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Fractionated Repetitive Extracorporeal Shock Wave Therapy: A New Standard in Shock Wave Therapy?

Kisch T, Sorg H, Forstmeier V, Mailaender P, Kraemer R - Biomed Res Int (2015)

Bottom Line: However, a single treatment session or long intervals between sessions may reduce the therapeutic effect.Placebo group showed no statistically significant differences.The results indicate that frESWT may provide greater benefits in the treatment of distinct soft tissue disorders compared with single-session ESWT.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, Hand Surgery, Burn Unit, University Hospital Schleswig-Holstein, Campus Lübeck, University of Lübeck, 23538 Lübeck, Germany.

ABSTRACT

Background: ESWT has proven clinical benefit in dermatology and plastic surgery. It promotes wound healing and improves tissue regeneration, connective tissue disorders, and inflammatory skin diseases. However, a single treatment session or long intervals between sessions may reduce the therapeutic effect. The present study investigated the effects of fractionated repetitive treatment in skin microcirculation.

Methods: 32 rats were randomly assigned to two groups and received either fractionated repetitive high-energy ESWT every ten minutes or placebo shock wave treatment, applied to the dorsal lower leg. Microcirculatory effects were continuously assessed by combined laser Doppler imaging and photospectrometry.

Results: In experimental group, cutaneous tissue oxygen saturation was increased 1 minute after the first application and until the end of the measuring period at 80 minutes after the second treatment (P < 0.05). The third ESWT application boosted the effect to its highest extent. Cutaneous capillary blood flow showed a significant increase after the second application which was sustained for 20 minutes after the third application (P < 0.05). Placebo group showed no statistically significant differences.

Conclusions: Fractionated repetitive extracorporeal shock wave therapy (frESWT) boosts and prolongs the effects on cutaneous hemodynamics. The results indicate that frESWT may provide greater benefits in the treatment of distinct soft tissue disorders compared with single-session ESWT.

No MeSH data available.


Related in: MedlinePlus

Microcirculatory effects of frESWT on cutaneous postcapillary venous filling pressure. One minute after each application of frESWT (black) postcapillary venous filling pressure increased, statistically insignificant, respectively, and decreased to baseline 20 minutes after application. Placebo (grey) showed no relevant changes from baseline.
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fig2: Microcirculatory effects of frESWT on cutaneous postcapillary venous filling pressure. One minute after each application of frESWT (black) postcapillary venous filling pressure increased, statistically insignificant, respectively, and decreased to baseline 20 minutes after application. Placebo (grey) showed no relevant changes from baseline.

Mentions: Baseline cutaneous tissue oxygen saturation was similar in both groups (experimental group: 48.3 ± 12.8% and placebo group: 49.8 ± 12.4%, P > 0.05). Tissue oxygen saturation remained statistically unchanged from baseline until 80 minutes in the placebo group. In the experimental group, tissue oxygen saturation significantly increased by 65.6% (percentage change) one minute after the first application of ESWT (80.0 ± 11.1%; P < 0.05) and remained on an elevated level until the second ESWT application. The third application of ESWT boosted tissue oxygen saturation to the highest extent of 90.5 ± 7.4% (P < 0.05) and remained significantly increased until the end of measuring at 80 minutes (82.9 ± 14.5%; P < 0.05).


Fractionated Repetitive Extracorporeal Shock Wave Therapy: A New Standard in Shock Wave Therapy?

Kisch T, Sorg H, Forstmeier V, Mailaender P, Kraemer R - Biomed Res Int (2015)

Microcirculatory effects of frESWT on cutaneous postcapillary venous filling pressure. One minute after each application of frESWT (black) postcapillary venous filling pressure increased, statistically insignificant, respectively, and decreased to baseline 20 minutes after application. Placebo (grey) showed no relevant changes from baseline.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4530210&req=5

fig2: Microcirculatory effects of frESWT on cutaneous postcapillary venous filling pressure. One minute after each application of frESWT (black) postcapillary venous filling pressure increased, statistically insignificant, respectively, and decreased to baseline 20 minutes after application. Placebo (grey) showed no relevant changes from baseline.
Mentions: Baseline cutaneous tissue oxygen saturation was similar in both groups (experimental group: 48.3 ± 12.8% and placebo group: 49.8 ± 12.4%, P > 0.05). Tissue oxygen saturation remained statistically unchanged from baseline until 80 minutes in the placebo group. In the experimental group, tissue oxygen saturation significantly increased by 65.6% (percentage change) one minute after the first application of ESWT (80.0 ± 11.1%; P < 0.05) and remained on an elevated level until the second ESWT application. The third application of ESWT boosted tissue oxygen saturation to the highest extent of 90.5 ± 7.4% (P < 0.05) and remained significantly increased until the end of measuring at 80 minutes (82.9 ± 14.5%; P < 0.05).

Bottom Line: However, a single treatment session or long intervals between sessions may reduce the therapeutic effect.Placebo group showed no statistically significant differences.The results indicate that frESWT may provide greater benefits in the treatment of distinct soft tissue disorders compared with single-session ESWT.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, Hand Surgery, Burn Unit, University Hospital Schleswig-Holstein, Campus Lübeck, University of Lübeck, 23538 Lübeck, Germany.

ABSTRACT

Background: ESWT has proven clinical benefit in dermatology and plastic surgery. It promotes wound healing and improves tissue regeneration, connective tissue disorders, and inflammatory skin diseases. However, a single treatment session or long intervals between sessions may reduce the therapeutic effect. The present study investigated the effects of fractionated repetitive treatment in skin microcirculation.

Methods: 32 rats were randomly assigned to two groups and received either fractionated repetitive high-energy ESWT every ten minutes or placebo shock wave treatment, applied to the dorsal lower leg. Microcirculatory effects were continuously assessed by combined laser Doppler imaging and photospectrometry.

Results: In experimental group, cutaneous tissue oxygen saturation was increased 1 minute after the first application and until the end of the measuring period at 80 minutes after the second treatment (P < 0.05). The third ESWT application boosted the effect to its highest extent. Cutaneous capillary blood flow showed a significant increase after the second application which was sustained for 20 minutes after the third application (P < 0.05). Placebo group showed no statistically significant differences.

Conclusions: Fractionated repetitive extracorporeal shock wave therapy (frESWT) boosts and prolongs the effects on cutaneous hemodynamics. The results indicate that frESWT may provide greater benefits in the treatment of distinct soft tissue disorders compared with single-session ESWT.

No MeSH data available.


Related in: MedlinePlus