Effect Of Shock Wave Treatment Research Articles

The potential of pulsed electromagnetic field-generated shock waves for reducing microbial load and improving homogenization in raw milk

Milk is a highly nutritious food essential for human consumption. However, traditional thermal processing methods can reduce its nutritional value and cause unwanted changes. The use of shock waves produced by pulsed electromagnetic fields (PEMFs) has been explored as a means to reduce pathogenic microorganisms. The effect of shock wave treatment on microbial load and particle distribution in packaged fresh cow's milk was investigated. Additionally, the impact of shock wave treatment on Salmonella enterica counts in a bacterial suspension of phosphate-buffered saline (PBS) was evaluated, as this bacterium is a significant milkborne pathogen. Treatment with 1000 impulses from an electromagnetic shock wave generator resulted in a 0.7-log reduction in the total bacterial count of milk. In a separate experiment, a 300-impulse shock wave treatment applied to a Salmonella enterica suspension achieved a 3-log reduction in bacterial counts. Furthermore, shock wave treatment resulted in a decrease in milk particle size compared to untreated milk. Notably, the volume of milk used in this study aligns with commercially available packaged products, enhancing the experiment's industrial relevance. The use of PEMF to generate shock waves could provide a novel approach for future studies focused on reducing the microbial load of milk and improving its homogenization.

Effect of Shock Wave Treatment on Developing Structure and the Properties of Obtained Polytetrafluorethylene

Effect of Shock Wave Treatment on Developing Structure and the Properties of Obtained Polytetrafluorethylene

Study on effects of shockwave treatment on PVA films in view of electrical property changes

The shock wave impact effects have been studied on PVA (Poly Vinyl Alcohol), thin films in view of morphological and electrical property changes. The PVA films of thickness around 0.25 mm are subjected to shock waves impact of Mach number around 1.7 to 1.8. The samples are subjected to 0, 25, 50, 100 and 150 numbers of shocks, in a time interval of around 15 s between the shocks. The shock waves are generated with an in-house developed shock tube capable of producing shock waves of Mach number up to 2. The films are further characterized with FTIR, UV–visible spectral analysis for chemical and physical changes and the EDAX, SEM image analysis further confirmed the effects. The trend in the I-V characteristics and the impedance data obtained clearly shows the significant increase in the conductivity of PVA films. Thus, shock wave impact method proves to be another method of treatment of materials and the results obtained promises about the possible electrical applications of PVA films.

Shock wave therapy in cardiology: a commentary

The evidences in favor of efficiency of shock-wave in ischemic heart disease therapy are originated mainly from small, uncontrolled observational studies. The experiments have relatively short duration. The shock-wave therapy benefits for ischemic heart disease have been explained by heightened myocardial perfusion and angiogenesis attributed among others to activation of vascular endothelial growth factors of the VEGF group. The role of VEGF in heart diseases and atherosclerosis is ambivalent; along with potential benefit it may contribute to fibrosis. A shock wave induces tissue cavitation and shear stress to membranes. The vulnerability of cardiac muscle cells under conditions of ischemia is increased. Additional damage may contribute to the cell loss. Reported effects of shock-wave treatment may be transient and reactive in their nature. Clinical improvements in humans are caused, at least in part, by the placebo effect. Placebo therapy is beneficial for some patients; however, placebo must be harmless by definition. In conclusion, animal experiments with a longer follow-up are needed prior to the initiation of clinical research with large cohorts of patients. However, some possible late outcomes such as increased vascularization of atherosclerotic plaques and their instability cannot be reliably reproduced in experiments. A promising approach to the evaluation of net harm or benefit could be lifelong animal experiments with comparisons of average life span between test and control groups.

Effectiveness of Shockwave Treatment for Proximal Fifth Metatarsal Stress Fracture in Soccer Players

Effectiveness of Shockwave Treatment for Proximal Fifth Metatarsal Stress Fracture in Soccer Players

Effect of shock wave treatment on luminescence of ZnS:Cu,Cl phosphors

It is shown that shock wave treatment of ZnS:Cu phosphor between synthesis and annealing steps by placing phosphor powder into preservation ampoule and subjecting to the effect of explosion has positive effect on photo- and electroluminescence brightness due to increase of activator (copper) solubility in phosphor matrix and formation of additional ClS–CuZn and ClS–VZn luminescent centers.

Shock Wave Treatment Enhances Cell Proliferation and Improves Wound Healing by ATP Release-coupled Extracellular Signal-regulated Kinase (ERK) Activation

Shock wave treatment accelerates impaired wound healing in diverse clinical situations. However, the mechanisms underlying the beneficial effects of shock waves have not yet been fully revealed. Because cell proliferation is a major requirement in the wound healing cascade, we used in vitro studies and an in vivo wound healing model to study whether shock wave treatment influences proliferation by altering major extracellular factors and signaling pathways involved in cell proliferation. We identified extracellular ATP, released in an energy- and pulse number-dependent manner, as a trigger of the biological effects of shock wave treatment. Shock wave treatment induced ATP release, increased Erk1/2 and p38 MAPK activation, and enhanced proliferation in three different cell types (C3H10T1/2 murine mesenchymal progenitor cells, primary human adipose tissue-derived stem cells, and a human Jurkat T cell line) in vitro. Purinergic signaling-induced Erk1/2 activation was found to be essential for this proliferative effect, which was further confirmed by in vivo studies in a rat wound healing model where shock wave treatment induced proliferation and increased wound healing in an Erk1/2-dependent fashion. In summary, this report demonstrates that shock wave treatment triggers release of cellular ATP, which subsequently activates purinergic receptors and finally enhances proliferation in vitro and in vivo via downstream Erk1/2 signaling. In conclusion, our findings shed further light on the molecular mechanisms by which shock wave treatment exerts its beneficial effects. These findings could help to improve the clinical use of shock wave treatment for wound healing.

Shock wave treatment improves nerve regeneration in the rat

The aims of the experiments were to: (1) determine whether low-energy shock wave treatment accelerates the recovery of muscle sensitivity and functionality after a nerve lesion; and (2) assess the effect of shock waves on the regeneration of injured nerve fibers. After compression of a muscle nerve in rats the effects of shock wave treatment on the sequelae of the lesion were tested. In non-anesthetized animals, pressure pain thresholds and exploratory activity were determined. The influence of the treatment on the distance of nerve regeneration was studied in immunohistochemical experiments. Both behavioral and immunohistochemical data show that shock wave treatment accelerates the recovery of muscle sensitivity and functionality and promotes regeneration of injured nerve fibers. Treatment with focused shock waves induces an improvement of nerve regeneration in a rodent model of nerve compression.

Paper 26: The Effect of Shock Wave Treatment at the Tendon-Bone Interface: A Histomorphological and Biomechanical Study in Rabbits

Paper 26: The Effect of Shock Wave Treatment at the Tendon-Bone Interface: A Histomorphological and Biomechanical Study in Rabbits

Effect of shock-wave treatment of zinc sulfide on properties of ZnS:Cu,Mn phosphor

Method was developed for raising the brightness of photo- and electroluminescence from ZnS:Cu,Mn phosphor in dc and ac fields by preliminary shock-wave treatment of a starting zinc sulfide placed in a closed copper ampoule.

Effect of shock wave stimulation on hypertonic plantar flexor muscles in patients with cerebral palsy: A placebo-controlled study

Extracorporeal shock wave therapy has been reported to be effective in reducing muscle hypertonia in adults. To evaluate the effect of shock wave treatment of spastic muscles in children with cerebral palsy. Twelve children with spastic equinus foot (6 boys,6 girls; mean age 8 years (standard deviation (SD) 2.31)) were monitored. Clinical (Ashworth Scale, passive range of motion) and instrumental (pedobarography) examination were performed. This is an open study with one placebo treatment session, followed 6 weeks later by one active shockwave treatment session. Gastrocnemius muscles and soleus muscles were treated. After placebo stimulation no clinical or instrumental effect was seen. After a single active shock wave stimulation a significant decrease in the Ashworth Scale (from 3 to 2), an increase in the range of motion (from 20 degrees to 50 degrees), and an increase in the whole plantar surface area of the treated limb (from 40.3 to 80.2 cm2) were observed in all patients. This effect lasted for 4 weeks in all patients. A single active shock wave stimulation produced a significant long-lasting reduction in hypertonia in the plantar flexors in children with cerebral palsy.

Repetitive shock wave therapy for lateral elbow tendinopathy (tennis elbow): a systematic and qualitative analysis

Pooled meta-analyses of statistically and clinically heterogeneous data of randomised-controlled studies are difficult to interpret. Therefore, a qualitative study-by-study assessment was thought to be of greater relevance, to physicians confronted with a therapy-resistant tennis elbow patient, to determine the effectiveness of shock wave therapy (SWT) for lateral elbow tendinopathy. Orthopaedic clinic. Randomized trials were identified from a current search of The Cochrane Bone, Joint and Muscle Trauma Group specialized register of trials, the Cochrane Central Register of Controlled Trials, MEDLINE and reference lists of articles and dissertations. We included 10 trials that randomized 948 participants to SWT or placebo or treatment control. For each trial, two independent reviewers assessed the methodological quality and extracted data. Methodological quality criteria included appropriate randomization, allocation concealment, blinding, number lost to follow-up and intention-to-treat analysis. Conflicting results of the 10 studies were found. There was considerable heterogeneity in terms of methodological quality; treatment regimen; patient selection and follow-up period, precluding pooled analyses. Instead, individual trial results were described in the text. Only six trials had a high-quality methodology. Two independent high-quality randomized placebo-controlled trials (196 participants) reported significant success of SWT over placebo (65 versus 28%; 61 versus 29%). Design of both trials included enrolment of chronic recalcitrant patients only; 1500-2000 shocks of low-energy flux density (0.1 mJ/mm(2)) applied to the site of maximal discomfort (clinical focusing) in weekly intervals; no use of local anaesthesia and main follow-up at least 3 months after the last application. Three other independent high-quality trials (406 participants) did not find any benefit of SWT over placebo (32 versus 33%; 35 versus 34%; 39 versus 31%). In these three trials, study designs deviated from the design described earlier, enrolling acute patients or applying SWT under local anaesthesia or expanding the application intervals to 4 weeks, while reducing the main follow-up to 4 weeks. With current studies heterogeneous in terms of the duration of the disorder; type, frequency and total dose of SWT; period of time between SWT; type of management and control group; timing of follow-up and outcomes assessed, a pooled meta-analysis of SWT for lateral elbow tendinopathy was considered inappropriate. In a qualitative systematic per-study analysis identifying common and diverging details of 10 randomized-controlled trials, evidence was found for effectiveness of shock wave treatment for tennis elbow under well-defined, restrictive conditions only.

Effect of shock-wave treatment on the structure and hardening of austenitic steels

The structure and hardening of austenitic steels subjected to shock-wave treatment have been studied. This treatment is shown to form a structure whose cell size decreases with increasing pressure. The treatment-induced hardening of the steels can be estimated using the Hall-Petch relation. At the same degrees of residual deformation, shock-wave treatment results in a significantly higher degree of hardening of the austenitic steels as compared to cold rolling. The degree of hardening increases with decreasing stacking-fault energy in austenite.

The effect of shock wave treatment at the tendon-bone interface

This study was performed to investigate the effect of shock wave treatment on the healing at tendon-bone interface. Thirty-six New Zealand White rabbits were used in this study. The anterior cruciate ligament was excised and replaced with the long digital extensor. The right knees (study group) were treated with 500 impulses of shock waves at 14 kV, while the left knees (control group) received no shock waves. Twenty-four rabbits were sacrificed at 1,<th>2,<th>4,<th>8,<th>12 and 24-week intervals. The specimens were studied with histomorphological examination and immunohistochemical stains for neovascularization and angiogenic growth factors. Twelve rabbits were sacrificed at 12 and 24 weeks for biomechanical analysis. The results demonstrated that the study group showed significantly more trabecular bone around the tendon and better bonding between bone and tendon as compared with the control group. The expressions of angiogenic growth factors were significantly higher in the study group than the control group. The tensile strength of the tendon-bone interface was significantly higher in the study group than the control group. In conclusion, shock wave treatment significantly improves the healing of the tendon-bone interface in a bone tunnel in rabbits. The effect of shock waves appears to be time-dependent.

The mechanism of shock wave treatment in bone healing

The purpose of this study was to investigate the biological mechanism of shock wave treatment in bone healing in rabbits. A closed fracture of the right femur was created with a three-point bend method and the fracture was stabilized with an intra-medullary pin. Shock waves were applied one week after the fracture. Twenty-four New Zealand white rabbits were randomly divided into 3 groups. Group 1 (the control) received no shock waves; group 2 received low-energy; and group 3 high-energy shock waves. The animals were sacrificed at 24 weeks, and a 5-cm segment of the femur bone including the callus was harvested. The specimens were studied with histomorphological examination, biomechanical analysis and immunohistochemical stains. The results showed that high-energy shock waves improved bone healing with significant increases in cortical bone formation and the number neovascularization in histomorphology, better bone strength and bone mass in biomechanics, and increased expressions of angiogenic growth markers including BMP-2, eNOS, VEGF and PCNA than the control and low-energy shock wave groups. The effect of shock wave treatment appears to be dose-dependent. In conclusion, high-energy shock waves promote bone healing associated with ingrowth of neovascularization and increased expressions of angiogenic growth factors.

The effect of shock wave treatment at the tendon–bone interface—an histomorphological and biomechanical study in rabbits

Purpose. This study was performed to investigate the effect of shock wave treatment on the healing at tendon–bone interface in rabbits. Materials and methods. Thirty-six New Zealand White rabbits were used in this study. The anterior cruciate ligament was excised and replaced with the long digital extensor. The right knees (study group) were treated with 500 impulses of shock waves at 14 kV, while the left knees (control group) received no shock waves. Histomorphological studies were performed in 24 rabbits at 1, 2, 4, 8, 12 and 24 weeks. Biomechanical studies were performed in 12 rabbits at 12 and 24 weeks. Results. There was significantly more trabecular bone around the tendons noted in the study group compared with the control group at different time intervals after 4 weeks ( P < 0.05). The contacting between bone and tendon was significantly better in the study group than the control group after 8 weeks ( P < 0.05). The tensile strength of the tendon–bone interface was significantly higher in the study group than the control group at 24 weeks ( P = 0.018), whereas similar modes of graft failure were noted between the two groups. Conclusion. Shock wave treatment significantly improves the healing rate of the tendon–bone interface in a bone tunnel in rabbits. The effect of shock waves appears to be time-dependent.

Shock wave treatment shows dose-dependent enhancement of bone mass and bone strength after fracture of the femur

Shock wave treatment is believed to improve bone healing after fracture. The purpose of this study was to evaluate the effect of shock wave treatment on bone mass and bone strength after fracture of the femur in a rabbit model. A standardized closed fracture of the right femur was created with a three-point bending method in 24 New Zealand white rabbits. Animals were randomly divided into three groups: (1) control (no shock wave treatment), (2) low-energy (shock wave treatment at 0.18 mJ/mm 2 energy flux density with 2000 impulses), and (3) high-energy (shock wave treatment at 0.47 mJ/mm 2 energy flux density with 4000 impulses). Bone mass (bone mineral density (BMD), callus formation, ash and calcium contents) and bone strength (peak load, peak stress and modulus of elasticity) were assessed at 12 and 24 weeks after shock wave treatment. While the BMD values of the high-energy group were significantly higher than the control group ( P = 0.021), the BMD values between the low-energy and control groups were not statistically significant ( P = 0.358). The high-energy group showed significantly more callus formation ( P < 0.001), higher ash content ( P < 0.001) and calcium content ( P = 0.003) than the control and low-energy groups. With regard to bone strength, the high-energy group showed significantly higher peak load ( P = 0.012), peak stress ( P = 0.015) and modulus of elasticity ( P = 0.011) than the low-energy and control groups. Overall, the effect of shock wave treatment on bone mass and bone strength appears to be dose dependent in acute fracture healing in rabbits.

Enhancing mechanical strength during early fracture healing via shockwave treatment: an animal study

Objective. This investigation aims to determine (1) whether shockwave treatment helps fracture healing and (2) whether the effect of shockwave treatment on fracture healing is dose dependent. Design. Shockwave was applied over tibial osteotomy in an animal model to assess its effect on the healing of the fracture. Methodology. Bilateral tibial diaphyseal transverse osteotomy was conducted on 42 rabbits, dividing into experimental and control group, immobilized using an external skeletal fixator, with one leg tested with shockwave therapy and the contralateral leg acting as the control without therapy. Serial radiography and measurement of bone mineral density via dual-energy X-ray absorptiometry were performed to assess the fracture healing. The experimental animals had two or three sessions of shockwave therapy (5000 impulses, 0.32 mJ/mm 2, Orthopedic™) over the osteotomy sites on day 7, 21 and 35; while the control group did not receive any treatment. The animals were sacrificed on day 42 or 56. Then, bilateral tibias were harvested and sent for mechanical tests as well as the histological examination. The pertinent statistic methods were applied to analyze the results. Background. Shockwave therapy has become a useful alternative approach in treating various orthopedic conditions, but the mechanism which it works remains unclear. Thus far, shockwave therapy has been found effective in treating long bone pseudoarthrosis, but whether it can benefit fresh fracture healing continues to be debated. Results. Higher union rates occurred during the early but not the late stages in the experimental group, while mechanical strength was higher in the experimental group than in the control group. No significant dose-dependent response occurred between the second and third applications of shockwave treatment. No significant difference in mechanical strength occurred between the experimental groups at 4 weeks and the control group at 6 weeks, or between the experimental groups at 6 and 8 weeks. Furthermore, no significant correlation occurred between the absolute values of maximum torque and bone mineral density. Conclusion. Based on this investigation, shockwave treatment has a positive effect on early fracture healing while its long term effects require further investigation. Relevance Shockwave therapy can be a useful alternative adjunct modality in the treatment of fresh long bone fracture.

Treatment of calcifying tendinitis of the shoulder with shock wave therapy.

In a prospective clinical study, the effectiveness of shock wave treatment for calcifying tendinitis in 31 shoulders in 29 patients (14 women and 15 men) with an average age of 52 years was assessed. Each shoulder was treated with 1,000 impulses of shock waves at 14 kV. A 100-point Constant score system was used for evaluation. The overall results of 20 patients (21 shoulders) with 12 weeks followup were no complaints in 23.8%, significantly improved in 38.1%, some improvement in 14.3%, and unchanged in 23.8%. Considerable improvement was observed between 6 and 12 weeks. The results of seven patients with 24 weeks followup were no complaints in two patients, significantly improved in three, and unchanged in two patients. Radiographs showed complete elimination of the calcium deposits in six patients (28.6%), incomplete elimination in two patients (9.5%), and three patients (14.3%) had fragmentation of the calcium deposits. There was no recurrence of calcium deposits observed at 24 weeks. There was a correlation between the functional improvement and the elimination of calcium deposits. There were no device-related problems, systemic or local complications. Low-energy shock wave therapy may offer a new and safer additional nonoperative treatment for patients with calcifying tendinitis of the shoulder.

Treatment of lateral epicondylitis of the elbow with shock waves.

In a prospective clinical study, the effectiveness of shock wave treatment for lateral epicondylitis in 56 elbows in 53 patients (27 men and 26 women) with an average age of 46 years was investigated. Three patients received treatment for both elbows. Each elbow was treated with 1,000 impulses of shock waves at 14 kV. A 100-point scoring system was used for evaluation including 40 points for pain, 30 points for function, 20 points for strength, and 10 points for elbow motion. The intensity of pain was measured using a visual analogue scale from 0 to 10. The overall results were 13.2% excellent, 44.7% good, 36.8% acceptable, and 5.3 unchanged in 35 patients with 12 weeks followup; 30.8% excellent, 42.3% good, and 26.9% acceptable in 25 patients with 24 weeks followup. Considerable improvement was observed from 6 weeks to 6 months after the treatment. None of the patients' symptoms became worse. The results of nine patients who also received a second treatment were good in three patients, acceptable in five patients, and unchanged in one patient. There was no device-related problems, systemic, or local complications. Shock wave therapy may offer a new and safer nonoperative treatment for patients with lateral epidoncylitis of the elbow.