• 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.

• 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.

• PNF and Movement
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• v.18 no.2
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• pp.245-254
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• 2020

Purpose: The study investigated the effects of extracorporeal shock wave therapy with myofascial release techniques (ESWT+MFR) on pain, movement, and function in patients with myofascial pain syndrome. Methods: Forty participants with upper trapezius trigger points were recruited and randomly allocated to two groups: an experimental group (n = 20) and a control group (n = 20). The experimental group performed the ESWT+MFR, and the control group performed only myofascial release techniques. Each group was treated for 15 minutes, twice a week for four weeks. Pain was assessed using a visual analogue scale and a pressure pain threshold measure. Movement was assessed by cervical range of motion, and cervical and shoulder function were assessed on the Constant-Murley Scale and the Neck Disability Index before and after treatment. Results: The results indicate statistically significant improvements in the two groups on all parameters after intervention as compared to baseline (p < 0.05). As compared to the control group, the experimental group showed statistically significant improvements on the visual analogue scale and pressure pain threshold, cervical range of motion (except rotation), and on the Neck Disability Index (p < 0.05). Conclusion: The ESWT+MFR is more effective than myofascial release techniques for pain, movement, and function in patients with myofascial pain syndrome and would be clinically useful for physical therapists treating myofascial pain syndrome.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.237-249
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• 2021

Purpose : This study was to compare the effect changes after physical therapy (extracorporeal shock wave therapy + high-load strengthening exercise) or corticosteroid injection in patients diagnosed with chronic plantar fasciitis. Methods : A total of 40 patients were randomly assigned to each group of 20. According to the intervention method, "Group 1. Physiotherapy" was performed for 12 weeks, and "Group 2. Corticosteroid injection" was performed only once. As a pre-intervention test, plantar fascia thickness, pain intensity I, II (What is the most painful moment of the day?, How painful is the first step in the morning?), and functional performance were measured. To compare the effects of each group, the tests 3, 6, and 12 weeks after were also performed using the same measurement method. Also, after 12 weeks, patient satisfaction was also compared. Results : There was no significant difference between the groups in the change in the thickness of the plantar fascia during all periods. However, pain intensity I, II was significantly lower in Group 1 than in Group 2 at only 12 weeks and functional performance was also significantly increased in Group 1 compared to Group 2 at only 12 weeks. Also, there was no significant difference between groups in patient satisfaction. Conclusion : The physiotherapy protocol, which consisted of extracorporeal shock wave therapy and high-load strengthening exercise, showed excellent results, especially after 12 weeks, compared to corticosteroid injection. It is recommended as a more effective treatment method as it is possible to safely return to daily life by reducing pain and improving functional performance.

• Clinical Pain
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• v.20 no.1
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• pp.25-29
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• 2021

Upper limb morbidity including shoulder pain, lymphedema, adhesive capsulitis, myofascial pain syndrome, and limited range of motions (LROMs) occurs frequently in breast cancer patients. Especially restricted upper limb motion aggravated by chronic lymphedema results in functional limitation and impaired activities of daily living (ADL). However, conventional rehabilitation therapy including complex decongestive therapy and stretching exercise is insufficient for managing advanced breast cancer patients with complex upper limb morbidity. Here, we report a case of breast cancer-related chronic lymphedema in a 62-years old female with severe LROM in all joints of the affected upper extremity that caused severe disability in ADL. Significant improvements in range of motion and upper extremity function were observed after serial extracorporeal shock wave therapy (ESWT), combined with conventional rehabilitation therapy. Therefore, ESWT might be recommended for managing the extensive limited joint motion which causes functional decline in a patient of chronic lymphedema with trophic skin change.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.2
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• pp.41-48
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• 2021

Objectives To determine the evidence of effectiveness and safety of extracorporeal shock wave therapy (ESWT) with meridian and acupoint theory for knee osteoarthritis. Methods By March 3, 2021, five foreign electronic databases and six Korean medical electronic databases were reviewed with the key words 'extracorporeal shock wave' and '(acupoint OR acupuncture point)'. This key words was set up to increase the sensitivity of the search. After the search, knee osteoarthritis study was selected based on the title and abstract and then included after full-texts were read. Results Five randomized controlled trials were eligible in our inclusion criteria. The meta-analysis of three studies showed positive results for the using ESWT with meridian and acupoint theory for knee osteoarthritis compared with the control group on efficancy rate, visual analog scale and lysholm knee score. but there remains a conundrum regarding the safety of ESWT in the treatment of knee osteoarthritis. Conclusions Most of studies showed ESWT with meridian and acupoint theory were statistically effective to knee osteoarthritis. However there are limitations that the number of selected studies was small, risk of bias was unclear. So use of ESWT with meridian and acupoint theory for knee arthritis has limited evidence compared to usual care.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.2
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• pp.55-63
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• 2022

Objectives This review was conducted to evaluate effectiveness and safety of extracorporeal shock wave therapy (ESWT) with meridian and acupoint theory for adhesive capsulitis. Methods By December 2021, 11 electronic databases were reviewed with the key words 'extracorporeal shock wave' and '(acupuncture OR acupoint OR meridian)'. This key words was set up to increase the sensitivity of the search. After the search, adhesive capsulitis study was selected based on the title and abstract and then included after full-texts were read. Results Five randomized controlled trials were eligible in our inclusion criteria. The meta-analysis of 3 studies showed positive results for the using ESWT with meridian and acupoint theory for adhesive capsulitis compared with the control group on efficancy rate and range of shoulder flexion. Conclusions Some studies showed ESWT with meridian and acupoint theory were statistically effective to adhesive capsulitis. But the evidence is limited due to the defective design of the included randomized controlled trials (RCTs). So use of ESWT with meridian and acupoint theory for adhesive capsulitis has limited evidence. More well-designed RCTs are required to provide clearer evidence for this claim.

• The Journal of the Acoustical Society of Korea
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• v.41 no.5
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• pp.589-600
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• 2022

In order to verify the reliability of Dry Test Bench (DTB) used for testing the output energy from ballistic extracorporeal shock wave therapeutic devices, the measurements with DTB were compared with the acoustic energy measured with a Laser Doppler Vibrometer (LDV) for a commercial ballistic ESWT device. It was shown that the mechanical energy detected with DTB had variability maintained within 5 % at the same output power setting and also had a linear correlation (adj. R² = 0.991) with the acoustic energy measured with the LDV for the entire output power settings. Using the correlation between the two methods and the correlation on the acoustic energy measured in between air and water with the LDV, the DTB measurement can be used to estimate the energy flux density in water with an average error of 7.85 % for the entire output power settings of the ballistic shock wave generator considered in the experiment. DTB provides information limited to the output mechanical energy and therefore it is not suitable for testing the various acoustic output parameters required in IEC61846 and IEC63045. However, DTB that is simple in measurement principles and easy to use is expected for manufacturers and clinical users to monitor the performance of ballistic Extracorporeal Shock Wave Therapy (ESWT) devices.

• The Journal of the Acoustical Society of Korea
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• v.16 no.6
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• pp.36-40
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• 1997

The effectiveness of Extracorporeal Shock Wave Lithotripter(ESWL) for the therapy of calculus has been generally known in the field of urology. However, there are very little paper investigated about physical characteristics of sounds radiated when phantom is shotting with shock waves. Therefore, this paper, firstly, investigates the sounds radiated when impact is applied to the phantom with a single shot by an impact hammer and a clinical ESWL Next, it determines the variance of the sounds radiated during the breaking process using a piece of chalk as a phantom of a calculus. These results will be applied to the examination of the existence of the calculus at the focus and the monitoring the breaking process.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.163-167
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• 2006

Purpose: To evaluate the results of extracorporeal shock wave therapy (ESWT) for patients with chronic proximal plantar fascitis. Materials and Methods: Between April 2005 and April 2006, 35 cases (24 patients) who were followed more than 6 months were evaluated. By $EvoTron^{(R)}$, 2 sessions of ESWT (Group 1: 1200 and Group 2: 1500 shock waves / session of $0.12\;mJ/mm^2$) were performed at 2 weeks interval. The mean age was 40.0 (range, 15-59) years. 13 patients were male and 11 patients were female. Visual analogue scale (VAS) on daily activity and a 100-point scoring system including 70 points for pain and 30 points for function were used. The clinical outcomes were rated as follows: excellent, no pain on daily activity; good, less than 50% of previous VAS; fair, 50-75% of previous VAS; or poor, more than 75% of previous VAS. Excellent and good were graded as satisfactory results. We compare clinical results between groups and evaluate the relationships between clinical results and duration of symptom, fascial thickening and previous steroid injection were evaluated. Results: Overall satisfactory rate were 71.4%. There was no significant difference of clinical results between groups. And there were no significant difference between clinical results and duration of symtom, preoperative fascial thickening and previous steroid injection. Conclusions: ESWT for recalcitrant chronic proximal plantar fascitis is useful treatment method with high patient satisfaction and pain relief, but more long-term study must be needed.