1
|
Rathnayake A, Saboo A, Vangaveti V, Malabu U. Electromechanical therapy in diabetic foot ulcers patients: A systematic review and meta-analysis. J Diabetes Metab Disord 2023; 22:967-984. [PMID: 37969923 PMCID: PMC10638302 DOI: 10.1007/s40200-023-01240-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/22/2023] [Indexed: 11/17/2023]
Abstract
Purpose Diabetic foot ulcer (DFU) is one of the most devastating and troublesome consequences of diabetes. The current therapies are not always effective because of the complicated aetiology and interactions of local and systemic components in DFU. However, adjunctive therapy (electromechanical therapy) has become the latest modality in recent years, although there is a lack of significant research to support its utilization as a treatment standard. The purpose of this systematic research was to review the literature on the application of electromechanical therapies in the healing of DFUs. Methods For this systematic review, we searched PubMed, Medline, EmBase, the Cochrane library, and Google Scholar for the most current research (1990-2022) on electromechanical therapies for DFUs. We used the PICO method (where P is population, I is intervention, C is comparator/control, and O is outcome for our study) to establish research question with the terms [Electromechanical therapy OR Laser therapy OR photo therapy OR Ultrasound therapy OR Shockwave therapy] AND [diabetic foot ulcers OR diabetes] were used as search criteria. Searches were restricted to English language articles only. Whereas, Cochrane handbook of "Systematic Reviews of Interventions" with critical appraisal for medical and health sciences checklist for systematic review was used for risk of bias assessment. There were 39 publications in this study that were deemed to be acceptable. All the suitably selected studies include 1779 patients. Results The meta-analysis of 15 included research articles showed the overall effect was significant (P = 0.0002) thus supporting experimental groups have improvement in the DFUs healing in comparison to the control group. Conclusion This systematic review and meta-analysis revealed electromechanical treatments are significantly viable options for patients with DFUs. Electromechanical therapy can considerably reduce treatment ineffectiveness, accelerate healing, and minimize the time it takes for complete ulcer healing. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01240-2.
Collapse
Affiliation(s)
- Ayeshmanthe Rathnayake
- Translational Research in Endocrinology and Diabetes, College of Medicine and Dentistry, James Cook University, Townsville, 4811 Australia
| | - Apoorva Saboo
- Translational Research in Endocrinology and Diabetes, College of Medicine and Dentistry, James Cook University, Townsville, 4811 Australia
| | - Venkat Vangaveti
- Translational Research in Endocrinology and Diabetes, College of Medicine and Dentistry, James Cook University, Townsville, 4811 Australia
| | - Usman Malabu
- Translational Research in Endocrinology and Diabetes, College of Medicine and Dentistry, James Cook University, Townsville, 4811 Australia
- Department of Diabetes and Endocrinology, Townsville University Hospital, Douglas, Australia
| |
Collapse
|
2
|
Dymarek R, Kuberka I, Rosińczuk J, Walewicz K, Taradaj J, Sopel M. The Immediate Clinical Effects Following a Single Radial Shock Wave Therapy in Pressure Ulcers: A Preliminary Randomized Controlled Trial of The SHOWN Project. Adv Wound Care (New Rochelle) 2022; 12:440-452. [PMID: 35996355 DOI: 10.1089/wound.2021.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Recent preliminary reports indicate that extracorporeal shock wave therapy (ESWT) might be useful for chronic wounds, especially venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs). However, there is limited evidence for the utility and safety of ESWT in pressure ulcers (PUs). Therefore, this randomized controlled trial (RCT) aimed to assess immediate planimetric and clinical effects following a single radial ESWT session in PUs. APPROACH A group of 40 patients with PUs was randomly assigned into two groups: active ESWT (n=20), which underwent a single treatment with radial ESWT (300+100 impulses per 1 cm2, 2.5 bars, 0.15 mJ/mm2, and 5 Hz) and placebo ESWT (n=20) which was exposed to sham-radial ESWT. All patients continued standard wound care procedures. The planimetric assessment and clinical outcomes using Wound Bed Score (WBS) and Bates-Jansen Wound Assessment Tool (BWAT) were assessed before (M0) and after ESWT sessions (M1). RESULTS There was a significant planimetric enhancement observed after active ESWT reported as a reduction in all metric parameters: wound area from 11.51 cm2 to 8.09 cm2 (p<0.001), wound length from 4.97 cm to 4.41 cm (p<0.001), and wound width from 3.15 cm to 2.49 cm (p<0.0001). Also, there was a significant beneficial clinical improvement observed with a WBS as an increased score from 3.85 to 9.65 points (p<0.001) and with the BWAT as a decreased score from 45.45 to 30.70 points (p<0.001). In turn, a regression in the placebo ESWT group was observed in all studied outcomes. INNOVATION This study is the first RCT to provide the positive and immediate clinical effects of radial ESWT in promoting the healing of PUs. CONCLUSION This preliminary RCT showed that even a single session of ESWT is a promising and clinically effective modality in managing PUs. However, there is still limited data regarding the usefulness of ESWT in PUs, and further studies are in demand.
Collapse
Affiliation(s)
- Robert Dymarek
- Wroclaw Medical University, Department of Physiotherapy, Wroclaw, Poland;
| | - Izabela Kuberka
- Wroclaw Medical University, Division of Anaesthetic and Surgical Nursing, Wroclaw, Poland;
| | - Joanna Rosińczuk
- Wroclaw Medical University, Division of Internal Medicine Nursing, Wroclaw, Poland;
| | | | - Jakub Taradaj
- Jerzy Kukuczka Academy of Physical Education In Katowice, Institute of Physiotherapy and Health Sciences, Katowice, Poland;
| | - Mirosław Sopel
- Wroclaw Medical University, Department of Basic Sciences, Wroclaw, Poland;
| |
Collapse
|
3
|
Meng J, Jin C, Li J, Zhang S, Zhang M, Hao Z, Chen X, Song Z, Zhang L, Liang C. Metabolomics Analysis Reveals the Differential Metabolites and Establishes the Therapeutic Effect Prediction Nomogram Among CP/CPPS Patients Who Respond or Do Not Respond to LiST. Front Immunol 2022; 13:953403. [PMID: 35911714 PMCID: PMC9332892 DOI: 10.3389/fimmu.2022.953403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Low-intensity shockwave therapy (LiST) has been applied in the clinical treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but few studies have focused on the prediction of its therapeutic effect before treatment. Methods Seventy-five CP/CPPS patients from our institute between July 2020 and May 2021 were enrolled and received 3 Hz, 0.25 mJ/mm2 LiST once a week over the course of four weeks. The scores of the NIH-CPSI, IPSS questionnaire and demographic features before treatment were recorded. The plasma before LiST treatment was also collected, while liquid chromatography-tandem mass spectrometry was used to detect the metabolites. Least absolute shrinkage and selection operator (LASSO) regression analysis was employed to identify the prediction metabolites and generate the metabolism score. Receiver operating characteristic curves and calibration curves were drawn to assess the prediction accuracy of the nomogram. Results Twelve metabolites were identified at incomparable levels before and after LiST treatment. The metabolism score generated by LASSO analysis presented a perfect prediction value (AUC: 0.848, 95% CI: 0.719-0.940) in the training cohort and further increased to 0.892 (95% CI: 0.802-0.983) on the nomogram, which accompanied with the NIH-CPSI scores and age. Similar results of the metabolism score (AUC: 0.732, 95% CI: 0.516-0.889) and total nomogram (AUC: 0.968, 95% CI: 0.909-1.000) were obtained in the testing cohort. Further enrichment of the 12 metabolites indicated that the glycine and serine metabolism pathway was involved in the LiST treatment. Conclusion We used our system to accurately and quantitatively measure plasma metabolites and establish a predictive model to identify suitable patients for LiST treatment.
Collapse
Affiliation(s)
- Jialin Meng
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Chen Jin
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Jiawei Li
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Song Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Meng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Zongyao Hao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Xianguo Chen
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Zhengyao Song
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Li Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University; Institute of Urology & Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| |
Collapse
|
4
|
Pastor D, Valera H, Olmo JA, Estirado A, Martínez S. Shock wave and mesenchymal stem cells as treatment in the acute phase of spinal cord injury: A pilot study. Rehabilitacion (Madr) 2022; 56:1-10. [PMID: 33966896 DOI: 10.1016/j.rh.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Spinal cord injury (SCI) is a complex pathology with thousands of patients worldwide. During the acute early phase, neural tissue shows some regenerative properties that disappear at the chronic phase. Shock Waves and Stem Cells have been proposed as a possible therapy. METHODS Here, we analyse Shock Waves' immediate effect over spinal cord genetic response in the injured and healthy spinal cord and the effect of Shock Waves and combined Shock Waves plus Stem Cells distally grafted to treat the first month after spinal cord injury. RESULTS The immediate application of shock waves increases VEGF (Vascular Endothelial Growth Factor) but reduces the BDNF (Brain-Derived Growth Factor) RNA (Ribonucleic acid) response. Shock wave therapy increases GFAP (Glial fibrillary acidic protein) positive cells and vascularity during the treatment's acute phase. CONCLUSION Shock wave treatment seems to be enough to produce benefits in the acute phase of spinal cord injury, with no accumulative positive effects when mesenchymal stem cell graft is applied together.
Collapse
Affiliation(s)
- D Pastor
- Department of Sports Science, Sports Research Centre, University Miguel Hernández of Elche, Elche, Spain.
| | - H Valera
- Servicio de Rehabilitación, University Hospital Virgen de la Arrixaca, Murcia, Spain
| | - J A Olmo
- Servicio de Rehabilitación, University Hospital Virgen de la Arrixaca, Murcia, Spain
| | - A Estirado
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández de Elche - Centro Superior de Investigaciones Científicas, Spain
| | - S Martínez
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández de Elche - Centro Superior de Investigaciones Científicas, Spain
| |
Collapse
|
5
|
Siegal A, Chubak BM. Pharmaceutical and Energy-Based Management of Sexual Problems in Women. Urol Clin North Am 2021; 48:473-486. [PMID: 34602169 DOI: 10.1016/j.ucl.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article summarizes and critiques the evidence for use of available pharmacotherapies (vasoactive, psychoactive, and hormonal medications) and energy-based therapies (laser, radiofrequency, shockwave, and neurostimulation) for treatment of female sexual dysfunction. The enthusiasm with which energy-based treatments for sexual dysfunction have been adopted is disproportionate to the amount of data currently available to support their clinical use. Pharmacotherapy for female sexual dysfunction has considerably more research evidence to justify its use. Patients must be empowered to make an informed, autonomous determination as to whether the risk/reward ratio favors the use of pharmacotherapy, energy-based therapy, or some other treatment intervention.
Collapse
Affiliation(s)
- Alexandra Siegal
- Department of Urology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, 6th Floor, New York, NY 10029, USA
| | - Barbara M Chubak
- Department of Urology, Icahn School of Medicine at Mount Sinai, 10 Union Square #3A, New York, NY 10003, USA.
| |
Collapse
|
6
|
Holsapple JS, Cooper B, Berry SH, Staniszewska A, Dickson BM, Taylor JA, Bachoo P, Wilson HM. Low Intensity Shockwave Treatment Modulates Macrophage Functions Beneficial to Healing Chronic Wounds. Int J Mol Sci 2021; 22:ijms22157844. [PMID: 34360610 PMCID: PMC8346032 DOI: 10.3390/ijms22157844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 12/21/2022] Open
Abstract
Extracorporeal Shock Wave Therapy (ESWT) is used clinically in various disorders including chronic wounds for its pro-angiogenic, proliferative, and anti-inflammatory effects. However, the underlying cellular and molecular mechanisms driving therapeutic effects are not well characterized. Macrophages play a key role in all aspects of healing and their dysfunction results in failure to resolve chronic wounds. We investigated the role of ESWT on macrophage activity in chronic wound punch biopsies from patients with non-healing venous ulcers prior to, and two weeks post-ESWT, and in macrophage cultures treated with clinical shockwave intensities (150–500 impulses, 5 Hz, 0.1 mJ/mm2). Using wound area measurements and histological/immunohistochemical analysis of wound biopsies, we show ESWT enhanced healing of chronic ulcers associated with improved wound angiogenesis (CD31 staining), significantly decreased CD68-positive macrophages per biopsy area and generally increased macrophage activation. Shockwave treatment of macrophages in culture significantly boosted uptake of apoptotic cells, healing-associated cytokine and growth factor gene expressions and modulated macrophage morphology suggestive of macrophage activation, all of which contribute to wound resolution. Macrophage ERK activity was enhanced, suggesting one mechanotransduction pathway driving events. Collectively, these in vitro and in vivo findings reveal shockwaves as important regulators of macrophage functions linked with wound healing. This immunomodulation represents an underappreciated role of clinically applied shockwaves, which could be exploited for other macrophage-mediated disorders.
Collapse
Affiliation(s)
- Jason S. Holsapple
- School of Medicine, Medical Sciences & Dentistry, Institute of Medical Sciences, University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZD, UK; (J.S.H.); (A.S.); (S.H.B.); (B.M.D.); (J.A.T.)
| | - Ben Cooper
- Department of Vascular Surgery, NHS Grampian, Foresterhill Road, Aberdeen AB25 2ZN, UK; (B.C.); (P.B.)
| | - Susan H. Berry
- School of Medicine, Medical Sciences & Dentistry, Institute of Medical Sciences, University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZD, UK; (J.S.H.); (A.S.); (S.H.B.); (B.M.D.); (J.A.T.)
| | - Aleksandra Staniszewska
- School of Medicine, Medical Sciences & Dentistry, Institute of Medical Sciences, University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZD, UK; (J.S.H.); (A.S.); (S.H.B.); (B.M.D.); (J.A.T.)
| | - Bruce M. Dickson
- School of Medicine, Medical Sciences & Dentistry, Institute of Medical Sciences, University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZD, UK; (J.S.H.); (A.S.); (S.H.B.); (B.M.D.); (J.A.T.)
| | - Julie A. Taylor
- School of Medicine, Medical Sciences & Dentistry, Institute of Medical Sciences, University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZD, UK; (J.S.H.); (A.S.); (S.H.B.); (B.M.D.); (J.A.T.)
| | - Paul Bachoo
- Department of Vascular Surgery, NHS Grampian, Foresterhill Road, Aberdeen AB25 2ZN, UK; (B.C.); (P.B.)
| | - Heather M. Wilson
- School of Medicine, Medical Sciences & Dentistry, Institute of Medical Sciences, University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZD, UK; (J.S.H.); (A.S.); (S.H.B.); (B.M.D.); (J.A.T.)
- Correspondence:
| |
Collapse
|
7
|
Canguven O, Khalafalla K, Al Ansari A. Low-intensity extracorporeal shockwave therapy for erectile dysfunction. Arab J Urol 2021; 19:340-345. [PMID: 34552784 PMCID: PMC8451630 DOI: 10.1080/2090598x.2021.1948158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/05/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives: To review the current evidence of clinical effectiveness of low-intensity extracorporeal shockwave therapy (LI-ESWT) treatment for erectile dysfunction (ED). METHODS A selective database search using Medical Subject Headings (MeSH) terms 'low intensity extracorporeal shock wave therapy' and 'erectile dysfunction' was conducted in accordance with the Preferred Reporting Items for Systemic Reviews and Meta Analyses (PRISMA) guidelines to review the effectiveness of LI-ESWT for ED. We performed a systematic search of publications using the PubMed and Web of Science databases (January 2010-December 2020) for prospective randomised clinical trials (RCTs). The success rate of LI-ESWT associated with ED were recorded and analysed. RESULTS A total of 106 articles were reviewed after searching for the keywords. Overall, 11 RCTs were included in this systematic review. A total of 920 male patients were treated in 11 RCTs. The patients' ages ranged from 18 to 80 years and they had ≥3 months of ED symptoms. Vasculogenic and neurogenic causes were addressed in 81% and 19% of patients, respectively. Of the 920 patients, 348 patients had a statistically significant improvement in their erectile function after LI-ESWT; however, 572 did not have a statistically significant improvement. CONCLUSIONS The present review found that LI-ESWT has a role in ED treatment in laboratory studies, but its role in human clinical trials is still controversial. Further good quality studies need to be conducted to properly assess its true potential in ED treatment.
Collapse
|
8
|
Memariani H, Memariani M, Moravvej H, Shahidi-Dadras M. Emerging and Novel Therapies for Keloids: A compendious review. Sultan Qaboos Univ Med J 2021; 21:e22-e33. [PMID: 33777420 PMCID: PMC7968901 DOI: 10.18295/squmj.2021.21.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/27/2020] [Accepted: 08/13/2020] [Indexed: 12/31/2022] Open
Abstract
Keloids are abnormal fibroproliferative scars with aggressive dermal growth expanding beyond the borders of the original injury. Different therapeutic modalities, such as corticosteroids, surgical excision, topical silicone gel sheeting, laser therapy, cryotherapy, photodynamic therapy and radiotherapy, have been used to treat keloids; however, none of these modalities has proven completely effective. Recently, researchers have devised several promising anti-keloid therapies including anti-hypertensive pharmaceuticals, calcineurin inhibitors, electrical stimulation, mesenchymal stem cell therapy, microneedle physical contact and ribonucleic acid-based therapies. The present review summarises emerging and novel treatments for keloids. PubMed® (National Library of Medicine, Bethesda, Maryland, USA), EMBASE (Elsevier, Amsterdam, Netherlands) and Web of Science (Clarivate Analytics, Philadelphia, Pennsylvania, USA) were searched for relevant literature published between January 1987 to June 2020. A total of 118 articles were included in this review. A deeper understanding of the molecular mechanisms underlying keloid scarring pathogenesis would open further avenues for developing innovative treatments.
Collapse
Affiliation(s)
- Hamed Memariani
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojtaba Memariani
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Moravvej
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
9
|
Hendler KG, Canever JB, de Souza LG, das Neves LMS, de Cássia Registro Fonseca M, Kuriki HU, da Silva Aguiar Junior A, Barbosa RI, Marcolino AM. Comparison of photobiomodulation in the treatment of skin injury with an open wound in mice. Lasers Med Sci 2021; 36:1845-1854. [PMID: 33496904 DOI: 10.1007/s10103-020-03216-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
This study aimed to investigate the effects of photobiomodulation at a wavelength of 660 and 830 nm at different numbers of application points in the healing of open wounds in mice. In total, 120 mice were divided into 10 groups. The animals were submitted to cutaneous lesion of the open wound type (1.5 × 1.5 cm). Photobiomodulation at a wavelength of 660 and 830 nm and total energy of 3.6 J were used, applied at 1, 4, 5, and 9 points, for 14 days. The animals were subjected to analysis of the lesion area, skin temperature, and histological analysis. Macroscopic analysis results showed a difference (p < 0.05) between the irradiated groups and the sham group at 14 days PO. There was no statistical difference in skin temperature. Histological analysis findings showed better results for the epidermis thickness. Regarding the number of blood vessels, a difference was found between the 1- and 5-point 830-nm photobiomodulation groups and between the 4-point 660-nm group and the naive group. A significant difference in the number of fibroblasts was observed between the 830- and 660-nm photobiomodulation groups and the naive and sham groups. When comparing photobiomodulation wavelength, the 830-nm groups were more effective, and we emphasize the groups irradiated at 5 points, which showed an improvement in macroscopic analysis and epidermis thickness, an increase in the number of vessels, and a lower number of fibroblasts on the 14th day after skin injury.
Collapse
Affiliation(s)
- Ketlyn Germann Hendler
- Laboratory of Assessment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Universidade Federal de Santa Catarina, Campus Araranguá - Campus Mato Alto, Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil.,Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina (LARAL/UFSC), Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil
| | - Jaquelini Betta Canever
- Laboratory of Assessment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Universidade Federal de Santa Catarina, Campus Araranguá - Campus Mato Alto, Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil
| | - Luana Gabriel de Souza
- Laboratory of Assessment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Universidade Federal de Santa Catarina, Campus Araranguá - Campus Mato Alto, Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil.,Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina (LARAL/UFSC), Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil
| | - Laís Mara Siqueira das Neves
- Laboratory of Assessment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Universidade Federal de Santa Catarina, Campus Araranguá - Campus Mato Alto, Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil
| | - Marisa de Cássia Registro Fonseca
- Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School of the University of São Paulo (USP), Av. dos Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Heloyse Uliam Kuriki
- Laboratory of Assessment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Universidade Federal de Santa Catarina, Campus Araranguá - Campus Mato Alto, Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil.,Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina (LARAL/UFSC), Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil
| | - Aderbal da Silva Aguiar Junior
- Laboratory of Assessment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Universidade Federal de Santa Catarina, Campus Araranguá - Campus Mato Alto, Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil.,Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina (LARAL/UFSC), Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil
| | - Rafael Inácio Barbosa
- Laboratory of Assessment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Universidade Federal de Santa Catarina, Campus Araranguá - Campus Mato Alto, Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil.,Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina (LARAL/UFSC), Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil
| | - Alexandre Marcio Marcolino
- Laboratory of Assessment and Rehabilitation of the Locomotor Apparatus, Department of Health Sciences, Universidade Federal de Santa Catarina, Campus Araranguá - Campus Mato Alto, Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil. .,Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina (LARAL/UFSC), Rua Pedro João Pereira, 150, Araranguá, Santa Catarina, 88905-120, Brazil.
| |
Collapse
|
10
|
Li B, Wang R, Huang X, Ou Y, Jia Z, Lin S, Zhang Y, Xia H, Chen B. Extracorporeal Shock Wave Therapy Promotes Osteogenic Differentiation in a Rabbit Osteoporosis Model. Front Endocrinol (Lausanne) 2021; 12:627718. [PMID: 33841330 PMCID: PMC8027252 DOI: 10.3389/fendo.2021.627718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/08/2021] [Indexed: 01/16/2023] Open
Abstract
Extracorporeal shock wave therapy (ESWT) has been identified to accelerate bone formation. However, detailed mechanism has not been fully explained. In this study, we found that ESWT promoted osteoblast formation in vitro. Local ESW treatment of femur increased bone formation in vivo. Furthermore, changing the density or frequency of energy, there was no statistical difference in osteogenic differentiation. Therapeutically, local ESW therapy relieved bone loss and increased the number of bone trabecular in a rabbit osteoporosis model and promoted endogenous levels of SMAD2 protein expression. Thus, ESWT may be a potential therapy by promoting osteoblast maturation through TGF-β/SMAD2 pathway.
Collapse
Affiliation(s)
- Baofeng Li
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangdong Key Lab of Orthopedic Technology and Implant Materials, Guangzhou, China
| | - Renkai Wang
- Department of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangdong Key Lab of Orthopedic Technology and Implant Materials, Guangzhou, China
| | - Xianyin Huang
- School of Clinical Medicine,Guangdong Pharmaceutical University, Guangzhou, China
| | - Yongliang Ou
- Department of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangdong Key Lab of Orthopedic Technology and Implant Materials, Guangzhou, China
| | - Zhenyu Jia
- Department of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangdong Key Lab of Orthopedic Technology and Implant Materials, Guangzhou, China
| | - Shanghui Lin
- Department of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangdong Key Lab of Orthopedic Technology and Implant Materials, Guangzhou, China
| | - Ying Zhang
- Department of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangdong Key Lab of Orthopedic Technology and Implant Materials, Guangzhou, China
| | - Hong Xia
- Department of Orthopaedics, General Hospital of Southern Theater Command of PLA, Guangdong Key Lab of Orthopedic Technology and Implant Materials, Guangzhou, China
| | - Bei Chen
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Bei Chen,
| |
Collapse
|
11
|
The Impact of Extracorporeal Shock Wave Therapy on Microcirculation in Diabetic Feet: A Pilot Study. Adv Skin Wound Care 2020; 32:563-567. [PMID: 31764146 DOI: 10.1097/01.asw.0000604180.54706.b2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Patients with diabetic foot commonly experience vascular insufficiency and compromised tissue perfusion. Extracorporeal shockwave therapy (ESWT) reportedly promotes wound healing and angiogenesis, but clinical studies on the effect of ESWT on angiogenesis are scarce and the exact mechanism remains unclear. OBJECTIVE To investigate the effect of ESWT on cutaneous microcirculation in diabetic feet. METHODS Ten patients with diabetic feet received ESWT twice weekly for a total of six sessions. Transcutaneous partial oxygen pressure (TcPO2) and cutaneous blood flow were measured before and after ESWT. MAIN RESULTS The treated feet showed statistically significant improvements in the mean TcPO2 (P < .01) and cutaneous blood flow level (P < .05) compared with control feet. In treated feet, TcPO2 increased by 19.6%, from 41.4 ± 9.9 to 49.5 ± 8.7 mm Hg (P < .05). In control feet, TcPO2 decreased by 11.6%, from 39.5 ± 14.0 to 34.9 ± 14.5 mm Hg (P = .059). The average cutaneous blood flow level of treated feet before ESWT was 36.9 ± 25.6, which increased to 48.3 ± 32.4 AU after ESWT (30.9% increase; P = .646). In control feet, the cutaneous blood flow level decreased from 80.5 ± 36.7 to 60.4 ± 38.8 AU, a decrease of 25.0% (P = .241). CONCLUSIONS These results demonstrate that ESWT may have beneficial effects on microcirculation in diabetic feet.
Collapse
|
12
|
Extracorporeal Shock Wave Therapy for Treating Foot Ulcers in Adults With Type 1 and Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Can J Diabetes 2020; 44:196-204.e3. [DOI: 10.1016/j.jcjd.2019.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/16/2019] [Indexed: 12/13/2022]
|
13
|
Matsuda M, Kanno H, Sugaya T, Yamaya S, Yahata K, Handa K, Shindo T, Shimokawa H, Ozawa H, Itoi E. Low-energy extracorporeal shock wave therapy promotes BDNF expression and improves functional recovery after spinal cord injury in rats. Exp Neurol 2020; 328:113251. [PMID: 32087252 DOI: 10.1016/j.expneurol.2020.113251] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 02/07/2023]
Abstract
Low-energy extracorporeal shock wave therapy (ESWT) has been used to treat various human diseases. Previous studies have shown that low-energy ESWT promotes the release of various cell growth factors and trophic factors from the cells surrounding the target lesion. The aim of the current study was to determine whether the application of low-energy ESWT upregulates the expression of brain-derived neurotrophic factor (BDNF) and reduces neural tissue damage and functional impairment using a rat model of thoracic spinal cord contusion injury. We found that low-energy ESWT promoted BDNF expression in the damaged neural tissue. The expression of BDNF was increased in various neural cells at the lesion. Additionally, low-energy ESWT increased the area of spared white matter and the number of oligodendrocytes in the injured spinal cord compared with untreated control animals. There were more axonal fibers around the injured site after the application of low-energy ESWT than control. Importantly, low-energy ESWT improved the locomotor functions evaluated by both the BBB scale and ladder rung walking test in addition to the sensory function measured using a von Frey test. Moreover, the electrophysiological assessment confirmed that the conductivity of the central motor pathway in the injured spinal cord was restored by low-energy ESWT. These findings indicate that low-energy ESWT promotes BDNF expression at the lesion site and reduces the neural tissue damage and functional impairment following spinal cord injury. Our results support the potential application of low-energy ESWT as a novel therapeutic strategy for treating spinal cord injury.
Collapse
Affiliation(s)
- Michiharu Matsuda
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Haruo Kanno
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
| | - Takehiro Sugaya
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Seiji Yamaya
- Department of Orthopaedic Surgery, Sendai Nishitaga National Hospital, Sendai 982-8555, Japan.
| | - Kenichiro Yahata
- Department of Orthopaedic Surgery, Sendai Nishitaga National Hospital, Sendai 982-8555, Japan
| | - Kyoichi Handa
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
| | - Tomohiko Shindo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
| | - Hiroshi Ozawa
- Department of Orthopaedic Surgery, Tohoku Medical and Pharmaceutical University, Faculty of Medicine, 1-15-1, Fukumuro Miyagino-ku, Sendai 983-8536, Japan.
| | - Eiji Itoi
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
| |
Collapse
|
14
|
Therapeutic areas of Li-ESWT in sexual medicine other than erectile dysfunction. Int J Impot Res 2019; 31:223-230. [DOI: 10.1038/s41443-019-0114-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/16/2018] [Accepted: 12/20/2018] [Indexed: 12/18/2022]
|
15
|
Chen RF, Chang CH, Wang CT, Yang MY, Wang CJ, Kuo YR. Modulation of vascular endothelial growth factor and mitogen-activated protein kinase-related pathway involved in extracorporeal shockwave therapy accelerate diabetic wound healing. Wound Repair Regen 2018; 27:69-79. [PMID: 30394625 DOI: 10.1111/wrr.12686] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 09/27/2018] [Accepted: 10/13/2018] [Indexed: 12/28/2022]
Abstract
Extracorporeal shockwave therapy (ESWT) has a significant positive effect to accelerate chronic wound healing. This study investigated whether the vascular endothelial growth factor (VEGF)-related pathway has involved in ESWT enhancement of diabetic wound healing. A dorsal skin defect (area, 6 × 5 cm) in a streptozotocin-induced diabetes rodent model was used. Thirty-two male Wistar rats were divided into four groups. Group I consisted of nondiabetic control; group II, diabetic control without treatment; group III, diabetic rats received ESWT; and group IV, rats received Avastin (a VEGF monoclonal antibody) on day 0 (post-wounding immediately) to day 7 and ESWT on day 3 and day 7. The wound healing was assessed clinically. The VEGF, endothelial nitric oxide synthase (eNOS), and Ki-67 were analyzed with immunohistochemical staining. The mRNA expression of mitogen-activated protein kinase-related genes was measured by real-time quantitative real-time polymerase chain reaction. The results revealed wound size was significantly reduced in the ESWT-treated rats as compared to the diabetic control (p < 0.01). The positive effect of ESWT-increasing wound healing was significantly suppressed in pretreatment of the Avastin group. Histological findings revealed significant increase in neo-vessels in the ESWT group as compared to the control. In immunohistochemical stain, significant increases in VEGF, eNOS, and Ki-67 expressions were noted in the ESWT group as compared to that in controls. However, Avastin suppressed the shockwave effect and down-regulation of VEGF, eNOS, and Ki-67 expressions in the Avastin-ESWT group as compared to that in the ESWT alone group. We found that highly mRNA expression of Kras, Raf1, Mek1, Jnkk, Jnk, and Jun at early stage in the ESWT group, as compared to the diabetic control. These evidences indicated treatment with multiple sessions of ESWT significantly enhanced diabetic wound healing associated with increased neovascularization and tissue regeneration. The bio-mechanism of ESWT-enhanced wound healing is correlated with VEGF and mitogen-activated protein kinase-mediated pathway.
Collapse
Affiliation(s)
- Rong-Fu Chen
- Department of Surgery, Division of Plastic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chih-Hau Chang
- Department of Surgery, Division of Plastic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Ting Wang
- Department of Surgery, Division of Plastic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ming-Yu Yang
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Ching-Jen Wang
- Department of Orthopaedics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yur-Ren Kuo
- Department of Surgery, Division of Plastic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Orthopaedic Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| |
Collapse
|
16
|
Ashrafi M, Novak-Frazer L, Morris J, Baguneid M, Rautemaa-Richardson R, Bayat A. Electrical stimulation disrupts biofilms in a human wound model and reveals the potential for monitoring treatment response with volatile biomarkers. Wound Repair Regen 2018; 27:5-18. [DOI: 10.1111/wrr.12679] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 10/08/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Mohammed Ashrafi
- Plastic & Reconstructive Surgery Research, Division of Musculoskeletal & Dermatological Sciences; School of Biological Sciences, University of Manchester; Manchester United Kingdom
- Manchester University NHS Foundation Trust; Wythenshawe Hospital; Manchester United Kingdom
- Bioengineering Group, School of Materials; University of Manchester; Manchester United Kingdom
| | - Lilyann Novak-Frazer
- Manchester University NHS Foundation Trust; Wythenshawe Hospital; Manchester United Kingdom
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Division of Infection, Immunity and Respiratory Medicine; School of Biological Sciences, The University of Manchester and Manchester University NHS Foundation Trust; Manchester United Kingdom
| | - Julie Morris
- Honorary Reader in Medical Statistics; Manchester University NHS Foundation Trust, Wythenshawe Hospital; Manchester United Kingdom
| | - Mohamed Baguneid
- Manchester University NHS Foundation Trust; Wythenshawe Hospital; Manchester United Kingdom
| | - Riina Rautemaa-Richardson
- Manchester University NHS Foundation Trust; Wythenshawe Hospital; Manchester United Kingdom
- Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Division of Infection, Immunity and Respiratory Medicine; School of Biological Sciences, The University of Manchester and Manchester University NHS Foundation Trust; Manchester United Kingdom
| | - Ardeshir Bayat
- Plastic & Reconstructive Surgery Research, Division of Musculoskeletal & Dermatological Sciences; School of Biological Sciences, University of Manchester; Manchester United Kingdom
- Manchester University NHS Foundation Trust; Wythenshawe Hospital; Manchester United Kingdom
| |
Collapse
|
17
|
Zissler A, Stoiber W, Pittner S, Sänger AM. Extracorporeal Shock Wave Therapy in Acute Injury Care: A Systematic Review. Rehabil Process Outcome 2018. [DOI: 10.1177/1179572718765138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objectives: We provide a systematic review of the literature to identify clinical studies assessing the effects of extracorporeal shock wave therapy (ESWT) on acutely injured tissues of human subjects, also highlighting the biological mechanisms by which the technique is proposed to promote the processes of early tissue repair. Special attention is also paid to the progress of research in animal models. Method: A systematic review of the literature on ESWT of acute injuries of bone and soft tissue as available in the PubMed/MEDLINE, Cochrane CENTRAL, SPORTDiscus, and CINAHL databases up to December 2017 was conducted. Results: A total of 10 studies were included. There is some evidence for the application of ESWT in an early postacute injury phase. Most studies report benefits with no or minimal side effects. However, different types of treated tissues and wounds (varying cause and severity) and resulting heterogeneity in study design and outcome measurement make it difficult to compare studies. The picture of knowledge remains limited by an apparent lack of data on optimal treatment timing and on tissue- and injury-specific parameters. Conclusions: Although the amount of studies to date is still limited, recent clinical research has presented first successful steps to introduce ESWT as a means of treatment in acute injury care. Therefore, on the basis of the analyzed data, further testing is encouraged to validate optimal timing, physical settings, and possible long-term effects to exclude potential risks.
Collapse
Affiliation(s)
- Angela Zissler
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Walter Stoiber
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | - Stefan Pittner
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | | |
Collapse
|
18
|
Dolibog P, Dolibog P, Franek A, Brzezińska-Wcisło L, Arasiewicz H, Wróbel B, Chmielewska D, Ziaja J, Błaszczak E. Randomized, controlled clinical pilot study of venous leg ulcers treated with using two types of shockwave therapy. Int J Med Sci 2018; 15:1275-1285. [PMID: 30275753 PMCID: PMC6158659 DOI: 10.7150/ijms.26614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 06/30/2018] [Indexed: 11/05/2022] Open
Abstract
Background. Venous leg ulcers are difficult to heal wounds. The basis of their physiotherapeutic treatment is compression therapy. However, for many years, the search for additional or other methods to supplement the treatment of venous ulcers, which would shorten the duration of treatment, is underway. One of such methods is the shockwave therapy. Methods. The purpose of our study was to compare radial shockwave therapy (R-ESWT) with focused shockwave therapy (F-ESWT) in venous leg ulcers treatment. Patients were randomly assigned to tree groups. In the first group the radial shockwave therapy (0.17mJ/mm2, 100 impulses/cm2, 5 Hz), in the second group the focused shockwave therapy (0.173mJ/mm2, 100 impulses/cm2, 5 Hz) was used and in third group standard care was used. Patients in shockwave therapy groups were given 6 treatments at five-day intervals. Total area, circumference, Gilman index, maximum length and maximum width of ulcers were measured. The patients from the third group wet gauze dressing with saline and gently compressing elastic bandages were used (standard wound care SWC). Results. Analysis of the results shows that a complete cure of ulcers was achieved in 35% of patients who were treated with radial shockwave, 26% of patients with focused shockwave used. There is statistically significant difference between the standard care and radial shockwave therapy as well as between the standard care and focused shockwave therapy. There is no statistically significant difference between the use of radial and focused shockwave in the treatment of venous leg ulcers (p> 0.05). Conclusion. There is no statistically significant difference between the use of radial and focused shockwave in the treatment of venous leg ulcers. Treatment of venous leg ulcers with shockwaves is more effective than the standard wound care.
Collapse
Affiliation(s)
- Patrycja Dolibog
- Chair and Department of Medical Biophysics, School of Medicine in Katowice, Medical University of Silesia
| | - Paweł Dolibog
- Chair and Department of Medical Biophysics, School of Medicine in Katowice, Medical University of Silesia
| | - Andrzej Franek
- Chair and Department of Medical Biophysics, School of Medicine in Katowice, Medical University of Silesia
| | | | - Hubert Arasiewicz
- Department of Dermatology, School of Medicine in Katowice, Medical University of Silesia
| | - Beata Wróbel
- Chair and Department of Medical Biophysics, School of Medicine in Katowice, Medical University of Silesia
| | - Daria Chmielewska
- Department of Basics of Physiotherapy, Faculty of Physiotherapy, Academy of Physical Education in Katowice
| | - Jacek Ziaja
- Department of General, Vascular and Transplant Surgery, School of Medicine in Katowice, Medical University of Silesia
| | - Edward Błaszczak
- Chair and Department of Medical Biophysics, School of Medicine in Katowice, Medical University of Silesia
| |
Collapse
|