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Shockwave therapy has become a part of physical therapy treatments. On the market there are many devices which descriptions contain name abbreviations of English origin. The article is an attempt to organize this issue.

Focused Shockwave therapy – FSWT

 

FSWT – Focused Shock Wave Therapy – this kind of interaction, from which the therapy took its name, has been created as the first. Its main application was to break up kidney and gall stones without direct contact with them. The treatment is performed through the skin.
The front of the head is a cut element of the rotary block, often sphere. Mechanical wave generated by that head meets in the tissue to form a local maximum.
Stones – whether kidney or gall – are fragile. This strong interaction that causes mechanical stress, which in turn lead to the degradation into smaller components. In this way, the division of too large stones takes place to expel naturally smaller fragments.

emitery fswt

Fig. 1. Emitter types of FSWT- focused shock wave therapy, from the left, respectively: piezoelectric, electromagnetic (flat coil) and electromagnetic (solenoid coil).

Focused shock wave is more often used in physical therapy. The achieved local pressure is much higher than in the case of a radial wave. In the course of treatment with the use of focused wave it is recommended to use functional and diagnostic tests usually based on ultrasonography.

Shockwave therapy parameters

Shockwave is characterized by very high pressure – 10-100MPA in very short time of 0,2 sec.

impuls zogniskowanej fali uderzeniowejThese parameters cause that it has a very strong interaction and it may have devastating effects.

Shockwave therapy — Energy density needed for a given type of treatment

The shockwave, depending on the energy density, may be used for various purposes .
zakres działania fswt

The chart indicates that the values of up to 0.3 mJ / mm2 result in cell regeneration. Values reaching up to 0.5 mJ / mm2 can be used for pain therapy. Values starting from 0.3 mJ / mm2 and ending on 1 mJ / mm2 can be used for the treatment of pseudoarthrosis.
All values greater than 0.5 mJ / mm2 are considered to be of high energy level and can be used to dissolve kidney or gall stones. Method of dissolving that kind of stones with the use of ESWT is called lithotripsy.

Shockwave therapy – biological effects

  • Increase in cell permeability,
  • Stimulation of microcirculation, both blood and lymph,
  • Release of the P substance,
  • Release of nitric oxide (NO), thereby causing vasodilation,
  • Bactericidal effect,
  • Release of growth factors (blood vessels, epithelium, bones, collagen, etc.),
  • Stimulation of stem cells.

 

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