• 한국음향학회지
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• 제39권4호
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• pp.303-317
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• 2020

체외충격파치료술(Extracorporeal Shock Wave Therapy, ESWT)은 보존적인 치료가 어려운 근골격계 난치성 통증 치료 뿐 아니라 심혈관계 질환까지 적용 분야가 확대되고 있는 혁신적인 치료술이다. 본 연구에서는 국내에서 사용되는 집속형 ESWT 치료기의 성능을 결정하는 충격파 음향 출력의 분포를 조사했다. 분석에 사용된 데이터는 식약처에 등록된 30개 기술 문서를 통해 수집했다. 조사 결과, ESWT 치료기 충격파의 집속 특성은, 초점 거리가 5 mm ~ 65 mm, 초점 폭이 3 mm ~ 30 mm, 초점 깊이가 4 mm ~ 108 mm 범위에서 변화하고 있다. 충격파의 최대 양압(P+)는 7 MPa ~ 280 MPa, 초점에서 에너지 밀도 Energy Flux Density(EFD)는 0.0035 mJ/㎟ ~ 35 mJ/㎟, 펄스당 에너지(E)는 0.737 mJ ~ 80.86 mJ로 매우 넓은 범위에서 분포하고 있다. P+ 및 EFD 상관성 분석에 포함된 모든 국내산 PE 방식 제품(5개) 및 1개의 EM 방식 국산 치료기는 P+ 및 EFD가 통상적인 범위를 크게 벗어나고 있으며, 예상되는 상관성을 따르지 않고 있어, 데이터의 신뢰성을 인정하기 어려운 상태이다. 음향 출력의 값에 신뢰성을 부여하기 어려운 경우, 식약처에서 인정하는 시험 검사 기관을 통해 사후 시험 검사 및 관리가 요구된다. 충격파 음향 출력에 대한 통과 기준이 치료기의 적응증에 대한 임상 시험 결과를 근거로 설정될 수 있도록 식약처의 규정 및 가이드라인 개선이 필요하다.

• The Journal of Korean Physical Therapy
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• 제34권3호
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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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• 제18권2호
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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.

• 대한통합의학회지
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• 제9권4호
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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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• 제20권1호
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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.

• 한방재활의학과학회지
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• 제31권2호
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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.

• 한방재활의학과학회지
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• 제32권2호
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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.

• 한국음향학회지
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• 제41권5호
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• pp.589-600
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• 2022

탄도형 체외 충격파 치료기의 출력 에너지를 측정하는 Dry Test Bench(DTB)의 신뢰성을 검증하기 위해, 상용 탄도형 충격파 치료기에 대해 Laser Doppler Vibrometer(LDV)로 측정된 충격파의 음향 에너지와 비교했다. 실험 결과, DTB로 측정된 역학적 에너지는, 동일한 출력 설정에서, 5 % 이내의 변동성을 보이며, 치료기의 전 출력 설정 범위에서 LDV로 측정된 충격파의 음향 에너지와 선형적인 상관성(adj. R² = 0.991)을 확인했다. 두 측정 방법의 상관성과, LDV을 이용하여 공기 및 수중에서 측정된 충격파 음향 에너지의 상관성(adj. R² = 0.995)을 통합하면, DTB 측정으로부터 수중에서 발생된 충격파의 energy flux density를 평균 7.85 % 오차로 추정된다. DTB는 치료기의 출력에너지에 대한 정보만 제공하기 때문에, IEC61846 및 IEC63045에서 요구하는 다양한 충격파의 음향 출력을 시험하는 도구로 적합하지 않다. 그러나 측정 원리가 단순하고 사용이 용이한 DTB는 제조사 및 사용자가 탄도형 Extracorporeal Shock Wave Therapy(ESWT) 치료기의 성능을 관리하는 목적으로 유용하게 사용될 수 있을 것으로 기대된다.

• 한국음향학회지
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• 제16권6호
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• pp.36-40
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• 1997

결석 치료에 있어서, 체외 충격파 결석 파쇄 장치(Extracorporeal Shock Wave Lithotripter)의 유효성은 잘 알려져 있지만 , 충격파 조사시의 물리적 특성에 관한 기초적인 연구보고는 드문 실정이다. 따라서, 본 연구는 충격파에 의한 파쇄과정에 있어서의 물리적 특성을 조사하기 위하여, 체외 충격파 결석 파쇄 장치에 의한 대상물 파쇄시에 발생하는 음을 분석하는 연구를 행한다. 또한, 본 논문에서는, 결석모델로서 chalk를 선정하여, 단발 충격을 가할 시의 방사음의 특징을 조사하고, 아울러, 임상용 결석 파쇄 장치를 사용한 모의실험에 의해 전술한 실험결과를 확인한다. 그 결과, 고유 진동의 피크 주파수가 충격횟수에 따라 변환되는 것이 확인되어, 실제로 장치를 임상용으로 사용할 때, 파쇄 과정 감시에 충분히 활용 가능하다.

• 대한족부족관절학회지
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• 제10권2호
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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.