Biological effects of extracorporeal shockwave therapy in tendons: A systematic review

Abstract

Extracorporeal shockwave therapy was initially used for kidney stone disintegration and its application was then extended to calcific tendinitis. The therapeutic field expanded and included numerous types of tendinopathies, from shoulder to plantar fascia. The clinical benefits were documented in trials and the effects and mechanisms were studied on models including animal and human tendons. The present systematic review outlines a large spectrum of biological effects. First, an optimal dose is adapted for each species and each tendon; exceeding the optimal dose may lead to structural injury. Furthermore, the biological effects may be grouped into neovascularization induction, cellularity and extracellular matrix changes, metalloprotease and cytokine modulation, as well as lubricin production. As a result, the remodeled tendon displays improved biomechanical properties to resist stress.

Indikacije i liječenje udarnim valom u fizikalnoj medicini i rehabilitaciji

“…Valovi imaju incijalno visoki pozitivni tlak (do 80 MPa) s brzim usponom vala (30-120 ns), nakon čega slijedi negativni val nižeg tlaka (5-10 MPa). 4 Trajanje impulsa je kratko, oko 5 µs. 5 Generatori fokusiranog udarnog vala mogu biti elektrohidraulični, elektromagnetski i piezoelektrični, o čemu ovisi dubina prodiranja (Slika 1.).…”