Long-Term Follow up of the Effects of Extracorporeal Shockwave Therapy (ESWT) on Microcirculation in a Denervated Muscle Flap

Abstract

Extracorporeal Shock Wave Therapy (ESWT) is a golden standard for treatment of kidney and urinary calculi. It is also widely used in a number of orthopedic pathologies and other fields of medicine. Although clinical success the exact mechanism of shock wave technology is not well established. Cremaster muscle model used in our experiment is structurally and functionally similar to other skeletal muscles (striated muscle). The aim of the study was to evaluate influence of ESWT treatment on microcirculation and leukocyte-endothelial interactions after longer time period post ESWT application. In experiment we used 34 Lewis rats weighting 125-160 grams. Animals were divided into 4 groups--Group 1 (n = 10) control, without ESWT application, group 2 (n = 8), in which measurements were performed 3 days after application of 500 impulses of ESWT; group 3 (n = 8) in which measurements were performed 7 days after application of 500 impulses of ESWT; group 4 (n = 8), in which measurements were performed 21 days after application of 500 impulses of ESWT. The experiment showed a decrease in functional capillaries activity, we also observed the reduction in leukocyte rolling over the endothelium and an increase in flow velocity in V1 venules. ESWT therapy after 3, 7 and 21 days decreases inflammatory process in the muscle, the other of its effect is weakened. This confirms that the treatment had a positive effect if ESWT is applied repeatedly, because only in this case a wave maintains its beneficial effects.