Repetitive shock wave therapy improves muscular microcirculation.


Author: Kisch T1, Wuerfel W2, Forstmeier V3, Liodaki E4, Stang FH4, Knobloch K5, Mailaender P4, Kraemer R4

Affiliation: <sup>1</sup>Department of Plastic Surgery, Hand Surgery, Burn Unit, University Hospital Schleswig-Holstein, Campus Lübeck, University of Lübeck, Lübeck, Germany. Electronic address: tobias.kisch@gmx.de.

<sup>2</sup>Department of Otolaryngology, Hannover Medical School, Hannover, Germany.

<sup>3</sup>Department of Visceral and Thoracic Surgery, German Armed Forces Hospital Ulm, Ulm, Germany.

<sup>4</sup>Department of Plastic Surgery, Hand Surgery, Burn Unit, University Hospital Schleswig-Holstein, Campus Lübeck, University of Lübeck, Lübeck, Germany.

<sup>5</sup>SportPraxis Prof. Dr. Karsten Knobloch, Hannover, Germany.
Conference/Journal: J Surg Res.
Date published: 2016 Apr
Other:
 Volume ID: 201   ,  Issue ID: 2   ,  Pages: 440-5   ,  Special Notes: doi: 10.1016/j.jss.2015.11.049. Epub  2015 Nov 30.   ,  Word Count: 257  
    BACKGROUND: Extracorporeal shock wave therapy (ESWT) is mainly applied in tendon as well as bone problems based on stem-cell activation and healing acceleration. The effect of ESWT on muscle tissue is much less understood to date. However, from a clinical perspective, muscle injuries are of distinct interest especially in elite athletes such as soccer players.



MATERIAL AND METHODS: A total of 26 rats were randomized into two groups. Group A received a single application of high-energetic focused ESWT (0.3 mJ/mm(2), 4 Hz, 1000 impulses, 10 J), whereas group B underwent the same procedure every 10 min for three sessions (3 × 0.3 mJ/mm(2), 4 Hz, 3 × 1000 impulses, totaling 30 J). Blood flow at a depth of 8 mm was measured continuously and noninvasively by a combined Laser-Doppler-Imaging and photospectrometric technique (Oxygen-to-see, O2C, LEA Medizintechnik, Germany).



RESULTS: One minute after the application of high-energy ESWT blood flow in group A increased by 16.5% (P = 0.007). Thereafter, it decreased from minute 2 after application and remained significantly unchanged to baseline value until the end of the measuring period at 50 min (P = 0.550). Group B showed a similar significant increase in blood flow of 16.4% (P = 0.049) and a decrease afterward, too. After the second focused ESWT blood flow was boosted to 26.6% (P = 0.004), remaining significantly elevated until the third application was initiated. Muscular blood flow was increased to 29.8% after the third focused ESWT (P < 0.001), remaining significantly increased for another 10 min.



CONCLUSIONS: Focused ESWT enhances blood flow in the muscle of rats. Moreover, repetitive ESWT extended this beneficial effect.



Copyright © 2016 Elsevier Inc. All rights reserved.



KEYWORDS: ESWT; Muscular microcirculation; Repetitive shockwave therapy



PMID: 27020830  DOI: 10.1016/j.jss.2015.11.049