Radial extracorporeal shock wave treatment harms developing chicken embryos.
Ontology highlight
ABSTRACT:
SUBMITTER: Kiessling MC
PROVIDER: S-EPMC4319177 | biostudies-other | 2015
REPOSITORIES: biostudies-other
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Project description:Although radial extracorporeal shock wave therapy (rESWT) has been widely used to treat orthopedic disorders with promising clinical results, rESWT largely relies on clinicians' personal experiences and arbitrary judgments, without knowing relationships between administration doses and effective doses at target sites. In fact, practitioners lack a general and reliable way to assess propagation and distribution of pressure waves inside biological tissues quantitatively. This study develops a methodology to combine experimental measurements and computational simulations to obtain pressure fields from rESWT through calibrating and validating computational models with experimental measurements. Wave pressures at the bottom of a petri dish and inside biological tissues are measured, respectively, by attaching and implanting flexible membrane sensors. Detailed wave dynamics are simulated through explicit finite element analyses. The data decipher that waves from rESWT radiate directionally and can be modeled as acoustic waves generated from a vibrating circular piston. Models are thus established to correlate pressure amplitudes at the bottom of petri dishes and in the axial direction of biological tissues. Additionally, a pilot simulation upon rESWT for human lumbar reveals a detailed and realistic pressure field mapping. This study will open a new avenue of personalized treatment planning and mechanism research for rESWT.
| S-EPMC5867036 | biostudies-literature
Project description:ObjectivesThis study was conducted to compare the effects of radial and focused extracorporeal shock wave therapy (ESWT) in patients with coccydynia.Patients and methodsIn this prospective randomized double-blind study conducted between March 2021 and October 2021, 60 patients with coccydynia (50 males, 10 females; mean age: 35.9±12.0 years, range 18 to 65 years) were randomized into three groups (n=20) according to different wave types of ESWT: focused, radial, and sham. The Visual Analog Scale (VAS) was used for pain assessment, and the Oswestry Disability Index (ODI) was used for functional assessment in all patients before the treatment (baseline), after the completion of four sessions of treatment (fourth week), one month after the end of the treatment (eighth week), and three months after the end of the treatment (16th week).ResultsThe mean body mass index of the participants was 26.2±3.0. Compared to baseline, the VAS scores at four weeks were reduced only in the radial ESWT group (p<0.05). Compared to baseline, the VAS and ODI scores at eight and 16 weeks were significantly reduced in both the focused and radial ESWT groups (p<0.05 for all). The radial ESWT group was significantly superior to the focused ESWT group in the comparisons between the groups at four weeks in the VAS values and at 16 weeks in the ODI scores (p<0.05 for all).ConclusionRadial and focused ESWT are both effective in treating coccydynia compared to sham ESWT. However, radial ESWT may be more effective in the treatment of coccydynia.
| S-EPMC10186009 | biostudies-literature
Project description:Antibiotic management of low-virulent implant-associated infections induced by Cutibacterium acnes may be compromised by multi-drug resistance development, side effects, and increased cost. Therefore, we sought to assess the effects of shock wave therapy against the above pathogen using an in vitro model of infection. We used a total of 120 roughened titanium alloy disks, simulating orthopedic biomaterials, to assess the results of radial extracorporeal shock wave therapy (rESWT) against C. acnes (ATCC 11827) biofilms relative to untreated control. In particular, we considered 1.6 to 2.5 Bar with a frequency ranging from 8-11 Hz and 95 to 143 impulses per disk to investigate the antibacterial effect of rESWT against C. acnes planktonic (free-floating) and biofilm forms. Planktonic bacteria load diminished by 54% compared to untreated control after a 1.8-bar setting with a frequency of 8 Hz and 95 impulses was applied (median absorbance (MA) for intervention vs. control groups was 0.9245 (IQR= 0.888 to 0.104) vs. 0.7705 (IQR = 0.712 to 0.864), respectively, p = 0.001). Likewise, a statistically significant reduction in the amount of biofilm relative to untreated control was documented when the above setting was considered (MA for treatment vs biofilm control groups was 0.244 (IQR= 0.215-0.282) and 0.298 (IQR = 0.247-0.307), respectively, p = 0.033). A 50% biofilm eradication was documented following application of low-pressure and low-frequency radial shock waves, so rESWT could be investigated as an adjuvant treatment to antibiotics, but it cannot be recommended as a standalone treatment against device-associated infections induced by C. ances.
| S-EPMC7285346 | biostudies-literature
Project description:Lateral elbow tendinopathy (LET) is characterized by pain, poor muscle strength of the wrist ex-tensors, and disability. Among the conservative rehabilitative approaches, focal as well as radial extracorporeal shock wave therapy (ESWT), are considered effective in LET management. The objective of this study was to compare the safety and effectiveness of focal (fESWT) and radial (rESWT) in terms of LET symptoms and the strength of wrist extensors, taking into account potential gender differences. This is a retrospective longitudinal cohort study of patients with LET treated with ESWT that had received a clinical and functional evaluation, including visuo-analogic scale (VAS), muscle strength using an electronic dynamometer during Cozen’s test, and the patient-rated tennis elbow evaluation (PRTEE) questionnaire. Follow-ups were carried out weekly in four visits after enrollment, and at 8 and 12 weeks. During the follow-ups, the VAS score decreased in both treatments, even if patients receiving fESWT reported early pain relief compared to those treated with rESWT (time for treatment p-value < 0.001). Additionally, peak muscle strength increased independently of the device used, and again more rapidly in the fESWT group (time for treatment p-value < 0.001). In the stratified analysis for sex and for the type of ESWT, rESWT appears to be less effective in female participants in terms of mean muscle strength and PRTEE scores, without differences according to the type of device used. The rESWT group reported a higher rate of minor adverse events (i.e., discomfort, p = 0.03) compared to fESWT. Our data suggest that both fESWT and rESWT might be effective in improving LET symptoms, even if the higher rate of painful procedures were reported in patients treated with rESWT.
| S-EPMC10002308 | biostudies-literature
Project description:Conflicting reports in the literature have raised the question whether radial extracorporeal shock wave therapy (rESWT) devices and vibrating massage devices have similar energy signatures and, hence, cause similar bioeffects in treated tissues.We used laser fiber optic probe hydrophone (FOPH) measurements, high-speed imaging and x-ray film analysis to compare fundamental elements of the energy signatures of two rESWT devices (Swiss DolorClast; Electro Medical Systems, Nyon, Switzerland; D-Actor 200; Storz Medical, Tägerwillen, Switzerland) and a vibrating massage device (Vibracare; G5/General Physiotherapy, Inc., Earth City, MO, USA). To assert potential bioeffects of these treatment modalities we investigated the influence of rESWT and vibrating massage devices on locomotion ability of Caenorhabditis elegans (C. elegans) worms.FOPH measurements demonstrated that both rESWT devices generated acoustic waves with comparable pressure and energy flux density. Furthermore, both rESWT devices generated cavitation as evidenced by high-speed imaging and caused mechanical damage on the surface of x-ray film. The vibrating massage device did not show any of these characteristics. Moreover, locomotion ability of C. elegans was statistically significantly impaired after exposure to radial extracorporeal shock waves but was unaffected after exposure of worms to the vibrating massage device.The results of the present study indicate that both energy signature and bioeffects of rESWT devices are fundamentally different from those of vibrating massage devices.Prior ESWT studies have shown that tissues treated with sufficient quantities of acoustic sound waves undergo cavitation build-up, mechanotransduction, and ultimately, a biological alteration that "kick-starts" the healing response. Due to their different treatment indications and contra-indications rESWT devices cannot be equated to vibrating massage devices and should be used with due caution in clinical practice.
| S-EPMC4625004 | biostudies-literature
Project description:IntroductionStructural abnormalities in the shoulder joint are a common complication post stroke, and the consequent pain and functional limitations become devastating quality of life problems for such patients. Shock wave therapy is a non-invasive method that can enhance the level of perfusion in ischaemic tissues, relieve inflammation, and promote healing. The aim of the study was to examine the efficacy of radial extracorporeal shock wave therapy (rESWT) on pain and disability levels in stroke patients with shoulder structural abnormalities.Material and methodsThirty subacute stroke patients aged between 40 and 60 years were randomly allocated into 2 equal groups after signing an institutional consent form. The real rESWT group (GA) underwent rESWT in addition to a designed program of physical therapy to the shoulder joint. The control group (GB) received sham rESWT in addition to the same physical therapy program as for GA. The treatment protocol for both groups was 2 times per week for a month. Baseline and post-intervention findings in both groups were assessed and compared for primary outcomes including shoulder structural changes, pressure pain threshold (PPT), and shoulder disability, measured by ultrasonography (USS), a handheld algometer, and the shoulder pain disability index (SPADI), respectively.ResultsSignificant reduction of all post-treatment SPADI scores (pain, disability, and total scores) in both groups with a remarkable decrease in the rESWT group (GA) (p < 0.05). In addition, USS scores and PPT findings showed notable preference in favour of the GA group, which was demonstrated as significant decrease in USS score with an increase in PPT findings only in the rESWT group (GA) (p < 0.05).ConclusionsThe addition of radial extracorporeal shock wave therapy (rESWT) to a designed physical therapy program is more efficient in reducing shoulder structural abnormalities, pain, and disability in subacute stroke patients.
| S-EPMC10696966 | biostudies-literature
Project description:ObjectivesTo explore whether radial extracorporeal shock wave therapy (rESWT) can alleviate acute inflammation of human primary tenocytes by the integrin-focal adhesion kinase (FAK)-p38 mitogen-activated protein kinase (MAPK) pathway.MethodsWestern blotting was used to evaluate the changes in the integrin-FAK-p38MAPK signaling pathway mediated by rESWT using specific antibodies targeting the phosphorylation sites of intracellular signal pathway proteins.ResultsrESWT up-regulated FAK phosphorylation and down-regulated p38MAPK phosphorylation levels in a tumor necrosis factor (TNF)-α-induced acute inflammation model of human primary tenocytes. Pretreatment with an integrin inhibitor significantly reduced rESWT-mediated downregulation of p38MAPK phosphorylation and attenuated its reversal effect on the increased secretion of pro-inflammatory cytokines in TNF-α-induced human primary tenocytes.ConclusionsOur results imply that rESWT may partially alleviate acute inflammation in human primary tenocytes through the integrin-FAK-p38MAPK pathway.
| S-EPMC10251031 | biostudies-literature
Project description:Diabetic foot ulcers (DFUs), the most serious complication of diabetes mellitus, can induce high morbidity, the need to amputate lower extremities, and even death. Although many adjunctive strategies have been applied for the treatment of DFUs, the low treatment efficiency, potential side effects, and high cost are still huge challenges. Recently, nanomaterial-based drug delivery systems (NDDSs) have achieved targeted drug delivery and controlled drug release, offering great promises in various therapeutics for diverse disorders. Additionally, the radial extracorporeal shock wave (rESW) has been shown to function as a robust trigger source for the NDDS to release its contents, as the rESW harbors a potent capability in generating pressure waves and in creating the cavitation effect. Here, we explored the performance of oxygen-loaded nanoperfluorocarbon (Nano-PFC) combined with the rESW as a treatment for DFUs. Prior to in vivo assessment, we first demonstrated the high oxygen affinity in vitro and great biocompatibility of Nano-PFC. Moreover, the rESW-responsive oxygen release behavior from oxygen-saturated Nano-PFC was also successfully verified in vitro and in vivo. Importantly, the wound healing of DFUs was significantly accelerated due to improved blood microcirculation, which was a result of rESW therapy (rESWT), and the targeted release of oxygen into the wound from oxygen-loaded Nano-PFC, which was triggered by the rESW. Collectively, the oxygen-saturated Nano-PFC and rESW provide a completely new approach to treat DFUs, and this study highlights the advantages of combining nanotechnology with rESW in therapeutics.
| S-EPMC6710755 | biostudies-literature
Project description:BackgroundThe reported success rates for treatments of kidney stones with either extracorporeal shock wave lithotripsy (ESWL) or flexible ureterorenoscopy (URS) are conflicting. We aimed to compare the efficacy and safety of ESWL and URS for previously untreated renal calculi.MethodsAll patients treated with ESWL or URS at our tertiary care centre between 2003 and 2015 were retrospectively identified. Patients with previously untreated kidney stones and a stone diameter of 5-20?mm were included. Stone-free, freedom from reintervention and complication rates were recorded. Independent predictors of stone-free and freedom from reintervention rates were identified by multivariable logistic regression and a propensity score-matched analysis was performed.ResultsA total of 1282 patients met the inclusion criteria, of whom 999 (78%) underwent ESWL and 283 (22%) had URS. During post-operative follow-up, only treatment modality and stone size could independently predict stone-free and freedom from reintervention rates. After propensity score matching, ESWL showed significantly lower stone-free rates [ESWL (71%) versus URS (84%)] and fewer patients with freedom from reintervention [ESWL (55%) versus URS (79%)] than URS. Complications were scarce for both treatments and included Clavien Grade 3a in 0.8% versus 0% and Grade 3b in 0.5% versus 0.4% of ESWL and URS treated patients, respectively.ConclusionsTreatment success was mainly dependent on stone size and treatment modality. URS might be the better treatment option for previously untreated kidney stones 5-20?mm, with similar morbidity but higher stone-free rates and fewer reinterventions than ESWL.
| S-EPMC6007408 | biostudies-literature
Project description:BackgroundThe present study attempted to investigate the therapeutic effect and duration of low intensity extracorporeal shock wave therapy (LiESWT) on overactive bladder (OAB) symptoms, including social activity and the quality of life (QoL).MethodsIn this prospective, randomized, single-blinded clinical trial, 65 participants with OAB symptom were randomly divided into receive LiESWT (0.25 mJ/mm2, 3000 pulses, 3 pulses/second) once a week for 8 weeks, or an identical sham LiESWT treatment without the energy transmission. We analyzed the difference in overactive bladder symptom score (OABSS) and 3-day urinary diary as the primary end. The secondary endpoint consisted of the change in uroflowmetry, post-voided residual (PVR) urine, and validated standardized questionnaires at the baseline (W0), 4-week (W4) and 8-week (W8) of LiESWT, and 1-month (F1), 3-month (F3) and 6-month (F6) follow-up after LiESWT.Results8-week LiESWT could significantly decrease urinary frequency, nocturia, urgency, and PVR volume, but meaningfully increase functional bladder capacity, average voided volume and maximal flow rate (Qmax) as compared with the W0 in the LiESWT group. In addition, the scores calculated from questionnaires were meaningfully reduced at W4, W8, F1, F3, and F6 in the LiESWT group.ConclusionsOur results revealed that the therapeutic efficacy of LiESWT could improve voided volume and ameliorate OAB symptoms, such as urgency, frequency, nocturia, and urinary incontinence, and lasted up to 6 month of follow-up. Moreover, LiESWT treatment brought statistically significant and clinically meaningful improvements in social activity and QoL of patients. These findings suggested that LiESWT could serve as an alternative non-invasive therapy for OAB patients.
| S-EPMC8235660 | biostudies-literature