• The Journal of the Acoustical Society of Korea
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• v.29 no.3E
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• pp.119-130
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• 2010

Extracorporeal shock wave therapy (ESWT) is simply evolved from extracorporeal shock wave lithotripsy known as a revolutionary non-invasive technique for treating kidney stone diseases. Since ESWT was approved for treating plantar fasciitis by FDA in 2000, it has been rapidly accepted into various clinical practices. Its indication includes chronic tendinitis and pseudoarthrosis, and has been widened to various applications other than orthopeadics. Little has been reported on their acoustic properties, yet, even if a number of clinical ESWT systems are readily available. This article reviews the acoustical aspects of ESWT and discusses critical issues towards acoustic exposure optimization and shock wave dosimetry.

• Journal of Korean Foot and Ankle Society
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• v.11 no.1
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• pp.51-56
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• 2007

Purpose: The objective of this study was to report the outcomes of patients treated with extracorporeal shock wave therapy (ESWT) for refractory plantar fasciitis of the foot. Materials and Methods: From November 2005 to October 2006, a total of sixty-two patients with refractory plantar fasciitis were treated with extracorporeal shock wave therapy. The main outcome measurements were visual analogue scale (VAS) and Roles and Maudsley score evaluated before treatment and at one and six months after treatment. Results: Roles and Maudsley score was excellent (0%), good (6.4%), fair (35.4%) and poor (58.2%) before treatment which improved to excellent (56.5%), good (38.7%), fair (4.8%) and poor (0%) at final follow-up. VAS scores also significantly improved after ESWT (p<0.05). There was no statistically significant correlation between clinical results and body mass index (BMI) (p=0.102). Conclusion: Extracorporeal shock wave therapy appears to be an effective and safe treatment modality for refractory plantar fasciitis and may help the patient to avoid surgery for refractory heel pain.

• Physical Therapy Rehabilitation Science
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• v.3 no.2
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• pp.142-147
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• 2014

Objective: This study aims to investigate high energy and low energy extracorporeal shockwave therapy (ESWT) and which one is more effective for shoulder pain. Design: Single blind randomized controlled trial. Methods: Fifty two subjects with upper trapezius (UT) trigger point (TrP) participated in this study. They were allocated to high energy (n=26) and low energy group (n=26). This study applies ESWT and investigates the changes of pressure pain threshold (PPT) and visual analogue scale (VAS). The high and low energy groups received focused piezo electric type ESWT 4 Hz, 1,000 pulses and 0.351 and $0.092mJ/mm^2$ respectively. Outcome measures of PPT and pain was measured by algometer and pain VAS. These measurements were performed before and after treatment. Results: The PPT value was significantly increased in both groups after treatment (p<0.05) and VAS scores were significantly decreased after treatment in both groups (p<0.05). However, there were no significant differences between groups. Conclusions: ESWT is an effective treatment for the application of the UT TrP. Although there were significant effects of extracorporeal shock wave therapy on PPT and VAS scores, there were no signficant differences between high and low energy extracorporeal shock wave therapy.

• Physical Therapy Rehabilitation Science
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• v.12 no.1
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• pp.48-55
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• 2023

Objective: The purpose of this study is to compare the effects of extracorporeal shock wave therapy (ESWT) and injection therapy through qualitative and quantitative analysis by synthesizing randomized controlled trials (RCTs) conducted on patients with various shoulder diseases. Design: A systematic review and meta-analysis of randomized controlled trials Methods: This review conducted a literature search through international electronic databases in January 2023 to compare the effects of ESWT and injection therapy. Qualitative analysis was performed as a risk of bias tool, and quantitative analysis was synthesized with a random effect model to show the effect size as a standardized mean difference (SMD). Results: Five RCTs involving 298 individuals with shoulder disorders were included in this systematic review and meta-analysis. ESWT showed a moderate effect on pain (SMD=-0.44; 95% CI, -0.95 to 0.06) and a large effect on shoulder function (SMD =-0.81; 95% CI, -1.70 to 0.07) than injection therapy. A significant difference was found in the shoulder range of motion, showing a large effect size (SMD=1.50; 95% CI, 0.58 to 2.43). Conclusions: When considering treatment options for the management of patients complaining of shoulder disorders, it is appropriate to recommend ESWT first rather than injection therapy to increase the range of motion of the joint. In addition, ESWT is safe for pain control and shoulder function improvement, and a positive prognosis could be expected.

• PNF and Movement
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• v.18 no.1
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• pp.117-126
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• 2020

Purpose: The purpose of this study was to investigate the effects of extracorporeal shock-wave therapy (ESWT) on pain, grip strength, and upper-extremity function in patients diagnosed with lateral epicondylitis and to provide an effective intervention method for lateral epicondylitis. Methods: Twenty patients with lateral epicondylitis were randomly assigned to the ESWT group (n = 10) and the stretching exercise group (n = 10). Interventions in both groups were performed six times twice a week for three weeks. The visible analog scale (VAS) was used to measure pain change. A dynamometer was used to measure grip strength (GS). Patient-rated tennis elbow evaluation (PRTEE) was used to measure the upper-extremity function. Results: There were significant differences in pain, grip strength, and upper-extremity function in both groups before and after intervention (p < 0.05). There were also significant differences in pain, grip strength, and upper-extremity function between the groups after intervention (p < 0.05). Conclusion: This study showed very positive improvement in pain, grip strength, and upper-extremity function after ESWT in patients with lateral epicondylitis. Therefore, ESWT can be recommended for patients with lateral epicondylitis.

• Physical Therapy Korea
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• v.28 no.1
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• pp.53-58
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• 2021

Background: To evaluate whether extracorporeal shock wave therapy (ESWT) in the pain point is a more effective treatment than the trigger point for myofascial pain syndrome (MPS) of the upper trapezius. Objects: The purpose of this study was to compare the most effective areas when applying extracorporeal shock wave therapy. Methods: A total of 30 patients with MPS were randomly assigned to the trigger point in the ESWT (n = 15) and pain point ESWT (n = 15) groups. Interventions in both groups were performed in one session, i.e., 2,000 shocks with 1.5 bar intensity. Pain and function were assessed using the visual analog scale (VAS) and cervical range of motion (ROM) and based on mechanical muscle properties. Statistical analysis was performed using the repeated measures two-way analysis of variance to determine the significance probability between pre- and post-test. Results: Changes in mechanical muscle properties were not statistically significant between the two groups. However, VAS and cervical ROM showed statistically significant differences at pre- and post-intervention, regardless of the group (p < 0.05). Conclusion: Although no significant difference was observed in the intervention effect, applying an extracorporeal shock wave to the pain point rather than the pain trigger point should be considered in order to save time in effectively and accurately identifying the pain trigger point and site.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.141-152
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• 2021

Purpose: This study aimed to compare the effects of ischemic compression (IC) therapy and extracorporeal shock wave therapy (ESWT) in patients with upper trapezius myofascial pain syndrome and to present an effective treatment method for these patients. Methods: A total of 42 patients with upper trapezius myofascial pain syndrome were randomly assigned to the IC group (n = 21) and ESWT group (n = 21). IC therapy and ESWT were performed in the IC and ESWT groups, respectively. Treatment was applied to the trigger point of the upper trapezius muscle. Visual analog scales (VAS), pain pressure threshold (PPT), range of motion, neck disability index (NDI), and fear-avoidance belief questionnaire (FABQ) were evaluated before and after the intervention to compare its effectiveness. Results: Both groups showed significant differences before and after the intervention in VAS, PPT, NDI, FABQ, flexion, extension, right side bending, and left side bending (p <.05). In addition, there were significant differences in the IC group compared to the ESWT group in VAS, PPT, and NDI (p <.05). Conclusion: IC therapy and ESWT applied to patients with upper trapezius myofascial pain syndrome are mediating methods of pain, function, and psychosocial effects. In addition, IC therapy may be a more effective mediating method for pain and dysfunction than ESWT.

• Clinical Pain
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• v.19 no.1
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• pp.28-31
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• 2020

The incidence of heterotopic ossification (HO) was reported to be higher in combat-injured patients than in civilian trauma patients. HO is often considered a possible cause of residual limbs pain in amputee. Here, we report the case of a 21-year-old male, who underwent a traumatic right transfemoral and left transtibial amputation with two segments of painful HO around his left amputation site. We report the effect of extracorporeal shock wave therapy (ESWT) on size and pain associated with HO. After ESWT, the visual analog scale score decreased from 5~6 to 0~1 and the size of two masses decreased from 13.1 × 6.7 mm and 12.5 mm to 11.9 × 4.7 mm and 12.2 mm, respectively. To the best of our knowledge, this is the first case that has reported on the treatment of HO using ESWT for a traumatic transtibial amputation patient. The case suggests that ESWT could serve as a complementary treatment for HO in traumatic amputation patient.

• The Journal of Korean Physical Therapy
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• v.34 no.3
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• pp.91-97
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• 2022

Purpose: This study investigated the short-term effectiveness of extracorporeal shock wave therapy (ESWT) on pain, the ankle instability, the ankle function, dorsiflexion range of motion (ROM), and dynamic balance in patients with chronic ankle instability (CAI). Methods: Eighteen participants were divided into an experimental (n=9) and control group (n=9). The ESWT in the experimental group was applied to the lateral collateral ligament in combination with the tibialis anterior whereas the ESWT was applied to the lateral collateral ligament of the ankle alone in the control group. Pain, the ankle instability, the ankle function, dorsiflexion ROM, and dynamic balance were measured using the Visual analog scale, Cumberland ankle instability tool, American Orthopedic Foot and Ankle Society ankle-hindfoot score, weight-bearing lunge, and Y-balance test, before and after ESWT intervention. Results: Significant interactions (group × time) and time effects were observed in the dorsiflexion ROM and dynamic balance. Bonferroni's post-hoc analysis showed that the experimental group revealed a more significant change in dorsiflexion ROM and dynamic balance than the control group. There was a significant time effect in the pain, the ankle instability, and the ankle function, but no significant interaction (group × time) was observed. Conclusion: The ESWT could improve the pain, ankle instability, ankle function, dorsiflexion ROM, and dynamic balance in patients with CAI. Furthermore, the ESWT combined with lateral ankle ligaments and tibialis anterior more improves the dorsiflexion ROM and dynamic balance.

• The Journal of the Acoustical Society of Korea
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• v.39 no.4
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• pp.303-317
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• 2020

Extracorporeal Shock Wave Therapy (ESWT) is an innovative treatment in chronic musculoskeletal pain management and cardiovascular diseases. In this study, we surveyed the acoustic shock wave outputs from the domestically used focal type ESWT devices. The survey data were collected through 30 technical documents registered to the Ministry of Food and Drug Safety (MFDS), Rep. Korea. The results show that the focusing geometry varies largely, 5 mm to 65 mm in the focal length, 3 mm to 30 mm in focal width, and 4 mm to 108 mm in focal depth. The maximum positive pressure (P+) ranges from 7 MPa to 280 MPa, the focal Energy Flux Density (EFD) from 0.0035 mJ/㎟ to 35 mJ/㎟, and the energy per pulse (E) from 0.737 mJ to 80.86 mJ. All domestic PE-type (five) and one EM-type domestic devices included in the analysis of the correlation between P+ and EFD are shown to be far beyond the usual ranges and do not comply with expected correlation so that the reliability of their data was suspected. For the suspected, post-performance tests are required by a recognized testing agency. MFDS guidelines need to be revised so that the pass criteria for the shock wave acoustic outputs can be based on the clinical tests for indications.