Predictability of the individual clinical outcome of extracorporeal shock wave therapy for cellulite

Abstract

BackgroundExtracorporeal shock wave therapy has been successfully introduced for the treatment of cellulite in recent years. However, it is still unknown whether the individual clinical outcome of cellulite treatment with extracorporeal shock wave therapy can be predicted by the patient’s individual cellulite grade at baseline, individual patient age, body mass index (BMI), weight, and/or height.MethodsFourteen Caucasian females with cellulite were enrolled in a prospective, single-center, randomized, open-label Phase II study. The mean (± standard error of the mean) cellulite grade at baseline was 2.5±0.09 and mean BMI was 22.8±1.17. All patients were treated with radial extracorporeal shock waves using the Swiss DolorClast® device (Electro Medical Systems, S.A., Nyon, Switzerland). Patients were treated unilaterally with 2 weekly treatments for 4 weeks on a randomly selected side (left or right), totaling eight treatments on the selected side. Treatment was performed at 3.5–4.0 bar, with 15,000 impulses per session applied at 15 Hz. Impulses were homogeneously distributed over the posterior thigh and buttock area (resulting in 7,500 impulses per area). Treatment success was evaluated after the last treatment and 4 weeks later by clinical examination, photographic documentation, contact thermography, and patient satisfaction questionnaires.ResultsThe mean cellulite grade improved from 2.5±0.09 at baseline to 1.57±0.18 after the last treatment (ie, mean δ-1 was 0.93 cellulite grades) and 1.68±0.16 at follow-up (ie, mean δ-2 was 0.82 cellulite grades). Compared with baseline, no patient’s condition worsened, the treatment was well tolerated, and no unwanted side effects were observed. No statistically significant (ie, P<0.05) correlation was found between individual values for δ-1 and δ-2 and cellulite grade at baseline, BMI, weight, height, or age.ConclusionRadial shock wave therapy is a safe and effective treatment option for cellulite. The individual clinical outcome cannot be predicted by the patient’s individual cellulite grade at baseline, BMI, weight, height, or age.

Radial Shock Wave Devices Generate Cavitation

“…Both rESWT devices (D-Actor 200 and Swiss DolorClast) generated characteristic pressure waves and cavitation, and caused clearly discernible damage on x-ray films. For the Swiss DolorClast the present study confirms and expands results from earlier studies [ 2 , 3 , 7 , 8 , 47 , 51 ]. However, this was in sharp contrast to the vibrating massage device, whose energy signature could not be measured due to the device’s oscillation, and which neither produced cavitation bubbles nor damage on x-ray films.…”

“…Radial extracorporeal shock wave therapy (rESWT) is widely used in the non-invasive treatment of various diseases of the musculoskeletal system and other soft tissue disorders (see, e.g., [ 1 – 3 ]). Several studies addressed the molecular and cellular mechanisms of rESWT on these conditions including the mediation of cell apoptosis, enhanced angiogenesis and wound healing as well as new bone formation (see, e.g., [ 4 , 5 , 6 ]).…”

Comparison between shock wave therapy and mechanical massage for the treatment of cellulite in women

“…The non-significant results of weight, plicometry, and perimetry found in this study corroborate the research by Schlaudraff et al [20], who, upon analysing 14 participants after 8 sessions of treatment with radial extracorporeal shock waves, observed no correlation between the individual values of body mass index, weight, height, or age. Regarding the values obtained in the pre-and post-treatment ultrasound, an improvement in the fat layer and septa, these data are in agreement with a study by Nassar et al [21], whose randomized clinical trial with 15 women receiving 8 shock wave therapy sessions over 4 weeks demonstrated a decrease in the fat layer thickness of the thigh region as analysed by ultrasound imaging.…”

Efeito da terapia de ondas de choque extracorpórea no tecido tegumentar e adiposo subcutâneo de indivíduos portadores de obesidade grau II

“…No presente estudo demostramos que seu estimulo fisiológico pode ocorrer através do processo biológico da lipólise por via apoptótica. 71,72,117 Evidenciamos que o tecido tratado com ESWT apresentou um aumento significativo de células adiposas positivas para Caspase-3 e para Cleaved Caspase-3. A caspase-3 é ativada na célula apoptótica tanto por vias extrínsecas (mediada por receptores celulares) quanto intrínsecas (mitocondriais).…”