>
slide11. Possible side effects 12 Pain
Infection
Allergic reaction
Nerve injuries and tissue damage Possible Contraindications 10,11,13 Anemia, hemodynamic instability
Unstable angina, Sepsis
Infection
Systemic disease
Bone marrow pathology
Thrombocytopenia
Systemic steroid use
Anticoagulation therapy<br>
slide12. Informing Patients<br>
slide13. SUMMARY 2, 14,15 Many cases have positive outcomes from PRP injections
Increased healing rates are not guaranteed
Many unanswered questions remain:
Dosing, timing, frequency of injections, optimal physiologic conditions for injections, location of delivery, age of individual, etc.
Thus, deeming the procedure as “experimental” and not covered by insurance.
There is ongoing research on this topic with new evidence being found
Prevent/ treat infections
Promote nerve regeneration<br>
slide14. Questions?<br>
slide15. Resources Platlete Rich Plasma (PRP) – Integrative Health & Wellness. Accessed June 8, 2022. https://integrative-health.com/functional-medicine/platlete-rich-plasma-prp/.
Middleton KK, Barro V, Muller B, Terada S, Fu FH. Evaluation of the effects of platelet-rich plasma (PRP) therapy involved in the healing of sports-related soft tissue injuries. Iowa Orthop J. 2012;32:150-163.
Cole BJ, Seroyer ST, Filardo G, Bajaj S, Fortier LA. Platelet-rich plasma: where are we now and where are we going? Sports Health. 2010;2(3):203-210. doi:10.1177/1941738110366385
Liu S-S, Xu L-L, Fan S, et al. Effect of platelet-rich plasma injection combined with individualised comprehensive physical therapy on temporomandibular joint osteoarthritis: A prospective cohort study. J Oral Rehabil. 2022;49(2):150-159. doi:10.1111/joor.13261
Schneider A, Burr R, Garbis N, Salazar D. Platelet-rich plasma and the shoulder: clinical indications and outcomes. Curr Rev Musculoskelet Med. 2018;11(4):593-597. doi:10.1007/s12178-018-9517-9
A Hamid MS, Mohamed Ali MR, Yusof A, George J, Lee LPC. Platelet-rich plasma injections for the treatment of hamstring injuries: a randomized controlled trial. Am J Sports Med. 2014;42(10):2410-2418. doi:10.1177/0363546514541540
Poudel B, Pandey S. Hamstring Injury. In: StatPearls. StatPearls Publishing; 2021.
Jeong DU, Lee CR, Lee JH, et al. Clinical applications of platelet-rich plasma in patellar tendinopathy. Biomed Res Int. 2014;2014:249498. doi:10.1155/2014/249498
Clare D, Desai M. Platelet-Rich Plasma Protocol. Accessed June 8, 2022. https://releasept.com/wp-content/uploads/2019/05/PRP-Protocol_Release-final-.pdf
Luzo ACM, Fávaro WJ, Seabra AB, Durán N. What is the potential use of platelet-rich-plasma (PRP) in cancer treatment? A mini review. Heliyon. 2020;6(3):e03660. doi:10.1016/j.heliyon.2020.e03660
Jain NK, Gulati M. Platelet-rich plasma: a healing virtuoso. Blood Res. 2016;51(1):3-5. doi:10.5045/br.2016.51.1.3
Latalski M, Walczyk A, Fatyga M, et al. Allergic reaction to platelet-rich plasma (PRP): Case report. Medicine. 2019;98(10):e14702. doi:10.1097/MD.0000000000014702
Yaari L, Dolev A, Haviv B. [platelet rich plasma injection as treatment for rotator cuff tendinopathy and as an augmentation for rotator cuff repair]. Harefuah. 2019;158(6):395-397.
Zhang W, Guo Y, Kuss M, et al. Platelet-Rich Plasma for the Treatment of Tissue Infection: Preparation and Clinical Evaluation. Tissue Eng Part B Rev. 2019;25(3):225-236. doi:10.1089/ten.TEB.2018.0309
Yu W, Wang J, Yin J. Platelet-rich plasma: a promising product for treatment of peripheral nerve regeneration after nerve injury. Int J Neurosci. 2011;121(4):176-180. doi:10.3109/00207454.2010.544432<br>