Extracorporeal Shockwave Therapy Overview
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Questions and Answers

What is the primary effect of shock waves on soft tissue injuries?

  • They create superficial injuries without biological response.
  • They stimulate micro-injuries leading to an inflammatory response. (correct)
  • They have no significant impact on blood supply.
  • They stop the healing process in chronic conditions.

    • What biological response do the micro-injuries reportedly stimulate after effects from shock waves?

  • Decrease in membrane permeability.
  • Reduction of angiogenic growth factors.
  • Inhibition of neovascularization.
  • Expression of angiogenic growth factors and neovascularization. (correct)

    • How do the effects of ESWT improve treatment for chronic conditions?

  • By removing all blood supply to the injured tissue.
  • By initiating necrosis and stopping cellular activity.
  • By increasing blood supply and promoting soft tissue repair. (correct)
  • By creating permanent scarring in targeted areas.

    • What is one mechanism through which the effects of shock waves are mediated?

    <p>Cavitation and microstreaming. (C)</p> Signup and view all the answers

    What change occurs in membrane properties as a result of indirect effects from shock waves?

    <p>Increase in membrane permeability. (A)</p> Signup and view all the answers

    Which type of generator utilizes the principle of magnetic forces?

    <p>Electro-magnetic (A)</p> Signup and view all the answers

    What are the two basic physiological effects of extracorporeal shockwaves?

    <p>Direct and Indirect mechanical forces (A)</p> Signup and view all the answers

    Which of the following types of generators operates based on piezoelectric effects?

    <p>Piezoelectric (B)</p> Signup and view all the answers

    What is the primary contribution of cavitation to the efficacy of the therapy?

    <p>It creates bubbles that facilitate indirect mechanical forces. (C)</p> Signup and view all the answers

    Which type of shockwave generator is most likely to use pressurized air?

    <p>Ballistic (pneumatic) (C)</p> Signup and view all the answers

    How does the direct mechanical force of shockwaves impact the target area?

    <p>By concentrating energy at the target point. (D)</p> Signup and view all the answers

    Which of the following is NOT a type of generator used for producing extracorporeal shockwaves?

    <p>Acoustic (B)</p> Signup and view all the answers

    Which characteristic best describes the function of pneumatic (ballistic) generators?

    <p>They rely on high-pressure gas to create shockwaves. (C)</p> Signup and view all the answers

    Which of the following conditions is a common indication for Extracorporeal Shock Wave Therapy (ESWT)?

    <p>Tendinitis of the shoulder (D)</p> Signup and view all the answers

    Which of the following is NOT a contraindication for the use of ESWT?

    <p>Aging-related joint wear (C)</p> Signup and view all the answers

    Which condition related to the elbow can be treated with ESWT?

    <p>Tennis elbow (A)</p> Signup and view all the answers

    What complication may arise from using ESWT on an individual with severe bleeding tendencies?

    <p>Severe internal bleeding (B)</p> Signup and view all the answers

    Which of the following conditions would most likely benefit from ESWT?

    <p>Carpal tunnel syndrome (D)</p> Signup and view all the answers

    What is the primary mechanism through which extracorporeal shockwave therapy operates?

    <p>High-pressure mechanical waves impacting tissues (A)</p> Signup and view all the answers

    Which condition associated with the knee is indicated for ESWT?

    <p>Patellar tendinopathy (D)</p> Signup and view all the answers

    Which phase of the shockwave is characterized by high amplitude and positive pressure?

    <p>Initial positive phase (A)</p> Signup and view all the answers

    What is a potential effect of using ESWT on overinflated tissues?

    <p>Severe tissue damage (D)</p> Signup and view all the answers

    What effect does the compressive phase of the shockwave have on tissues?

    <p>Causes shear stress in the tissue (D)</p> Signup and view all the answers

    What happens during the negative pressure period of the shockwave?

    <p>Causes cavitation bubbles in the tissue (A)</p> Signup and view all the answers

    Which of the following conditions is commonly treated by ESWT?

    <p>Achilles tendinitis (B)</p> Signup and view all the answers

    How quickly does the transition from the positive pressure phase to the negative pressure phase occur?

    <p>Within microseconds (B)</p> Signup and view all the answers

    What characterizes the shockwave used in extracorporeal shockwave therapy?

    <p>It has a compressive phase followed by a tensile phase (C)</p> Signup and view all the answers

    What is the ambient condition that the shockwave returns to after its phases?

    <p>Ambient (basic) values (A)</p> Signup and view all the answers

    What is the main therapeutic purpose of extracorporeal shockwave therapy?

    <p>To violently impact biological tissues (A)</p> Signup and view all the answers

    What unit is used to express energy contained in shockwaves?

    <p>Millijoules (C)</p> Signup and view all the answers

    How is the energy flux density (EFD) measured?

    <p>In millijoules per square millimeter (D)</p> Signup and view all the answers

    Which of the following classifications does NOT accurately describe energy flux density (EFD)?

    <p>Extreme EFD (D)</p> Signup and view all the answers

    What is the energy flux density for low EFD categorized as?

    <p>Up to 0.8 mJ/mm² (C)</p> Signup and view all the answers

    How many shocks are most commonly applied per session in energy shock therapy?

    <p>1000-2000 shocks (A)</p> Signup and view all the answers

    How many sessions are typically used in most clinical research for energy shock therapy?

    <p>3-5 sessions (C)</p> Signup and view all the answers

    What is the maximum energy flux density for high EFD?

    <p>Over 6 mJ/mm² (C)</p> Signup and view all the answers

    What type of EFD is associated with a value of 28 mJ/mm²?

    <p>Medium EFD (A)</p> Signup and view all the answers

    What is the primary mechanism for generating focused shockwaves?

    <p>Accelerating a projectile through a tube (C)</p> Signup and view all the answers

    Which type of shockwave is generated by accelerating a projectile?

    <p>Radial shockwave (B)</p> Signup and view all the answers

    What limitation do radial shockwaves have compared to focused shockwaves?

    <p>Their penetration depth is limited to superficial levels (A)</p> Signup and view all the answers

    How does the convergent nature of focused shockwaves benefit their application?

    <p>It enhances their ability to penetrate deep into tissues (B)</p> Signup and view all the answers

    What is an essential component utilized for generating radial shockwaves?

    <p>An applicator that contacts the skin (B)</p> Signup and view all the answers

    What is one way that focused shockwaves differ from radial shockwaves in their deployment?

    <p>Focused shockwaves are concentrated and guided to deeper tissues (D)</p> Signup and view all the answers

    What is the role of lenses in the application of focused shockwaves?

    <p>To focus the generated waves onto targeted tissues (A)</p> Signup and view all the answers

    What characteristic of focused shockwaves allows penetration of deeper tissues?

    <p>Their convergent nature (D)</p> Signup and view all the answers

    Flashcards

    Focused Shockwave

    A type of shockwave generated and focused by a lens, allowing it to penetrate deep into tissues.

    Radial Shockwave

    A type of shockwave generated by accelerating a projectile through a tube, creating a wave that spreads outward.

    Deep Penetration

    The ability of focused shockwaves to penetrate deep into tissues.

    Superficial Penetration

    The characteristic of radial shockwaves to spread outward, limiting their penetration depth.

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    Convergent

    The direction in which a focused shockwave travels, towards a specific point.

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    Divergent

    The direction in which a radial shockwave travels, spreading outward in all directions.

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    Application Point

    The point of contact between the shockwave and the target tissue.

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    Issue/Tissue

    The tissue targeted by the shockwaves.

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    ESWT

    Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment that uses high-energy sound waves to stimulate healing in tissues.

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    What is ESWT used for?

    ESWT is a non-surgical option that uses shock waves to treat a variety of musculoskeletal conditions.

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    How is ESWT delivered?

    ESWT is delivered using a device that generates high-energy sound waves, which are directed at the affected area. These waves travel through the skin and tissues, causing a series of micro-traumas.

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    What does ESWT stimulate?

    The micro-traumas created by ESWT stimulate the body's natural healing process, leading to increased blood flow, tissue regeneration, and pain reduction.

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    What are the phases of a shockwave?

    Each shock wave consists of a rapid compression phase followed by a brief tension phase, creating a unique pressure pattern.

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    What effect does the compression phase have?

    The rapid compression phase creates shear stress, which can cause tissue damage. This damage triggers the body's healing response.

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    What effect does the tension phase have?

    The tension phase creates cavitation bubbles in the tissue, which contribute to pain relief and tissue regeneration.

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    What conditions can ESWT treat?

    ESWT is typically used to treat conditions like tendonitis, plantar fasciitis, and chronic muscle pain. It is also gaining popularity for its potential to heal bone fractures.

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    Types of ESWT Generators

    Different types of technology used to generate extracorporeal shock waves used in therapy.

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    Electro-hydraulic ESWT Generator

    A type of ESWT generator that relies on a rapid discharge of energy through a fluid to create shock waves.

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    Electro-magnetic ESWT Generator

    A type of ESWT generator that uses magnetic fields to generate shock waves.

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    Piezoelectric ESWT Generator

    A type of ESWT generator that uses the piezoelectric effect to create shock waves.

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    Ballistic (Pneumatic) ESWT Generator

    A type of ESWT generator that utilizes a projectile to generate shock waves.

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    Direct Mechanical Forces of ESWT

    The direct physical impact of shock waves on the targeted tissue.

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    Indirect Mechanical Forces (Cavitation) of ESWT

    The indirect effects of shock waves on the targeted tissue, caused by cavitation.

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    Cavitation

    The formation of bubbles in body fluids due to shock wave pressure fluctuations.

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    Direct Mechanical Effects of Shockwaves

    The immediate physical effects of shockwaves on living tissue. These effects include tiny tears and disruptions within the tissue, known as microtrauma.

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    Inflammatory Response

    The process where the body responds to injury or trauma by increasing blood flow to the affected area. This response helps deliver nutrients and immune cells to aid in healing.

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    Neovascularization

    The growth of new blood vessels within a tissue. This process is often triggered by injury, promoting tissue repair by carrying oxygen and nutrients.

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    Angiogenic Growth Factors (AGFs)

    Proteins that stimulate cell growth and repair. These factors play a role in the healing process after injury.

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    Soft-Tissue Repair

    A form of tissue repair that occurs after an injury. It involves the replacement of damaged tissue with similar tissue, restoring some of the original function.

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    Painful shoulder

    A painful shoulder condition that may involve inflammation of tendons and ligaments.

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    Plantar fasciitis

    A painful condition affecting the tissues in the heel.

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    Lateral or medial epicondylitis

    Pain and discomfort in the elbow, often caused by overuse or repetitive motions.

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    Patellar tendonopathy (jumper's knee)

    A painful condition affecting the knee, often caused by jumping or repetitive motions.

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    Trigger points

    Localized areas of muscle tightness and tenderness, often causing pain.

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    Carpal tunnel syndrome

    A condition affecting the wrist and hand, caused by compression of the median nerve.

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    Achilles tendinitis

    Inflammation of the Achilles tendon, the tendon connecting the calf muscle to the heel.

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    Iliotibial band syndrome

    A condition affecting the muscles in the lower legs, often causing pain and tightness.

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    Energy Flux Density (EFD)

    The amount of mechanical or acoustic energy contained within a shock wave, expressed in millijoules (mJ).

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    Energy Flux Density (EFD)

    A measure of energy flux density. It tells us how much mechanical or acoustic energy is packed into a specific area of the shock wave.

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    ESWT Treatment Classification

    Classifying ESWT treatments based on the energy density delivered by the shock waves. Different levels correspond to varying levels of energy intensity.

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    Low EFD

    ESWT treatments with an EFD of up to 0.08 mJ/mm2. Considered lower energy levels.

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    Medium EFD

    ESWT treatments with an EFD of up to 0.28 mJ/mm2. Represents a medium level of energy intensity.

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    High EFD

    ESWT treatments with an EFD exceeding 0.6 mJ/mm2. Considered the highest energy level.

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    Number of Shocks

    The number of shock waves delivered during an ESWT session. Typical ranges are 1000 to 2000 shocks.

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    Number of Sessions

    The duration of ESWT treatment, often consisting of 3-5 sessions depending on the condition being treated and individual patient needs.

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    Study Notes

    Extracorporeal Shockwave Therapy (ESWT)

    • ESWT is the application of high-pressure mechanical waves outside the body to treat biological tissues.
      • The waves create a shockwave effect.
      • Initial phase is positive and very rapid, high amplitude.
      • Followed by a quick negative pressure phase then returns to ambient values.
      • Waveform has compressive and tensile phases.
      • Compressive phase causes shear stress.
      • Tensile phase creates cavitation bubbles.

    Types of Shockwaves

    • Focused ESWT: Generated inside the applicator and focused by a lens through the tissue
    • Radial ESWT: Generated by accelerating a projectile through a tube, the projectile impacts the applicator placed on the skin.

    ESWT Generators

    • Four types of generators use different methods to create shockwaves.
      • Electrohydraulic: uses spark discharge
      • Electromagnetic: uses electromagnetic fields
      • Piezoelectric: uses vibrations
      • Ballistic (pneumatic): uses pressured air to accelerate a projectile

    Physiological Effects of ESWT

    • Direct Mechanical Effects: Pulse energy concentrated at the target point, causes microtrauma, initiating an inflammatory process.
    • Indirect Mechanical Forces (Cavitation): Cavitation (bubbles in the tissue) plays a role in therapy efficacy.
      • Increases blood supply.
      • Promotes soft tissue repair.
      • Ionizes molecules.
      • Increases membrane permeability.
      • Increases cellular activity.

    Common Indications

    • Painful shoulder (calcification, tendonitis, impingement syndrome).
    • Plantar fasciitis.
    • Radial/ulnar epicondylitis.
    • Patellar tendinopathy (jumper's knee).
    • Trigger Points.
    • Carpal tunnel syndrome.
    • Achilles tendinitis.
    • Iliotibial band syndrome.

    Contraindications

    • Over gas-filled tissues (lungs, intestines).
    • Over reproductive organs (uterus).
    • Over electronic implants.
    • Over sites of acute injury
    • Blood clotting therapies requiring cautious usage
    • Over epiphyseal plates.

    Adverse Effects

    • Usually temporary and minor.
      • Skin irritation.
      • Numbness or paresthesia.
    • Possible severe adverse events:
      • Swelling.
      • Reddening.
      • Hematomas.
      • Petechiae (small red/purple spots due to broken capillaries).

    Treatment Dose

    • Energy Flux Density (EFD): Amount of mechanical acoustic energy per unit area.
      • Low EFD: Up to 0.08 mJ/mm²
      • Medium EFD: Up to 0.28 mJ/mm²
      • High EFD: Over 0.6 mJ/mm²
    • Number of Shocks: Typically 1000-2000 shocks per session.
    • Number of Sessions: Often 3-5 treatments.
    • Sessions should be spaced so tissue reaction can subside.

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    Extracorporeal Shockwave Therapy PDF

    Description

    Explore the principles and mechanisms of Extracorporeal Shockwave Therapy (ESWT) used in medical treatments. This quiz covers types of shockwaves, the functioning of generators, and their applications. Discover how these high-pressure mechanical waves impact biological tissues.

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