Me: I wanted to go deeper in the research for this method because it looks very promising as another tool. In my opinion, it might be better than LIPUS in helping achieve height increase.
From study 1…
The researchers tried the application of radial extracorporeal shock wave therapy (rESWT) to get bones to growth and form. There was 4000 impulses of the shock waves used on one of the hind legs of 13 rabbits. The other is not treated with rESWT as the control. after a week the shockwaves were doen again. What they found was that the rESWT significantly increase new bone formation at all time points throughout the study’s time period. It is interesting that the rate of bone formation was at the maximum at 4 weeks. The most amazing thing was the the location of the long bone which was closest to the shock wave application was where the most bone formation was found. It seems that the ESWT induced osteogenesis is dosage dependent. The best thing is that so trauma like hemmorhage or microfractures were found. The researchers conclude with “This is the first study demonstrating low-energy radial shock waves to induce new bone formation in vivo. Based on our results, repetition of ESWT in 6-week intervals can be recommended.”
From study 2…
The researchers found that using ESWT was safe and a great alternative for fracture/ non union healing. It seemed to work better for tropic nonunions (with calluses) than atropic nonunions (without calluses). The study dosage is …”The shock waves were applied in 3-5 sessions of 2500 to 3000 impulses each given at 0.25-0.84 mJ/mm2, at intervals of 48-72 hours between sessions. A maximum of 3 cycles of treatment was given, at 3-month intervals.” The healing reduced the time needed for a large percentage but a smaller percentage did not see any healing.
From study 3...
This is another study which comfirms that ESWT is amazing. It has been used to heal achilles tendinitis and the researchers in this study wanted to shows that it heals the tendinitis by increasing the expression of TGF-Beta1 and IGF-1. The study varied the impulse dosage from 0, 200, 500, and 1000 impulses. The optimal dosage for the mice in the study was around 200 impulse at around 0.2 mJ/mm^2. Through out the entire study the expression of IGF-1 was elevated dramatically. It seems to show that cell proliferation, cell hypertrophy, and tissue regeneration were all effects. There was also a proliferation of tenocytes and neovascularization (new blood vessels).
From ScienceDirect.com study link HERE…
Radial Extracorporeal Shock Wave Therapy (rESWT) Induces New Bone Formation in vivo: Results of an Animal Study in Rabbits
Abstract
The aim of this study was to investigate if radial extracorporeal shock wave therapy (rESWT) induces new bone formation and to study the time course of ESWT-induced osteogenesis. A total of 4000 impulses of radial shock waves (0.16 mJ/mm²) were applied to one hind leg of 13 New Zealand white rabbits with the contralateral side used for control. Treatment was repeated after 7 days. Fluorochrome sequence labeling of new bone formation was performed by subcutaneous injection of tetracycline, calcein green, alizarin red and calcein blue. Animals were sacrificed 2 weeks (n = 4), 4 weeks (n = 4) and 6 weeks (n = 5) after the first rESWT and bone sections were analyzed by fluorescence microscopy. Deposits of fluorochromes were classified and analyzed for significance with the Fisher exact test. rESWT significantly increased new bone formation at all time points over the 6-week study period. Intensity of ossification reached a peak after 4 weeks and declined at the end of the study. New bone formation was significantly higher and persisted longer at the ventral cortex, which was located in the direction to the shock wave device, compared with the dorsal cortex, emphasizing the dose-dependent process of ESWT-induced osteogenesis. No traumata, such as hemorrhage, periosteal detachment or microfractures, were observed by histologic and radiologic assessment. This is the first study demonstrating low-energy radial shock waves to induce new bone formation in vivo. Based on our results, repetition of ESWT in 6-week intervals can be recommended. Application to bone regions at increased fracture risk (e.g., in osteoporosis) are possible clinical indications.
Effects of Extracorporeal Shock Wave Therapy on Fracture Nonunions
Maria Chiara Vulpiani, MD, Mario Vetrano, MD, Federica Conforti, MD, Lucia Minutolo, MD, Donatella
Trischitta, MD, John P. Furia, MD, and Andrea Ferretti, MD
Abstract
The purpose of this study was to examine the effect of focused extracorporeal shock wave therapy (ESWT) on the treatment of nonunions. As part of a prospective study, we included 143 patients (average age, 41.4 years) with a diagnosis of nonunion (mean, 14.1 months; range, 6-84 months). High-energy shock wave treatment was applied using electromagnetic shock wave generators. The shock waves were applied in 3-5 sessions of
2500 to 3000 impulses each given at 0.25-0.84 mJ/mm2, at intervals of 48-72 hours between sessions. A maximum of 3 cycles of treatment was given, at 3-month intervals. The patients were followed during a 12-month period until fracture healing or, in case of failure, until another therapy was adopted. Complete healing was observed in 80 of 143 cases (55.9%) at an average time of 7.6 months (range, 2-24 months). Partial healing occurred in 41 cases (28.7%) and no healing was observed in 22 cases (15.4%). Patients with trophic nonunions had a better success rate than patients with atrophic nonunions (P<.05). The results show ESWT is a safe and effective treatment for nonunions. ESWT is more effective for trophic nonunions than atrophic nonunion
From the Journal Of Orthopaedic Research website study 3 link HERE…
Extracorporeal shock waves promote healing of collagenase-induced Achilles tendinitis and increase TGF-b1 and IGF-I expression
Yeung-Jen Chen a, Ching-Jen Wang b, Kuender D. Yang c, Yur-Ren Kuo d, Hui-Chen Huang c, Yu-Ting Huang c, Yi-Chih Sun c, Feng-Sheng Wang
c,*
- a Department of Orthopaedic Trauma, Chang Gung University, Linkou, Taiwan
- b Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- c Department of Medical Research, Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung, Kaohsiung 833, Taiwan
- d Department of Trauma, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
Received 28 April 2003; accepted 20 October 2003
Abstract
Extracorporeal shock waves (ESW) have recently been used in resolving tendinitis. However, mechanisms by which ESW promote tendon repair is not fully understood. In this study, we reported that an optimal ESW treatment promoted healing of Achilles tendintis by inducing TGF-b1 and IGF-I. Rats with the collagenease-induced Achilles tendinitis were given a single ESW treatment (0.16 mJ/mm2 energy flux density) with 0, 200, 500 and 1000 impulses. Achilles tendons were subjected to biomechanical (load to failure and stiffness), biochemical properties (DNA, glycosaminoglycan and hydroxyproline content) and histological
assessment. ESW with 200 impulses restored biomechanical and biochemical characteristics of healing tendons 12 weeks after treatment. However, ESW treatments with 500 and 1000 impulses elicited inhibitory effects on tendinitis repair. Histological observation demonstrated that ESW treatment resolved edema, swelling, and inflammatory cell infiltration in injured tendons. Lesion site underwent intensive tenocyte proliferation, neovascularization and progressive tendon tissue regeneration. Tenocytes at
the hypertrophied cellular tissue and newly developed tendon tissue expressed strong proliferating cell nuclear antigen (PCNA) after ESW treatment, suggesting that physical ESW could increase the mitogenic responses of tendons. Moreover, the proliferation of
tenocytes adjunct to hypertrophied cell aggregate and newly formed tendon tissue coincided with intensive TGF-b1 and IGF-I expression. Increasing TGF-b1 expression was noted in the early stage of tendon repair, and elevated IGF-I expression was persisted
throughout the healing period. Together, low-energy shock wave effectively promoted tendon healing. TGF-b1 and IGF-I played important roles in mediating ESW-stimulated cell proliferation and tissue regeneration of tendon.
2003 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.
