Influence of different energy patterns on efficacy of radial shock wave therapy

Kenmoku, Tomonori; Iwakura, Nahoko; Ochiai, Nobuyasu; Saisu, Takashi; Ohtori, Seiji; Takahashi, Kenji; Nakazawa, Takahiro; Fukuda, Michinari; Takaso, Masashi

doi:10.1016/j.jos.2020.07.009

Cited by 9 publications

(10 citation statements)

References 31 publications

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“…The material properties used in the simulation are given in Table S1, Supporting Information. In order to simulate the interaction between rESW and HZN, rESW of 4 bar, a common clinical protocol for the treatment of musculoskeletal disorders, [34,35] was set on the surface of the spherical shell. The coupled Euler-Lagrange (CEL) numerical approach was chosen to describe the interaction between the rESW and the HZNs as well as the surrounding water medium.…”

Section: Resultsmentioning

confidence: 99%

A Bone‐Penetrating Precise Controllable Drug Release System Enables Localized Treatment of Osteoporotic Fracture Prevention via Modulating Osteoblast‐Osteoclast Communication

Liang

Chen

Xie

et al. 2023

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Improving local bone mineral density (BMD) at fracture‐prone sites of bone is a clinical concern for osteoporotic fracture prevention. In this study, a featured radial extracorporeal shock wave (rESW) responsive nano‐drug delivery system (NDDS) is developed for local treatment. Based on a mechanic simulation, a sequence of hollow zoledronic acid (ZOL)‐contained nanoparticles (HZNs) with controllable shell thickness that predicts various mechanical responsive properties is constructed by controlling the deposition time of ZOL and Ca2+ on liposome templates. Attributed to the controllable shell thickness, the fragmentation of HZNs and the release of ZOL and Ca2+ can be precisely controlled with the intervention of rESW. Furthermore, the distinct effect of HZNs with different shell thicknesses on bone metabolism after fragmentation is verified. In vitro co‐culture experiments demonstrate that although HZN2 does not have the strongest osteoclasts inhibitory effect, the best pro‐osteoblasts mineralization results are achieved via maintaining osteoblast‐osteoclast (OB‐OC) communication. In vivo, the HZN2 group also shows the strongest local BMD enhancement after rESW intervention and significantly improves bone‐related parameters and mechanical properties in the ovariectomy (OVX)‐induced osteoporosis (OP) rats. These findings suggest that an adjustable and precise rESW‐responsive NDDS can effectively improve local BMD in OP therapy.

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Section: Resultsmentioning

confidence: 99%

A Bone‐Penetrating Precise Controllable Drug Release System Enables Localized Treatment of Osteoporotic Fracture Prevention via Modulating Osteoblast‐Osteoclast Communication

Liang

Chen

Xie

et al. 2023

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“…As a result, the modes of action and the effects of R-SWT on living tissue may differ from those of F-SWT. Many authors [ 34 ] reported that histological reaction to the ESWT depended on the total energy delivered to the tissue (total effectiveness energy = EFD [mJ/mm 2 ] × mm 2 × number) (mJ). However, considering the patient's tolerance to ESWT, R-SWT with medium EFD (4.0 ± 0.35 bar) and F-SWT with low EFD (0.09 ± 0.018 mJ/mm 2 ) were used in our study.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Focused Shockwave Therapy versus Radial Shockwave Therapy for Noncalcific Rotator Cuff Tendinopathies: A Randomized Clinical Trial

Shi

et al. 2021

BioMed Research International

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Background. The superiority of focused shockwave therapy (F-SWT) versus radial shockwave therapy (R-SWT) for treating noncalcific rotator cuff tendinopathies remains controversial. This study is aimed at comparing the effectiveness of F-SWT versus R-SWT for the management of noncalcific rotator cuff tendinopathies. Methods. A total of 46 patients affected by noncalcific rotator cuff tendinopathies were randomly divided into 2 groups of 23 individuals. Patients in group A received 4 sessions of F-SWT, while patients in group B were treated by 4 sessions of R-SWT. In each session, mean energy flux density (EFD) for F-SW 3000 shots was 0.09 ± 0.018 mJ/mm2 with 5.1 ± 0.5 Hz, while average pressure for R-SW 3000 shots was 4.0 ± 0.35 bar with 3.2 ± 0.0 Hz. Pain level and shoulder function were assessed with the numerical rating scale (NRS) and Constant-Murley Scale (CMS). The primary endpoint was the change in the mean NRS pain score from baseline to 24 weeks after the intervention. Secondary endpoints were changes in the mean NRS pain scores at all other follow-up points, changes in the mean CMS scores, and radiographic findings. Results. There were no significant differences between the two groups regarding NRS pain score and CMS score within 24 weeks after intervention (all p > 0.05 ). However, F-SWT resulted in significantly lower NRS compared with R-SWT at 24 weeks and 48 weeks after treatment ( 2.7 ± 1.0 vs. 4.5 ± 1.2 and 1.4 ± 1.0 vs. 3.0 ± 0.8 , respectively, all p < 0.001 ). Similar results were found in CMS changes and radiographic findings. Conclusions. Both F-SWT and R-SWT are effective in patients with noncalcific rotator cuff tendinopathy. F-SWT proved to be significantly superior to R-SWT at long-term follow-up (more than 24 weeks). This trial is registered with ChiCTR1900022932.

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“…ESWT treatment was then repeated under anesthesia every 3 days for 4 weeks. 14,[16][17][18] The rats were randomly allocated to three groups: one that received 500 shocks only in the lymphedematous forelimb (Forelimb/ESWT, n ¼ 5), one that received 300 shocks in the axillary region and 200 shocks in the lymphedematous forelimb (AxillaþForelimb/ESWT; n ¼ 5), and an untreated control group (n ¼ 7). The treated limbs were compared with the opposite forelimb of each rat.…”

Section: Application Of Eswtmentioning

confidence: 99%

Two methods of extracorporeal shock-wave therapy in a rat model of secondary lymphedema: a pilot study

et al. 2021

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Objectives To compare the effectiveness of two methods of extracorporeal shock-wave therapy (ESWT) in a rat model of forelimb lymphedema, induced by axillary lymph node dissection. Methods Sprague–Dawley rats were randomly allocated to a group that received 500 ESWT shocks only in the lymphedematous forelimb (Forelimb/ESWT) and a group that received 300 ESWT shocks in the axilla and 200 shocks in the lymphedematous forelimb (Axilla+Forelimb/ESWT). The circumferences of each limb were then measured. Immunohistochemistry for a pan-endothelial marker (cluster of differentiation [CD]31) and lymphatic vessel endothelial hyaluronan receptor-1, and western blot analysis for vascular endothelial growth factor receptor-3 (VEGFR3) and VEGF-C were performed. Results The circumferences of the limbs showed significant effects of group and time following surgery. The circumferences at the carpal joint and 2.5 cm above were smallest in the naïve limbs, larger in the Axilla+Forelimb/ESWT group, and the largest in the control group. VEGFR3 tended to be expressed at a higher level in the Axilla+Forelimb/ESWT group (1.96-fold) than in the Forelimb/ESWT group (1.20-fold) versus the opposite non-edematous forelimbs, although this difference was not statistically significant. Conclusions These data suggest that ESWT protocols have differential effects on angiogenesis and lymphangiogenesis in lymphedematous limbs.

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Influence of different energy patterns on efficacy of radial shock wave therapy

Cited by 9 publications

References 31 publications

A Bone‐Penetrating Precise Controllable Drug Release System Enables Localized Treatment of Osteoporotic Fracture Prevention via Modulating Osteoblast‐Osteoclast Communication

A Bone‐Penetrating Precise Controllable Drug Release System Enables Localized Treatment of Osteoporotic Fracture Prevention via Modulating Osteoblast‐Osteoclast Communication

Effectiveness of Focused Shockwave Therapy versus Radial Shockwave Therapy for Noncalcific Rotator Cuff Tendinopathies: A Randomized Clinical Trial

Two methods of extracorporeal shock-wave therapy in a rat model of secondary lymphedema: a pilot study

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