Shock Wave Treatment Research Articles

"Dynamic stress-induced alterations in the physical and electrical properties of poly (vinyl alcohol) films via novel low-energy shock wave treatment"

In this study, the polyvinyl alcohol (PVA) films were subjected to a continuous impact of a series of low-energy shock waves of supersonic speed having Mach number around 1.6 to 1.7. The PVA samples were exposed to a series of 50, 100 and 150 number of shock wave shots. The shock wave treated samples are subjected to physical, chemical and electrical property testing. The results of the characterization revealed that the unusual physical conditions resulting from the shock wave impact phenomenon could induce intriguing physicochemical effects beyond mere physical damage to the material. Specifically, we observed a 0.1 eV decrease in the energy gap of the PVA material and an increase in electrical conductivity from 8×10−5Scm−1 to 21 ×10−5Scm−1. Furthermore, a significant increase in the crystallinity of the amorphous PVA material was noted, with the degree of crystallinity rising from 12% to 35% after the shock wave treatment. Additionally, it was observed that the material's nature shifted from hydrophilic to hydrophobic. Consequently, the study suggests that the shock wave treatment method for material processing could offer a promising approach to tailor the physical and electrical properties of materials.

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

Extracorporeal Shock Wave Therapy in Calcifying Tendonitis of the Shoulder. Case Report

Calcific tendonitis in the shoulder is very common. Patients who do not improve with physical therapy treatment may benefit from shockwave treatment before an invasive procedure is indicated. The focused shockwave treatment has a high degree of recommendation in calcific tendonitis of the shoulder, according to several studies with a high level of evidence. This report shows a 58-year-old female patient with calcific tendonitis of the shoulder with pain for more than 6 months without response to medication and rehabilitation treatment. Four sessions of 3000 pulses were performed with a focused shockwave piezoelectric device, with a maximum level of energy of 0.4 mj/mm2. Pain remission and calcification resorption were verified 3 months after the last application. Extracorporeal Shockwave Treatment is a safe and effective alternative for calcific tendonitis of the shoulder. Keywords: ESWT, calcific tendinopathy, shoulder

Comparative study between ultrasound-guided local injection of corticosteroid and shockwave in treatment of greater trochanteric pain

Comparative study between ultrasound-guided local injection of corticosteroid and shockwave in treatment of greater trochanteric pain

Extracorporeal ShockWave Treatment vs. mesotherapy in the treatment of myofascial syndromes: a clinical trial.

Numerous scientific papers have compared different treatment options in the management of myofascial pain syndrome. This study evaluated the efficacy of Extracorporeal ShockWave Treatment (ESWT) and mesotherapy in patients with Myofascial Pain Syndrome (MPS) in terms of improvement in pain, functional capacity, and quality of life. A case-control study was conducted on 54 patients, who were randomized into 2 groups: group A, consisting of 27 patients, who were treated with 5 sessions of focal ESWT on a weekly basis; and group B, consisting of 27 patients, who underwent 5 sessions of mesotherapy with Thiocolchicoside fl 4 mg/2 mL and Mepivacaine fl 10 mg/1 mL on a weekly basis. Patients were evaluated at enrollment (T0), after 5 weeks, at the end of rehabilitation treatment (T1), and at a follow- up 30 days after the end of treatment (T2), by administering rating scales (Numeric Rating Scale (NRS) - Pressure Pain Threshold (PPT) - Short Form-36 (SF-36)). The results showed that focal ESWT and Mesoterapy are two valid and effective treatment options in reducing algic symptoms and improving short- and long-term quality of life. However, the use of ESWTs, despite being mildly painful but tolerated, has been shown to be superior to mesotherapy in terms of pain reduction and increased functional capacity.

Variations in Low Intensity Shockwave Treatment Protocols for Erectile Dysfunction: A Review of the Literature and Guide to Offering Treatment.

Low-intensity shockwave therapy (LiSWT) for erectile dysfunction (ED) continues to gain popularity in both clinical practice and the academic literature. The majority of trials and meta-analysis studies have shown LiSWT to be low risk with a trend toward positive improvements in International Index of Erectile Function (IIEF) scores. However, there is still debate over the clinical utility of LiSWT and there is no agreed upon optimal treatment protocol. In this review article we summarize published meta-analysis studies of LiSWT for ED, and review the treatment protocols from randomized sham-control trials published in the last 10 years. We found the most common device settings were an energy of 0.09 mJ/mm² and a frequency of 5 Hz. Shock number and location varied, but the most common protocol was 1,500 shocks per session, with 900 shocks to the penis (shaft, base, or hilum) and 600 shocks to the proximal corpora/crura. Protocols ranged from 4 to 12 treatment sessions. We also describe our institutional experience with LiSWT, including patient counseling and treatment protocol.

Ultrasound-Guided Needle-Knife Combined with Shockwave Treatment of 60 Cases of Gluteal Epithelial Neuritis

Ultrasound-Guided Needle-Knife Combined with Shockwave Treatment of 60 Cases of Gluteal Epithelial Neuritis

Pain Management with Extracorporeal Shockwave Treatment in Multiple Level Clay-shoveler’s Fracture in a Novice Golfer: A Case Report

Pain Management with Extracorporeal Shockwave Treatment in Multiple Level Clay-shoveler’s Fracture in a Novice Golfer: A Case Report

Effect of Extra-Corporeal Shockwave Treatment in a Patient with Patellofemoral Pain Syndrome

Effect of Extra-Corporeal Shockwave Treatment in a Patient with Patellofemoral Pain Syndrome

Simulation of the Mechanical Behavior of a Dental Implant in Bone Tissue Under Shock Wave Treatment

Simulation of the Mechanical Behavior of a Dental Implant in Bone Tissue Under Shock Wave Treatment

Treatment Options for Erectile Dysfunction in Diabetics

Erectile dysfunction (ED) is defined as the persistent inability to achieve or maintain a penile erection suitable for sexual intercourse. This condition is common with diabetic males. This article comprehensively reviews various treatment options for Erectile Dysfunction (ED) in diabetic men, with a specific focus on the potential of Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT). Persistent hyperglycemia may decrease nitric oxide (NO) generation, the cycloguanosine monophosphate (cGMP) pathway, reactive free radical levels, the RhoA/Rho kinase pathway, and nerve function, all of which may be contributing factors to ED in diabetic patients. Elevated AGE expression in diabetes individuals' corpus cavernosum may result in structural alterations to the tissue, including thicker arterial walls, decreased flexibility, endothelial dysfunction, and atherosclerosis. Chronic hyperglycemia can produce nerve injury that affects both autonomic and other sensory patterns. The following are existing treatment options for ED; oral phosphodiesterase type 5 (PDE5) inhibitor, intracavernosal injection therapy, Intraurethral PGE1 suppository (IUS), Vacuum Erection Device (VED) and penile prosthesis or penile implant. Low-Intensity Extracorporeal Shockwave therapy (LI-ESWT), the treatment options for ED is a non-invasive procedure that focuses on address the root causes of ED. The mechanism underlying the efficacy of shock wave treatment is vasodilation and angiogenesis leading to improved blood flow to the penis by upregulating vascular endothelial growth factor (VEGF), nitric oxide synthase (NOS) and proliferating cell nuclear antigen. The review unveiled the success potential of (LI-ESWT) in treating diabetic impotence.

Management of Patellar Tendinopathy

Patellar tendinopathy is a common pathology typically seen in athletes involved in repetitive explosive jumping and running activities. Also known as jumpers’ knee, it is commonly seen in high-level basketball players. Typically, athletes continue to play with symptoms, which can be aggravated and progress to partial patellar tendon tears. When partial patellar tendon tears occur, prolonged recovery and decreased performance is commonly seen. The pathology and treatment can be frustrating for both the athlete and medical provider. Patellar tendinopathy typically does not involve inflammation but rather microinjury to the tendon fibers, which leads to mucoid degeneration, necrosis, and loss of transitional fibrocartilage. When partial tendon tears do occur, the typical location is posteromedially adjacent to the patella. Treatment involves a stepwise approach starting with nonoperative means, including activity modification, nonsteroidal anti-inflammatories, and physical therapy focused on eccentrics. Extracorporeal shock wave treatments and injections with platelet-rich plasma or bone marrow aspirate concentrate should be considered, with evolving literature to support their use. Ultrasound percutaneous tendon scrapping with a needle supplemented with the aforementioned injections is an emerging treatment option that the authors have found to be helpful, although further studies are required. Surgical intervention is considered after failure of nonoperative treatments, and typically occurs in tears greater than 50% of the tendon thickness and in tendons with increased thickness (>8.8 mm). Open or arthroscopic debridement can be considered, with no studies showing superior outcomes with either technique; however, no high-quality comparison studies exist. The authors prefer an open technique where, much like a bone–patellar tendon–bone harvest, the unhealthy proximal tendon and bone are excised with then closure of the healthy tendon with absorbable sutures. Suture anchor repair may also be used when necessary. In a recent systematic review, surgical management of patellar tendinopathy has been shown to result in improved patient-reported outcomes with return to sport at high levels.1 Treatment for the difficult and sometimes frustrating pathology of patellar tendinopathy continues to evolve, with biologic and less-invasive ultrasound-based treatments showing promise, and surgical intervention providing reliable outcomes.

Principle and design of clinical efficacy observation of extracorporeal cardiac shock wave therapy for patients with myocardial ischemia-reperfusion injury: A prospective randomized controlled trial protocol

Background Acute ST-segment elevation myocardial infarction (STEMI) remains a serious life threatening event with a poor prognosis due to myocardial ischemia/reperfusion injury despite coronary revascularization. Extracorporeal cardiac shock wave (ECSW) is a safe, effective and non-invasive new method for the treatment of cardiovascular diseases. The current results show that extracorporeal cardiac shock wave provides a new treatment option for patients with severe and advanced coronary heart disease. However, there are relatively few clinical studies on the application of in vitro cardiac shock waves in patients with myocardial ischemia-reperfusion injury. We hypothesized that extracorporeal cardiac shock therapy would also be effective in reducing clinical endpoints in patients with STEMI reperfusion. Objective This study is order to provide a new therapeutic method for patients with myocardial ischemia-reperfusion injury and reveal the possible mechanism of ECSW for ischemia-reperfusion injury. Methods and materials CEECSWIIRI is a single-center, prospective randomized controlled trial that plans to enroll 102 eligible patients with acute ST-segment elevation myocardial infarction reperfusion. Eligible patients with STEMI reperfusion will be randomly divided into external cardiac shock therapy (ECSW) trial group and blank control group. The blank control group will receive optimal drug therapy, and the experimental group will receive optimal drug therapy combined with ECSW. The shock wave treatment plan will be 3-month therapy, specifically 1 week of treatment per month, 3 weeks of rest, 3 times of ECSW in each treatment week, respectively on the first day, the third day and the fifth day of the treatment week, lasting for 3 months and follow-up for 2 years. The primary endpoint will be to assess the 2-year improvement in all-cause death, re-hospitalization due to cardiovascular disease, major unintentional cerebrovascular events, including cardiogenic death, myocardial infarction, heart failure, arrhythmia, emergency coronary revascularization, and stroke in patients with STEMI reperfusion. Secondary endpoints will include improvements in angina pectoris, quality of life, cardiac structure and function, coronary microcirculation, and endothelial progenitor cell-derived miR-140-3p in relation to survival outcomes. Trial registration number ClinicalTrial.gov.org PRS:NCT05624203; Date of registration: November 12, 2022.

Mechanical Properties of Titanium Grade 1 After Laser Shock Wave Treatment

Abstract In the presented work the impact of a laser shock wave on the mechanical properties of a Titanium Grade 1 was investigated. Based on a series of experimental studies related to the impact of the laser shock wave on the tested material, the impact of the given treatment on the structure and mechanical properties was assessed. The influence of the environment on the distribution of plasma temperature and pressure in the material during the implementation of the laser shock wave was analyzed. The effect of the laser treatment on the structure and micromechanical properties was initially estimated on the basis of the analysis of experimental results in the form of static strength test of samples after laser treatment. A slight increase in material strength was detected with a minimal decrease in ductility. In order to comprehensively understand the observed phenomenon, a number of fractographic tests were performed, especially the analysis of the porosity of the fracture surfaces. A decrease in the porosity of the material after impact laser treatment was observed as a result of local plastic deformation.

Investigating the impact of pulsed plasma-based shockwave technology on the characteristics of Indian crude oil

The declining production from oil wells has become a growing concern worldwide, primarily because conventional methods are becoming less efficient in extracting the original oil reserves. Due to limitations associated with traditional oil recovery techniques, including their high expenses, depth limitations, heat losses, instability of additives, and environmental hazards, it is imperative to investigate the impact of alternative technologies on reservoir fluid properties and recovery. This research proposes a pulse plasma-based shockwave technology (PPBSW) using an indigenously developed tool that uses repeated electrohydraulic shock waves. The liquid pulsed discharge's plasma channel rapidly expands causing an electrohydraulic shock wave. The crude oil samples were exposed using repeated, steep-fronted shock waves of high strength. Crude oil samples were obtained from the Indian Oilfield and underwent characterization both before and after exposure to shockwaves. After the shockwave treatment, there were observable changes in the weight percentages of wax, saturates, aromatics, resins, and asphaltenes in the composition of the oil. C13 NMR investigations reveals that MCL (mean chain length) of the exposed samples was slightly affected. Further, the impact of shock wave on the viscosity of the crude oil was evaluated and viscosity of the samples found to be altered after exposure. Oil recovery was evaluated using core flooding studies on a saturated Berea sandstone core. The core was saturated using core plug saturator at 1000 psi. As a result of altered viscosity and reduced interactions between the rock and fluid, the oil recovery from the treated samples was approximately 24% greater as compared to the untreated samples. Given the oil recovery and mixed effect on the viscosity of studied crude oil samples, it can be inferred that PPBSW has a favourable effect on the hydrocarbon recovery.

A New Player in the Mechanobiology of Deep Fascia: Yes-Associated Protein (YAP).

Recent studies have demonstrated that fascial fibroblasts are susceptible to mechanical stimuli, leading to the remodeling of the extracellular matrix (ECM). Moreover, the extensive literature on Yes-associated protein (YAP) has shown its role in cell mechanics, linking cell properties, such as shape, adhesion, and size, to the expression of specific genes. The aim of this study was to investigate the presence of YAP in deep fascia and its activation after a mechanical stimulus was induced via a focal extracorporeal shockwave (fESW) treatment. Thoracolumbar fascia (TLF) samples were collected from eight patients (age: 30-70 years; four males and four females) who had undergone spine elective surgical procedures at the Orthopedic Clinic of University of Padova. YAP was measured in both tissue and TLF-derived fibroblasts through immunoblotting. COL1A1 and HABP2 gene expression were also evaluated in fibroblasts 2, 24, and 48 h after the fESW treatment. YAP was expressed in all the examined tissues. The ratio between the active/inactive forms (YAP/p-YAP) of the protein significantly increased in fascial fibroblasts after mechanical stimulation compared to untreated cells (p = 0.0022). Furthermore, COL1A1 and HABP2 gene expression levels were increased upon treatment. These findings demonstrate that YAP is expressed in the deep fascia of the thoracolumbar region, suggesting its involvement in fascial mechanotransduction processes, remodeling, regeneration, and fibrogenesis. This study indicates, for the first time, that YAP is a "new player" in the mechanobiology of deep fascia.

Preliminary investigation on the effect of extracorporeal shock wave combined with traction on joint contracture based on PTEN-PI3K/AKT pathway.

To investigate the intervention effect of extracorporeal shock wave combined with manual traction on fixation-induced knee contracture and its influence on PTEN-PI3K/AKT signaling pathway. Thirty-six SD male rats were randomly divided into six groups. The left knee joints were not fixed in the control group (C group). Rats in other groups underwent brace fixation in the extended position of the left knee. After 4 weeks of bracing, it is randomly divided into five groups: Model group (M group), natural recovery group (NR group), extracorporeal shock wave treatment group (ET group), manual traction group (MT group), and extracorporeal shock wave combined with manual traction group (CT group). Joint range of motion (ROM) of left knee was carried out to assess joint function. Hematoxylin and eosin (HE) staining and Masson staining were respectively used to assess the cell number and collagen deposition expression. Immunohistochemical staining and Western blot were used to assess protein levels of phosphatase and tensin homolog (PTEN), phosphatidylinositol 3-kinase (PI3K), and protein kinase B (AKT). The combined therapy was more effective than extracorporeal shock wave therapy or manual traction alone against the joint ROM, cell number and the collagen deposition, low-expression of PTEN, and overexpression of PI3K/AKT in the anterior joint capsule of rats with knee extension contracture. Extracorporeal shock wave combined with manual traction can promote the histopathological changes of anterior joint capsule fibrosis, upregulate the protein expression of PTEN and downregulate the protein expression of PI3K/AKT in the fibrotic joint capsule in a rat joint contracture model.

Effectiveness and safety of arthroscopy combined with radial extracorporeal shockwave therapy for osteochondritis of the talus: a prospective, single-centre, randomized, double-blind study.

Arthroscopic microfracture is a conventional form of treatment for patients with osteochondritis of the talus, involving an area of < 1.5 cm2. However, some patients have persistent pain and limitation of movement in the early postoperative period. No studies have investigated the combined treatment of microfracture and shortwave treatment in these patients. The aim of this prospective single-centre, randomized, double-blind, placebo-controlled trial was to compare the outcome in patients treated with arthroscopic microfracture combined with radial extracorporeal shockwave therapy (rESWT) and arthroscopic microfracture alone, in patients with ostechondritis of the talus. Patients were randomly enrolled into two groups. At three weeks postoperatively, the rESWT group was given shockwave treatment, once every other day, for five treatments. In the control group the head of the device which delivered the treatment had no energy output. The two groups were evaluated before surgery and at six weeks and three, six and 12 months postoperatively. The primary outcome measure was the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale. Secondary outcome measures included a visual analogue scale (VAS) score for pain and the area of bone marrow oedema of the talus as identified on sagittal fat suppression sequence MRI scans. A total of 40 patients were enrolled and randomly divided into the two groups, with 20 in each. There was no statistically significant difference in the baseline characteristics of the groups. No complications, such as wound infection or neurovascular injury, were found during follow-up of 12 months. The mean AOFAS scores in the rESWT group were significantly higher than those in the control group at three, six, and 12 months postoperatively (p < 0.05). The mean VAS pain scores in the rESWT group were also significantly lower than those in the control group at these times (p < 0.05). The mean area of bone marrow oedema in the rESWT group was significantly smaller at six and 12 months than in the control group at these times (p < 0.05). Local shockwave therapy was safe and effective in patients with osteochondiritis of the talus who were treated with a combination of arthroscopic surgery and rESWT. Preliminary results showed that, compared with arthroscopic microfracture alone, those treated with arthroscopic microfracture combined with rESWT had better relief of pain at three months postoperatively and improved weightbearing and motor function of the ankle.

Therapeutic effects following extracorporeal shock wave therapy for insertional and non-insertional Achilles tendinopathy

BackgroundThe treatment for Achilles tendinopathy varies widely, and there is no consensus regarding the optimal treatment for both non-insertional and insertional Achilles tendinopathy. The purpose of this study was to evaluate the clinical efficacy of extracorporeal shock wave therapy (ESWT) in the treatment of insertional and non-insertional Achilles tendinopathy (AT). MethodsSixty patients with AT were invited to participate in this study. Patients were allocated to one of two groups according to the site of the AT, including an insertional AT (IAT) group and a non-insertional AT (NIAT) group. ESWT was performed once a week for five weeks for both groups. The Victorian Institute of Sport Assessment-Achilles questionnaire (VISA-A) score and the visual analog scale (VAS) were used five times to evaluate the clinical outcomes, including before treatment, immediately after treatment, as well as one month, three months, and five years after treatment. ResultsAt three months after treatment, the IAT group exhibited a significantly higher VISA-A score (82 ± 6 vs. 76 ± 11; p = 0.01) and a significantly lower VAS score (1 ± 1 vs. 2 ± 1; p < 0.001) when compared with the NIAT group. At the five-year assessment, the IAT group (1 ± 1) had a significantly lower VAS score than the NIAT group (2 ± 1) (p = 0.02), while no significant difference for the VISA-A score was observed between the groups (84 ± 8 vs. 84 ± 10; p = 0.98). ConclusionsExtracorporeal shock wave treatment can improve the symptoms of both insertional and non-insertional AT. The IAT patients experienced better clinical outcomes compared with the NIAT patients.

The use of shock wave treatment in the regenerate of tibial pseudarthrosis

The use of shock wave treatment in the regenerate of tibial pseudarthrosis