ESWT治疗方法

1、瑞士瑞士 Dolorclast ESWT治疗方法治疗方法Doyle Huang HongMedical Sales ManagerEMS序言序言The application settings outlined herein (handpiece, applicator, number of treatments, number of impulses per treatment, frequency, air pressure) are non-binding recommendations. They are based on reports by experts in the scien

2、tific literature and at international congresses, respectively. When planning and performing treatments with the Swiss Dolorclast, these recommendations should be considered - as well as the individual experience of the therapist and the individual feedback of the patient, respectively. When perform

3、ing treatments of the musculo-skeletal indications presented here, the air pressure of the Swiss Dolorclast should be adjusted so that the patient experiences some dyscomfort at least during the first treatment but does not feel pain. The dyscomfort indicates that the peripheral nervous system is ac

4、tivated by the radial shock waves. During the following treatments the patient might not experience dyscomfort anymore, despite the possibility to increase the air pressure.Approximately 80% of all patients report a substantial improvement of the clinical situation (pain) after two treatment session

5、s. According to very recent studies, this is a good sign with respect to the prognosis of treatment outcome. Accordingly, it is possible to predict the treatment outcome after two treatment sessions but not before.Patients should not experience dyscomfort, or feel pain, when treated for the indicati

6、ons induratio penis plastica, acute and chronic soft tissue wounds, primary and secondary lymphedema, and cellulite. This is because treatment of these indications with radial shock waves does not aim at activating the peripheral nervous system.适应症适应症肩关节钙化性肌腱变性肩关节钙化性肌腱变性/ 肩峰下疼痛综合征肩峰下疼痛综合征 Calcifying

7、 tendonitis of the shoulder / subacromial pain syndrome网球肘网球肘(肱骨外上髁炎肱骨外上髁炎) Tennis elbow (Epicondylitis humeri radialis)大转子疼痛综合征大转子疼痛综合征 Greater trochanteric pain syndrome髌尖综合征髌尖综合征 Patella tip syndrome胫骨结节骨软骨炎胫骨结节骨软骨炎* Osgood-Schlatter disease*胫骨内侧应力综合征胫骨内侧应力综合征 Medial tibial stress syndrome跟腱止点炎跟腱

8、止点炎 Insertional Achilles tendinopathy慢性慢性midportion阿喀琉斯肌腱阿喀琉斯肌腱 Midportion chilles tendinopathy趾筋膜炎趾筋膜炎 Plantar fasciopathy肌筋膜疼痛综合征肌筋膜疼痛综合征/ 扳机点治疗扳机点治疗 Myofascial pain syndrome / trigger point treatment自发性下腰疼痛自发性下腰疼痛 Idiopathic lower back pain / pseudoradicular syndrome帕荣雷氏病帕荣雷氏病 Peyronies disease (

9、Induratio penis plastica)*急慢性软组织损伤（糖尿病足溃疡）急慢性软组织损伤（糖尿病足溃疡）* Acute and chronic soft tissue wounds (diabetic foot ulcera)*原发性和继发性淋巴水肿原发性和继发性淋巴水肿 Primary and secundary lymphedema*脂肪团脂肪团 Cellulite*肩关节钙化性肌腱变性肩关节钙化性肌腱变性5肩关节钙化性肌腱变性肩关节钙化性肌腱变性(1)触诊疼痛区域(同样使用于肩峰下疼痛综合征) 6标记疼痛区域(同样使用于肩峰下疼痛综合征) 肩关节钙化性肌腱变性肩关节钙化性肌腱

10、变性(2)7敷用耦合液(同样使用于肩峰下疼痛综合征) 肩关节钙化性肌腱变性肩关节钙化性肌腱变性(3)8用放散型手柄治疗用放散型手柄治疗冲击头冲击头: 15 mm治疗次数治疗次数: 3次 （一周间隔）每次治疗的冲击波次数每次治疗的冲击波次数: 2,000 次频率频率: 5 - 10 Hz压力压力: 2 - 4 bar参考文献参考文献: Magosch et al., 2003 Z Orthop 141:629-633 (in PubMed) (同样使用于肩峰下疼痛综合征)肩关节钙化性肌腱变性肩关节钙化性肌腱变性(4)9(同样使用于肩峰下疼痛综合征)肩关节钙化性肌腱变性肩关节钙化性肌腱变性(5)用

11、高能量型手柄治疗用高能量型手柄治疗冲击头冲击头: 15 mm治疗次数治疗次数: 3次 （一周间隔）每次治疗的冲击波次数每次治疗的冲击波次数: 2,000频率频率: 5 - 10 Hz压力压力: 1.5 - 3 bar参考文献参考文献: Magosch et al., 2003 Z Orthop 141:629-633 (in PubMed) 网球肘网球肘 (肱骨外上髁炎肱骨外上髁炎)11网球肘网球肘(肱骨外上髁炎肱骨外上髁炎) (1)触诊疼痛区域12标记疼痛区域网球肘网球肘(肱骨外上髁炎肱骨外上髁炎)(2)13敷用耦合液网球肘网球肘(肱骨外上髁炎肱骨外上髁炎)(3)14用放散型手柄治疗用放散型

12、手柄治疗冲击头冲击头: 15 mm治疗次数治疗次数: 3次 （一周间隔）每次治疗的冲击波次数每次治疗的冲击波次数: 2,000 次频率频率: 5 - 10 Hz压力压力: 1.5 - 3 bar参考文献参考文献: Sller, 2003 In: Maier M, Gillesberger F: Abstracts 2003 zur Muskuloskelettalen Stosswellentherapie. Kongressband des 3. Dreilndertreffens der sterreichischen, Schweizer und Deutschen Fachgesell

13、schaften. Books on Demand, Norderstedt, 2003, pp 121-122.网球肘网球肘(肱骨外上髁炎肱骨外上髁炎)(4)大转子疼痛综合征大转子疼痛综合征16大转子疼痛综合征大转子疼痛综合征(1)触诊疼痛区域17大转子疼痛综合征大转子疼痛综合征(2)标记疼痛区域18大转子疼痛综合征大转子疼痛综合征(3)敷用耦合液19大转子疼痛综合征大转子疼痛综合征(4)用放散型手柄治疗用放散型手柄治疗冲击头冲击头: 15 mm治疗次数治疗次数: 3次 （一周间隔）每次治疗的冲击波次数每次治疗的冲击波次数: 2,000 次频率频率: 5 - 10 Hz压力压力: 3 - 4

14、 bar参考文献参考文献: Furia et al., 2009 Am J Sports Med 37:1806-1813; Rompe et al., 2009 Am J Sports Med 2009;37:1981-1990 (both in PubMed)髌尖综合征髌尖综合征21髌尖综合征髌尖综合征(1)触诊疼痛区域22髌尖综合征髌尖综合征(2)标记疼痛区域23髌尖综合征髌尖综合征(3)敷用耦合液24髌尖综合征髌尖综合征 (4)用放散型手柄治疗用放散型手柄治疗冲击头冲击头: 15 mm治疗次数治疗次数: 3次 （一周间隔）每次治疗的冲击波次数每次治疗的冲击波次数: 2,000 次频率频

15、率: 5 - 10 Hz压力压力: 2 - 3 bar参考文献参考文献: Lohrer et al., 2002 Sportverl Sportschad 16:108-114 (in PubMed)胫骨结节骨软骨炎胫骨结节骨软骨炎26胫骨结节骨软骨炎胫骨结节骨软骨炎(1)触诊疼痛区域27胫骨结节骨软骨炎胫骨结节骨软骨炎(2)标记疼痛区域28胫骨结节骨软骨炎胫骨结节骨软骨炎(3)敷用耦合液29胫骨结节骨软骨炎胫骨结节骨软骨炎(4)用放散型手柄治疗用放散型手柄治疗冲击头冲击头: 15 mm治疗次数治疗次数: 3次 （一周间隔）每次治疗的冲击波次数每次治疗的冲击波次数: 2,000-3,000次频

16、率频率: 5 - 10 Hz压力压力: 2 - 3 bar参考文献参考文献: Titov and Litvinenko (2007) Abstracts 10th International Congress of the International Society for Musculoskeletal Shockwave Therapy, Toronto, Canada, 2007, pp. 46-47.Medial tibial stress syndrome31Medial tibial stress syndrome (1)Palpation of the painful regio

17、n32Medial tibial stress syndrome (2)Labeling of the painful region33Medial tibial stress syndrome (3)Application of coupling gel34Medial tibial stress syndrome (4)Treatment with the Radial handpieceApplicator: 15 mmNumber of treatments: 3 (at weekly intervals)Number of impulses per treatment: 2,000F

18、requency: 5 - 10 HzAir pressure: 2.5 - 3 barLiterature: Rompe et al., 2010 Am J Sports Med 38:125-132 (in PubMed)Insertional Achilles tendinopathy36Insertional Achilles tendinopathy (1)Palpation of the painful region37Insertional Achilles tendinopathy (2)Labeling of the painful region38Insertional A

19、chilles tendinopathy (3)Application of coupling gel39Insertional Achilles tendinopathy (4)Treatment with the Radial handpieceApplicator: 15 mmNumber of treatments: 3 (at weekly intervals)Number of impulses per treatment: 2,000Frequency: 5 - 10 HzAir pressure: 2.5 - 3 barLiterature: Rompe et al., 200

20、8 J Bone Joint Surg Am 90:52-61 (in PubMed)Midportion Achilles tendinopathy41Midportion Achilles tendinopathy (1)Palpation of the painful region42Midportion Achilles tendinopathy (2)Labeling of the painful region43Midportion Achilles tendinopathy (3)Application of coupling gel44Midportion Achilles t

21、endinopathy (4)Treatment with the Radial handpieceApplicator: 15 mmNumber of treatments: 3 (at weekly intervals)Number of impulses per treatment: 2,000Frequency: 5 - 10 HzAir pressure: 2 - 3 barLiterature: Rompe et al., 2007 Am J Sports Med 35:374-383; Rompe et al., 2009 Am J Sports Med 37:463-470 (

22、both in PubMed)Plantar fasciopathy46Plantar fasciopathy (1)Palpation of the painful region47Plantar fasciopathy (2)Labeling of the painful region48Plantar fasciopathy (3)Application of coupling gel49Plantar fasciopathy (4)Treatment with the Radial handpieceApplicator: 15 mmNumber of treatments: 3 (a

23、t weekly intervals)Number of impulses per treatment: 2,000Frequency: 5 - 10 HzAir pressure: 2.5 - 4 barLiterature: Gerdesmeyer et al., 2008 Am J Sports Med 36:2100-2109; Ibrahim et al., 2010 Foot & Ankle Int 31:391-397 (both in PubMed)50Plantar fasciopathy (5)Treatment with the Power+ handpieceA

24、pplicator: 15 mmNumber of treatments: 3 (at weekly intervals)Number of impulses per treatment: 2,000Frequency: 5 - 10 HzAir pressure: 2 - 3 barLiterature: Gerdesmeyer et al., 2008 Am J Sports Med 36:2100-2109; Ibrahim et al., 2010 Foot & Ankle Int 31:391-397 (both in PubMed)Myofascial pain syndr

25、ome / trigger point treatment52Myofascial pain syndrome / trigger point treatment (1)(treatment of the piriformis muscle shown as example) Palpation of the painful region53Labeling of the painful regionMyofascial pain syndrome / trigger point treatment (2)(treatment of the piriformis muscle shown as

26、 example) 54Application of coupling gelMyofascial pain syndrome / trigger point treatment (3)(treatment of the piriformis muscle shown as example) 55Treatment with the Power+ handpieceApplicator: 15 mm TriggerNumber of treatments: 3 (at weekly intervals)Number of impulses per treatment: 300 1,000 pe

27、r trigger pointFrequency: 8 - 20 HzAir pressure: 2.5 - 4 barLiterature: Bauermeister, 2003 In: Maier M, Gillesberger F: Abstracts 2003 zur Muskuloskelettalen Stosswellentherapie. Kongressband des 3. Dreilndertreffens der sterreichischen, Schweizer und Deutschen Fachgesellschaften. Books on Demand, N

28、orderstedt, 2003, pp 24-28.Myofascial pain syndrome / trigger point treatment (4)(treatment of the piriformis muscle shown as example) Idiopathic lower back pain / pseudoradicular syndrome57Idiopathic lower back pain / pseudoradicular syndrome (1)Palpation of the painful region58Labeling of the pain

29、ful regionIdiopathic lower back pain / pseudoradicular syndrome (2)59Application of coupling gelIdiopathic lower back pain / pseudoradicular syndrome (3)60Treatment with the Radial handpieceApplicator: 15 mmNumber of treatments: 3 (at weekly intervals)Number of impulses per treatment: 2,000Frequency

30、: 8 - 20 HzAir pressure: 2 - 3 barLiterature: Bauermeister, 2003 In: Maier M, Gillesberger F: Abstracts 2003 zur Muskuloskelettalen Stosswellentherapie. Kongressband des 3. Dreilndertreffens der sterreichischen, Schweizer und Deutschen Fachgesellschaften. Books on Demand, Norderstedt, 2003, pp 29-34

31、.Idiopathic lower back pain / pseudoradicular syndrome (4)Primary and secondary lymphedema62Primary and secondary lymphedema (1)Application of coupling gel(no need for palpation and labeling because the treatment area is visually identified)63Treatment with the Power+ handpieceApplicator: 36 mm Plan

32、arNumber of treatments: 10 (two treatments per week)Number of impulses per treatment: 200 300 per cm2 fibrotic skinFrequency: 4 - 10 HzAir pressure: 3 - 4 barLiterature: Michelini et al., 2008 Eur J Lymphol 19:10Primary and secondary lymphedema (2)高尔夫球肘高尔夫球肘(肱骨内上髁炎肱骨内上髁炎) 65高尔夫球肘高尔夫球肘(肱骨内上髁炎肱骨内上髁炎) (1)Palpation of