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Inferior heel pain
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Dishan Singh, Shelain Patel, Karan Malhotra
Extracorporeal shockwave therapy (ESWT) works through the application of high energy waves to the plantar fascia. There is no defined number or intensity of waves, nor frequency of sessions which increases the heterogeneity of studies which have investigated this modality. It is theorised to work in two ways: firstly neurogenically where it promotes excessive axonal activation that affects pain pathways, and destroys unmyelinated sensory fibres; and secondly by creating a pro-inflammatory environment through the secretion of growth factors that repair tissue, angiogenic growth factors that improve vascularity and increasing nitrous oxide levels that cause vasodilatation. A recent meta-analysis of thirteen trials consisting of 1,185 patients found that ESWT conferred superior outcomes to many other therapies (17).
Erectile Dysfunction
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Mark Johnson, Marco Falcone, Tarek M. A. Aly, Amr Abdel Raheem
Low-intensity extracorporeal shock wave therapy (Li-ESWT): Li-ESWT represents a new frontier for the treatment of ED. Its application has had a significant widespread impact on the andrological community in the last decade. This physical treatment relies on the transmission of low-intensity shock waves on the corpora cavernosa inducing a proper revascularization stimulus on the corporal tissue [40]. The clear advantages of this approach are the tolerability, the insignificant incidence of side effects, and the lack of contraindications. However, despite recent evidence supporting its efficacy in the treatment of ED, a specific treatment protocol and a specific indication on the amount of energy to be applied onto the penis remains an open issue. Furthermore, the indication of Li-ESWT in a specific category of patients, particularly after an iatrogenic pelvic plexus injury following radical prostatectomy, is still unclear [41]. It is however worth noting that Li-ESWT is not currently FDA approved and its use is considered experimental at present.
Metabolic Therapies for Muscle Injury
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
Ana V. Cintrón, Kenneth Cintron
Extracorporeal shock wave therapy has been widely employed in the treatment of enthesopathy with good clinical response; however, studies on its benefits after acute muscle injury are limited, although promising. For example, Zissler et al. [37] recently showed that the use of ESWT after acute cardiotoxin-induced injury to the quadriceps femoris muscle of rats, was associated with significantly higher contents of pax7-positive satellite cells, mitotically active H3P+ cells, and of cells expressing the myogenic regulatory factors myoD and myogenin, indicating enhanced proliferation and differentiation rates of satellite cells. Moreover, a clinical study by Costa et al. [38] showed that ESWT associated with physical therapy proved to be effective at treating long-term muscle injury, with good performance and the ability to return to sport practice for all patients in the trial, suggesting there may be a space for ESWT after both acute and chronic muscle injury.
The effect of extracorporeal shock wave on osteonecrosis of femoral head: a systematic review and meta–analysis
Published in The Physician and Sportsmedicine, 2022
Jin Mei, Lili Pang, Zhongchao Jiang
Extracorporeal shock wave therapy is a noninvasive treatment that applies in varied diseases. In addition, it is also implemented in orthopedics and traumatology for a period with a boom [8]. Nowadays, the application of ESWT in musculoskeletal disorders mainly included tendinopathies and bone defects [9]. In an animal experiment, ESWT may promote bone repair and increase bone mass in the necrotic femoral head [10]. In the first article about ESWT to ONFH published in 2001, Thiel M proposed that ESWT provide a suitable noninvasive way to treat ONFH [8]. Many articles show ESWT has an improvement in patients using the evaluation of HHS and VAS [11–13]. A case report even proved the efficiency of ESWT in patients with a stage of ARCO (Association Research Circulation Osseous) IV, but more random control trial needs to prove it is efficacious in advanced disease [14].
Comparison of focused and unfocused ESWT in treatment of erectile dysfunction
Published in The Aging Male, 2020
Recep Eryilmaz, Şeyhmus Kaplan, Rahmi Aslan, Murat Demir, Kerem Taken
After consent is obtained from local ethics committee (Decree No. 02/19.12.2018), 40 patients with ED were enrolled who applied to our outpatient clinic and who have been used phosphodiesterase 5 inhibitor (PDE5I) before application for the treatment of ED, but gained no benefit and also were diagnosed with vascular insufficiency in penile Doppler ultrasound; patients are divided into two groups with equal size and demographics. Focused LI-ESWT is performed in one group, while unfocused LI-ESWT is performed for the other group. (focused ESWT is the ESWT format used with focused probe on penile tissue. Unfocused ESWT is the ESWT format used with unfocused probe on penilw tissue) Patients received low-intensity extracorporeal shock wave therapy (Electronica Pagani, Italy) twice a week for 6 weeks at outpatient settings did not give local or systemic anesthesia. In each treatment session, 1800 LI-ESWT shocks at energy setting of 0.15 mJ/mm2 were delivered to six foci (two foci on the dorsum of corpus cavernosum, two foci at bilateral distal segment of bilateral crural areas, and two foci at proximal segment of crural areas; 300 shocks per focus). Treatment protocol is applied as two sessions of LI-ESWT per week for 3 weeks then no treatment is given for 3 weeks; and ultimately, LI-ESWT is started again in two sessions per week for 3 weeks.
Efficacy of physical therapy interventions for chronic lateral elbow tendinopathy: a systematic review
Published in Physical Therapy Reviews, 2020
Beshoy Girgis, José Alberto Duarte
Further systematic reviews have comparable conclusions to the results of the current review regarding specific interventions. These reviews, however, did not limit inclusion criteria to the recommended outcome measures [68–70]. Findings of Herd and Meserve [152] indicated the effectiveness of mobilization with movement, but they stated that their results should be generalized with care. Conversely, Hoogvliet et al. [153] concluded that evidence to support mobilization with movement is limited. Laimi et al. [154] mentioned that existing evidence on myofascial release therapy is insufficient to confirm its effectiveness for the treatment of chronic musculoskeletal pain. Reviews on the effectiveness of extracorporeal shockwave therapy had contradictory results. Stasinopoulos and Johnson [155] and Buchbinder et al. [156] showed that relevant studies had conflicting results. In addition, Rompe and Maffulli [157] concluded that qualitative evidence for the effectiveness of extracorporeal shockwave therapy exists under restrictive conditions only. Strujis et al. [158] demonstrated that definitive conclusions concerning the effectiveness of orthotic devices for LET could not be drawn. Other systematic reviews [159–165] have assessed the effectiveness of non-physical therapy interventions, however, these interventions are beyond the scope of the present review.