shockwave therapy Flashcards
ESWT
extracorporeal shockwave therapy
acoustic pressure wave to body for healing
whats considered low energy
whats considered high
.28
.6
up to _ mhmm considered safe on tendon
.28
Major cortical bone changes at ___ mJ/mm
0.6
two types of shockwave therapy
focussed
and radial
wheres max energy on focused
wheres max energy on radial
focused its at at the tip of triangle (target)
radial its at the source (base of triangle)
focused shockwaves
single pulse with wide frequency range
high pressure amp
low tensile wave
small pulse width and short rise time
Radial shockwaves
ordinary sound wave with pressure of 30 mpa
which graph, focused or radial is sharp up
focussed
which is a long rise time, radial or shockwave
radial
what has more penetration depth, focussed or radial
focussed is deeper
who delivers high energy
physicians (around .6 mJ/mm)
How much is low-medium energy
who delivers
.04-.28
PT
accorrding to international society of medical shockwave, who can do it
focused is by qualified physicians only
if physician has diagnosed then PT can do radial
whats focussed shockwave produced by
electrohydraulic
electromagnetic
piezoelectric
whats radial shockwave produced by
pneumatic
ballistic
is there a difference in radial or focussed shockwave
nothing
effects of shockwave in tissue
direct (mechanical) physical chemical (change in membrane permeability)
chemical (molecular change)
biological (leading to physiological change)
who delivers direct mechanical effects
physicians because its for non union fractions and needs anaesthesia
cellular damage results in release of ___ which lead to ___ which lead to ____
free radicals
inflammatory response
tissue healing
most important physical parameters impacting cellular effect of shockwave therapy
pressure distribution
energy density
total acoustic energy
observed cellular effects of shockwave therapy
inc local blood flow
apoptosis (cell death if does is too high)
stimulation of inflammatory response to promote tissue healing
indications for shockwave therapy
chronic tendinopathies
(tennis elbow, patellar, achilles, plantar)
Bone pathologies (delayed healing, non union, fracture)
skin pathologies (delayed wound healing, skin ulcer)
contraindications for shockwave therapy
near bone growth centre
malignant disease near treatment area
over ischemic tissue in someone with vascular disease
coagulation disorders
anti-coagulant meds
prosthetic device in area being treated
international society for mm shockwave therapy
malignant tumour in treatment area
fetus in the treatment area
10 adverse effects shockwave
pain skin reddening swelling nausea dizziness tremor sweating vasodilation
5 potential adverse effects
bruising
tendon rupture
rupture of plantar fascia
how unexpected adverse outcomes happen
contraindication
dose of condition
wrong area
equipment
risk reduction strategies
operator training
complete med history
informed consent
What do you need to decide
applied energy
number shocks
number of treatment
depth
shock number
1000-1500
number of shockwave treatments
3-5
5-10 days between treatment ?
shockwave devices are classified as class __ by health and need license to import and sell
ii
T/F need to attend a trainmen workshop before using shockwave clinically
T
