Extracorporeal Shock Wave ESWT Flashcards
What is ESWT
Low to large amplitude wave formed by the sudden mechanical compression of the medium
(Application of pressure mechanical waves)
Two types of shock waves
Focused SW
Radial SW
Focused SW :
What is it produced by:
What areas is it best for?
Superficial or deep?
Describe the pressure?
Describe rise time and pulse duration.
Large or Little energy flux density EFD (amount of acoustic energy per unit area) ?
Frequency ?
Describe applicator?
Medium?
Produced by:
- electrohydraulic : liquid pressure
- electromagnetic: electromagnetic field
- piezoelectric: crystals to convert mechanical E to electrical E
Small and precise locations
Deep
Higher compressive and tensile pressures
FAST rise time & SHORT pulse durations (microseconds)
Large EFD
4 - 5 HZ (less if painful)
Applicator is large and hard to manipulate
Medium: adjustable dome membranes that are filled with either gas, water, or gel (can be used as local analgesic)
Radial SW:
What is it produced by:
What areas is it best for?
Superficial or deep?
Describe the pressure?
Describe rise time and pulse duration.
Large or Little energy flux density EFD (amount of acoustic energy per unit area) ?
Frequency ?
Describe applicator?
Medium?
Produced by:
- pneumatical: compressed air
Unfocused larger areas (divergent spread)
Superficial
Lower compressive and tensile pressures
SLOW rise time
LONG pulse durations (milliseconds)
LESS EFDs
15-20 HZ
Applicator: smaller + easy to manipulate
Medium : aqua-sonic gel
Number of shocks per session
1000 - 4000
Number of treatment sessions
1-4 sessions separated over days or weeks
Therapeutic effects
Mechanical or acoustic energy
⬇️
Μicrotrauma + Fresh micro-injuries
⬇️
Angiogenic growth factors + neovascularization
⬇️
Increase blood supply
⬇️
Soft tissue repair
So basically (improve circulation and induce soft tissue repair)
Indication ESWT
Shoulder, elbow, Achilles, patellar tendinopathies
Shoulder calcific tendinitis
Plantar fasciopathy
Chronic heel pain
Nonunion/ delayed union bone fracture
Osteonecrosis
General contraindications ESWT (hint: 4)
Over gas filled tissue ex: lungs, intestines etc
(severe tissue damage)
Over uterus of pregnant woman (disrupts fetal development)
Electronic implant (interference)
Blood coagulation therapy (severe bleeding)
Local contraindication ESWT (hint: 3)
Acute injury (increases inflammatory process)
Large vessel/nerve (damage)
Epiphyseal plates (alters normal bone growth)
Risks of ESWT
Pain
Swelling
Discoloration
Bruising
