Mechanical Interatomic Bond Formation in Ethanol and Methanol-Ethanol Mixture by Laser-Driven Shock Waves.

Molecules, which were predicted to be produced by C-C or C-O bond formation between ethanol molecules induced by a laser-driven shock wave, were identified by gas chromatography-mass spectrometry. Moreover, the laser irradiation of a methanol-ethanol mixture revealed the formation of C-C and C-O bonds between both components. Particularly, four hemiacetals (methoxymethanol, 1-methoxyethanol, ethoxymethanol, and 1-ethoxyethanol) were identified in the Ar-saturated alcohol samples, whereas acetalization dominated sufficiently in the CO2-saturated samples, significantly reducing the hemiacetals. It was verified that some molecules were produced by the dropout of an ethanol part during the C-C or C-O bond formation, supporting the contribution of laser-driven shock waves.

Development of a novel CT-based index for predicting the number of extracorporeal shockwave lithotripsy (ESWL) sessions required for successful fragmentation of obstructing pancreatic duct stones.

BACKGROUND & AIM: Extracorporeal shock wave lithotripsy (ESWL) is used for the treatment of pancreatic duct stones (PDS) in patients with chronic pancreatitis (CP). We aimed to develop a CT based index to predict the required number of ESWL sessions for technical success. METHODS: We retrospectively evaluated patients with PDS secondary to CP who underwent ESWL. Technical success was defined as the complete fragmentation of stones to <3 mm. CT features including PDS size, number, location, and density in Hounsfield units (HU) were noted. We analyzed the relationship between PDS characteristics and the number of ESWL sessions required for technical success. A multiple linear regression model was used to combine size and density into the pancreatic duct stone (PDS) index that was translated into a web-based calculator. RESULTS: There were 206 subjects (mean age 38.6 ± 13.7 years, 59.2% male) who underwent ESWL. PDS size showed a moderate correlation with the number of ESWL sessions (r = 0.42, p < 0.01). PDS in the head required a fewer number of sessions in comparison to those in the body (1.4 ± 0.6 vs. 1.6 ± 0.7, p = 0.01). There was a strong correlation between PDS density and the number of ESWL sessions (r = 0.617, p-value <0.01). The PDS index {0.3793 + [0.0009755 x PDS density (HU)] + [0.02549 x PDS size (mm)]} could accurately predict the required number of ESWL sessions with an AUC of 0.872 (p < 0.01). CONCLUSION: The PDS index is a useful predictor of the number of ESWL sessions needed for technical success that can help in planning and patient counseling.

Preliminary study of extracorporeal shock wave alleviating joint capsule fibrosis caused by internal bleeding of knee joint in rats.

PURPOSE: Joint contracture is a common disease in clinical practice, joint bleeding is an important factor affecting the progression of joint contracture. This study aimed to explore the effect of extracorporeal shock wave on alleviating joint capsule fibrosis caused by intra-articular hemorrhage in rats. METHODS: Forty two SD rats were randomly divided into seven groups. Perform simple fixation and fixation after blood injection separately. Measure the range of motion of each group's knee joints and calculate the corresponding degree of contraction. Use HE staining and Masson staining to detect the number of anterior joint capsule cells and collagen deposition. Detection of changes in Wnt1, ß-catenin protein expression in joint capsule using Western blotting. RESULTS: Compared to group C, the degree of knee joint contracture in M1 and M2 groups of rats increased, and collagen deposition, cell number and Wnt1, ß-catenin protein expression also increased accordingly. Compared to M1 and M2 groups, the degree of knee contraction in E1 and E2 groups were reduced, while collagen deposition, cell number and Wnt1, ß-catenin protein expression were decreased, and the degree of joint contracture in NR1 and NR2 groups showed no significant improvement. Compared to NR1 and NR2 groups, the degree of knee contraction in E1 and E2 groups were reduced, while collagen deposition, cell number and Wnt1, ß-catenin protein expression were decreased. CONCLUSIONS: Both rat models of knee joint contracture were successful, and joint bleeding can exacerbate joint contracture. Extracorporeal shock waves alleviate joint capsule fibrosis caused by intra-articular bleeding in rats.

Predictive markers for infections after extracorporeal shockwave lithotripsy in patients with kidney stone based on a large prospective cohort.

OBJECTIVE: Infections in patients with kidney stones after extracorporeal shockwave lithotripsy (SWL) is a common clinical issue. However, the associated factors are unclear. Therefore, we aim to develop and validate a predictive model for infections after SWL in patients with kidney stone. METHODS: Between June 2020 and May 2022, consecutive kidney stone patients were enrolled. Of them, 553 patients comprised the development cohort. One hundred sixty-five patients comprised the validation cohort. The data were prospectively collected. The stepwise selection was applied using the likelihood ratio test with Akaike's information criterion as the stopping rule; A predictive model was constructed through multivariate logistic regression. The performance was evaluated regarding discrimination, calibration, and clinical usefulness. RESULTS: Predictors of infections after SWL in treating kidney stones included older age (OR = 1.026, p = 0.041), female (OR = 2.066, p = 0.039), higher BMI (OR = 1.072, p = 0.039), lower stone density (OR = 0.995, p < 0.001), and higher grade of hydronephrosis (OR = 5.148, p < 0.001). For the validation cohort, the model showed good discrimination with an area under the receiver operating characteristic curve of 0.839 (95% CI 0.736, 0.941) and good calibration. Decision curve analysis demonstrated that the model was also clinically useful. CONCLUSION: This study indicated that age, gender, BMI, stone density, and hydronephrosis grade were significant predictors of infections after SWL in treating kidney stones. It provided evidence in optimizing prevention and perioperative treatment strategies to reduce the risk of infection after SWL.

CT-based radiomics for predicting success of shock wave lithotripsy in ureteral stones larger than 1 cm.

PURPOSE: This study aims to investigate the predictive value of CT-based radiomics in determining the success of extracorporeal shock wave lithotripsy (SWL) treatment for ureteral stones larger than 10mm in adult patients. MATERIALS AND METHODS: A total of 301 eligible patients (165/136 successful/unsuccessful) who underwent SWL were retrospectively evaluated and divided into a training cohort (n = 241) and a test cohort (n = 60) following an 8:2 ratio. Univariate analysis was performed to assess clinical characteristics for constructing a nomogram. Radiomics and conventional radiological characteristics of stones were evaluated. Following feature selection, radiomics and radiological models were constructed using logistic regression (LR), support vector machine (SVM), random forest (RF), K nearest neighbor (KNN), and XGBoost. The models' performance was compared using metrics such as the area under the receiver operating characteristic curve (AUC), precision, recall, accuracy, and F1 score. Finally, a nomogram was created incorporating the best image model signature and clinical predictors. RESULTS: The SVM-based radiomics model showed superior predictive performance in both training and test cohorts (AUC: 0.956, 0.891, respectively). The nomogram, which combined SVM-based radiomics signature with proximal ureter diameter (PUD), demonstrated further improved predictive performance in the test cohort (AUC: 0.891 vs. 0.939, P = 0.166). CONCLUSIONS: Integration of CT-derived radiomics and PUD showed excellent ability to predict SWL treatment success in patients with ureteral stones larger than 10mm, providing a promising approach for clinical decision-making.

Extracorporeal shock wave lithotripsy versus laser lithotripsy in the treatment of post-SWL steinstrasse: a randomized comparative study.

OBJECTIVE: To compare the efficacy of Holmium laser lithotripsy with that of extracorporeal shock lithotripsy (SWL) for post-SWL ureteral steinstrasse. MATERIALS AND METHODS: From January 2022 to July 2023, 36 patients with post-SWL ureteral steinstrasse were randomly divided into laser lithotripsy and SWL groups. Patients with pain, moderate to marked hydronephrosis, large leading stone fragments, and showing no spontaneous resolution within 3-4 weeks after medical expulsive therapy were included. Patients with sepsis were excluded. The success rate was the primary outcome. We compared the perioperative data between the groups. RESULTS: The success rate was higher in the ureteroscopy group than in the SWL group (p = 0.034). SWL was a significantly longer operation, and the fluoroscopy time was significantly longer in the SWL group than in the URS group (p = 0.027). Auxiliary procedures were more frequently performed in the SWL group than in the URS group (p = 0.02). JJ stents were inserted in 100% of patients in the URS group. Three patients (16.7%) underwent conversion to laser ureteroscopy after the second SWL session failed. No significant difference in the incidence of postoperative complications was observed between the groups, but the incidence of postoperative LUT was high in the ureteroscopy group. The mean hospital stay was 30 h in the ureteroscopy group. SWL was performed without the need for hospital admission. CONCLUSION: Ureteroscopic laser lithotripsy for steinstrasse was safe and effective, with a higher success rate, shorter fluoroscopy time, and shorter recovery period than SWL.

Electroacupuncture combined with extracorporeal shock wave lithotripsy is beneficial for the expulsion of ureteral calculi: a prospective randomized trial.

PURPOSE: To evaluate the therapeutic efficacy and safety of electroacupuncture (EA) combined with extracorporeal shock wave lithotripsy (ESWL) in treating ureteral calculi. METHODS: This prospective randomized controlled trial included 207 patients with ureteral calculi who were randomly allocated to an experimental group that underwent EA plus ESWL (n = 95) and a control group that underwent only ESWL (n = 112). Imaging examinations were performed at 1, 2, and 4 weeks after the operation, followed by comparing the stone-clearance rate, time to first stone expulsion, and incidence of major complications between the two groups. RESULTS: The stone-clearance rates at 1 (59.1 vs. 37%, P = 0.002), 2 (86.4 vs. 59.3%, P = 0.000), and 4 (90.9 vs. 77.8%, P = 0.013) weeks after the operation in the experimental group were significantly higher than those in the control group. The time to first stone expulsion in the experimental group was significantly lower than that in the control group (1.29 ± 1.55 vs. 2.45 ± 3.11 days, respectively; P = 0.001). However, we found no difference in the incidence of major complications between the two groups (15.9 vs. 17.6%, P = 0.754). CONCLUSION: EA-assisted ESWL significantly improved stone clearance and shortened the time to stone expulsion without elevating the complication risk. However, a large-scale multicenter, prospective study is required to corroborate our conclusions.

Long-term experiences with high-energy shock wave therapy in the management chronic phase Peyronie's disease using two different electromagnetic lithotripters.

BACKGROUND: Extracorporeal shock wave lithotripsy represents one option for the non-surgical management of Peyronie's disease. Despite promising results, several questions are still pending. We want to present the long-term results of a retrospective study using high-energy extracorporeal shock wave lithotripsy. MATERIAL AND METHODS: We evaluated retrospectively 110 patients treated between 1996 and 2020 at the Department of Urology, SLK Kliniken Heilbronn for chronic phase Peyronie's disease using two electromagnetic lithotripters (Siemens Lithostar Plus Overhead Module, Siemens Lithoskop) applying high-energy shock waves under local anesthesia and sonographic or fluoroscopic control. A standardized questionnaire focused on the change in pain, curvature, sexual function and the need of penile surgery. RESULTS: In 85 of the 110 patients (mean age 54 years) we had sufficient data for evaluation. The median follow-up was 228 (6-288) months. There were no significant complications. Pain reduction was achieved in all patients, 65 (76%) patients were free of pain. Improvement of penile curvature was achieved in 43 patients (51%) ranging from 25% improvement (deflected angle < 30°) to 95% (angle 30-60°). 59 patients (69%) reported problems with sexual intercourse, 40 of those (68%) reported improvement. Only 9 (10.5%) patients underwent surgical correction. We did not observe any significant differences between both electromagnetic devices with stable long-term results. CONCLUSIONS: High-energy shock wave therapy delivered by two standard electromagnetic lithotripters is safe and efficient providing stable long-term results. In cases with significant plaque formation, the concept of high-energy ESWT should be considered in future studies.

Alfvén pulse driven spicule-like jets in the presence of thermal conduction and ion-neutral collision in two-fluid regime.

We present the formation of quasi-periodic cool spicule-like jets in the solar atmosphere using 2.5-D numerical simulation in two-fluid regime (ions+neutrals) under the presence of thermal conduction and ion-neutral collision. The nonlinear, impulsive Alfvénic perturbations at the top of the photosphere trigger field aligned magnetoacoustic perturbations due to ponderomotive force. The transport of energy from Alfvén pulse to such vertical velocity perturbations due to ponderomotive force is considered as an initial trigger mechanism. Thereafter, these velocity perturbations steepen into the shocks followed by quasi-periodic rise and fall of the cool jets transporting mass in the overlying corona. This article is part of the theme issue 'Partially ionized plasma of the solar atmosphere: recent advances and future pathways'.

Clinical Efficacy and Safety of Low-Energy Extracorporeal Shock Wave Therapy for Various Conditions of Deep Dermal and Subdermal Fibrosis.

BACKGROUND: Extracorporeal shock wave therapy (ESWT) enhances extracellular matrix remodeling and tissue regeneration by promoting growth factor release, regulating blood and lymphatic flows, and reducing fat and fibrotic tissues. Focused shock wave therapy (F-SWT), radial shock wave therapy (R-SWT), and combined F-SWT and R-SWT have been used to deliver different patterns of shock energy depending on the characteristics of the target lesions. METHODS: We investigated the efficacy and safety of ESWT in patients with dermal and subdermal fibrosis. Fifty-two patients treated with F-SWT and/or R-SWT for dermal and subdermal fibrosis caused due to various reasons were retrospectively analyzed by reviewing their medical records, clinical images, and ultrasound study images. RESULTS: The mean number of pulses administered for F-SWT on the cheek, temple, and chin were 2600.0 ± 1040.8 shocks/session and for R-SWT were 5080.0 ± 2234.6 pulses/session, and the number of treatment sessions were 8.0 ± 4.4. In patients who were treated with ESWT on the abdomen, the mean number of pulses for F-SWT were 2600.0 ± 2408.3 shocks/session and for R-SWT were 8400.0 ± 894.4 pulses/session, and the number of treatment sessions were 3.2 ± 1.6. Most patients were satisfied with the results. Pain during ESWT was well tolerated and post-ESWT edema was more common in R-SWT than in F-SWT. CONCLUSION: Our data demonstrated that ESWT effectively and safely improved the clinical appearance and functional movement of patients with dermal and subdermal fibrosis caused due to various reasons.

Comparative analysis of the therapeutic effects of extracorporeal shock wave therapy and high-intensity laser therapy in lateral epicondylitis: a randomised clinical trial.

Lateral epicondylitis (LE) presents a substantial obstacle due to the pain and functional decline, frequently requiring non-surgical treatments. This study contrasts the efficacy of high-intensity laser therapy (HILT) and extracorporeal shock wave therapy (ESWT) in managing LE. A prospective, randomized comparative trial was conducted with 50 participants assigned to either HILT or ESWT groups. Both groups received standard physiotherapy (exercise program and LE bandages), and outcomes, including tenderness, Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder, and Hand scale (Q-DASH), and grip strength, were assessed at baseline, 3rd weeks, and 12th weeks. The baseline features of the groups exhibited similarities (p > 0.05). In intra-group comparisons, both HILT and ESWT groups exhibited significant enhancements in tenderness, VAS, Q-DASH, and grip strength (p < 0.05). In inter-group comparisons, the HILT group exhibited superior outcomes in tenderness reduction, pain alleviation, and disability improvement compared to the ESWT group (p < 0.05). Grip strength did not differ significantly across the groups (p > 0.05). Both HILT and ESWT, when combined with standard physiotherapy, showed effectiveness in treating LE. However, HILT demonstrated greater efficacy in terms of tenderness reduction, pain relief, and disability improvement. This study suggests that non-invasive techniques, particularly HILT, can be preferable for managing LE.

Effects of radial extracorporeal shock wave therapy on flexor spasticity of the upper limb in post-stroke patients: A randomized controlled trial.

OBJECTIVE: This study aimed to assess the efficacy of radial extracorporeal shock wave therapy in treating upper limb spasticity after a stroke. DESIGN: Randomized controlled trial. SETTING: Zhujiang Hospital of Southern Medical University. SUBJECTS: This study included 95 people with stroke. INTERVENTION: The active (n = 47) and sham-placebo (n = 48) radial extracorporeal shockwave therapy groups received three treatment sessions (every third day). MAIN MEASURES: The Modified Ashworth Scale, Hmax/Mmax ratio, root mean square, co-contraction ratio, mechanical parameters of the muscle and temperature were measured at baseline and days 2, 5 and 8. RESULTS: Among the 135 potential participants screened, 100 were enrolled and allocated randomly, with 95 participants ultimately being included in the intent-to-treat analysis dataset. The active group showed significantly better improvements in upper limb spasticity and muscle function than did the sham-placebo group. Greater improvements in the Modified Ashworth Scale were observed in the active group than in the sham-placebo group (difference, -0.45; 95% CI, -0.69 to -0.22; P < 0.001). Moreover, significant differences in root mean square, co-contraction ratio and Hmax/Mmax ratio were observed between the two groups (all P < 0.001). The mechanical parameters of the biceps muscle were significantly better in the active group than in the sham-placebo group (P < 0.001). The active group had a higher temperature than the sham-placebo group, although the difference was not significant (P = 0.070). CONCLUSIONS: This study revealed that the treatment with extracorporeal shockwave therapy can relieve upper limb spasticity in people with stroke.

Effects of dexamethasone on the EC50 of remifentanil combined with dexmedetomidine achieving analgesia during pancreatic extracorporeal shockwave lithotripsy: a prospective, randomized and controlled study.

BACKGROUND: In addition to their classic genomic effects, glucocorticoids also manifest rapid non genomic effects. We speculate that dexamethasone has the potential prompt onset of analgesic effects. The objective of this study is to investigate the influence of a single preoperative dose of dexamethasone on the half maximal effective concentration (EC50) of remifentanil when combined with dexmedetomidine for pain relief during pancreatic extracorporeal shockwave lithotripsy (P-ESWL). METHODS: A total of 60 patients undergoing P-ESWL were enrolled and randomized at 1:1 ratio into the dexamethasone (DXM) group and the placebo group. Before anesthesia induction, patients in DXM group received an intravenous injection of 8 mg dexamethasone, while subjects in placebo group received an equal dose of physiological saline. Monitored anesthesia care (MAC) was performed based on remifentanil in combination with dexmedetomidine. Remifentanil was administered by TCI with an initial target concentration of 2.5 µg/mL for both groups. A positive response was defined as that VAS score > 3 by the patient at any time during the procedure. Subsequent target concentrations were adjusted by Dixon up-down sequential method, where dose modifications were performed by 0.3 ng/mL intervals, based on the response of the previous patient. The EC50 of remifentanil for pain relief during P-ESWL treatment was calculated using Dixon's up-and-down method. Hemodynamic variables, oxygen saturation and adverse events were also recorded. RESULTS: Dixon up-and-down method revealed that the EC50 of remifentanil was significantly higher in placebo group (2.65 ± 0.28 ng/mL) than in DXM group (2.02 ± 0.23 ng/ml) (P < 0.001). Hemodynamic parameter exhibited a significant decrease in mean arterial pressure (MAP) and heart rate (HR) before and after induction in placebo group; however, data of the two groups were comparable (P>0.05). Less adverse events occurred in DXM group, including the incidence of postoperative nausea and vomiting (PONV) and analgesia requirement with in the first 24 h following the procedure at ward. CONCLUSION: Dexamethasone exerted analgesic effects with a rapid onset, and patients received dexamethasone 8 mg preoperative had a lower required EC50 of remifentanil during P-ESWL. It is also associated with reduced PONV in addition to reduced postoperative analgesic consumption in the first postoperative 24 h. TRIAL REGISTRATION: Registered in the Chinese Clinical Trial Registry (ChiCTR2300078171) on 30/11/2023.

Evaluation of the efficacy of trigger points combined with extracorporeal shock waves in the treatment of plantar fasciitis: heel temperature and plantar pressure.

BACKGROUND: Plantar fasciitis (PF) is the most common cause of heel pain. Among conservative treatments, extracorporeal shock wave therapy (ESWT) is considered effective for refractory PF. Studies have shown that applying ESWT to the trigger points (TrPs) in the triceps surae may play an important role in pain treatment in patients with PF. Therefore, the purpose of this study was to combine the concept of trigger points and ESWT to explore the effect of this combination on plantar temperature and pressure in patients with PF. METHODS: After applying inclusion and exclusion criteria, 86 patients with PF were recruited from the pain clinic of Huadong Hospital, Fudan University and randomly divided into experimental (n = 43) and control groups (n = 43). The experimental group was treated with extracorporeal shock waves to treat the medial heel pain point and the gastrocnemius and soleus TrPs. The control group was only treated with extracorporeal shock waves at the medial heel pain point. The two groups were treated twice with an interval of 1 week. Primary measurements included a numerical rating scale (NRS) score (overall, first step, heel pain during daily activities), and secondary measurements included heel temperature, Roles-Maudsley score (RMS), and plantar pressure. All assessments were performed before treatment (i.e., baseline) and 6 and 12 weeks after treatment. RESULTS: During the trial, 3 patients in the experimental group withdrew from the study, 2 due to interruption of the course of treatment by the COVID-19 epidemic and 1 due to personal reasons. In the control group, 3 patients fell and were removed due to swelling of the heel. Therefore, only 80 patients with PF were finally included. After treatment, the two groups showed good results in NRS score (overall, first step, heel pain during daily activities), RMS, and plantar temperature, especially in the experimental group, who showed a significantly better effect than the control group. CONCLUSION: ESWT of the heel combined with the triceps trigger point of the calf can more effectively improve the pain, function and quality of life of refractory PF than ESWT of the heel alone. In addition, ESWT of the heel combined with the triceps trigger point of the calf can effectively reduce the skin temperature of the heel on the symptomatic side, indicating that the heel temperature as measured by infrared thermal imaging may be used as an independent tool to evaluate the therapeutic effect for patients with chronic PF. Although extracorporeal shock waves combined with TrPs treatment can cause changes in the patients' gait structure, plantar pressure is still difficult to use as an independent tool to evaluate the therapeutic effect for PF. TRIAL REGISTRATION: Registered in the Chinese Clinical Trial Registry ( www.chictr.org.cn ) on 12/17/2021 with the following code: ChiCTR-INR-2,100,054,439.

Effect of extracorporeal shockwave therapy for rotator cuff tendinopathy: a systematic review and meta-analysis.

BACKGROUND: Rotator cuff tendinopathy (RCT) is a widespread musculoskeletal disorder and a primary cause of shoulder pain and limited function. The resulting pain and limited functionality have a detrimental impact on the overall quality of life. The purpose of this study was to perform a systematic review of the effects of extracorporeal shock wave therapy (ESWT) for RCT. METHODS: The literature search was conducted on the following databases from inception to February 20, 2024: PubMed, Web of Science, the Cochrane Library, Scopus, MEDLINE, EMBASE, EBSCO, and China National Knowledge Infrastructure (CNKI) were checked to identify the potential studies exploring the effect of ESWT for the treatment of Rotator cuff tendinopathy (Calcification or non-calcification), control group for sham, other treatments (including placebo), without restriction of date, language. Two researchers independently screened literature, extracted data, evaluated the risk of bias in the included studies, and performed meta-analysis using RevMan 5.3 software. RESULTS: A total of 16 RCTs with 1093 patients were included. The results showed that compared with the control group, ESWT for pain score Visual Analogue Scale/Score (VAS) (SMD = -1.95, 95% CI -2.47, -1.41, P < 0.00001), function score Constant-Murley score (CMS) (SMD = 1.30, 95% CI 0.67, 1.92, P < 0.00001), University of California Los Angeles score (UCLA) (SMD = 2.69, 95% CI 1.64, 3.74, P < 0.00001), American Shoulder and Elbow Surgeons form (ASES) (SMD = 1.29, 95% CI 0.93, 1.65, P < 0.00001), Range of motion (ROM) External rotation (SMD = 1.00, 95% CI 0.29, 1.72, P = 0.02), Total effective rate (TER) (OR = 3.64, 95% CI 1.85, 7.14, P = 0.0002), the differences in the above results were statistically significant. But ROM-Abduction (SMD = 0.72, 95% CI -0.22, 1.66, P = 0.13), the difference was not statistically significant. CONCLUSION: Currently limited evidence suggests that, compared with the control group, ESWT can provide better pain relief, functional recovery, and maintenance of function in patients with RCT.

A randomized trial of treatment for anterior cruciate ligament reconstruction by radial extracorporeal shock wave therapy.

OBJECTIVE: The aim of this study was to explore the effects of radial extracorporeal shock wave therapy (rESWT) in patients with anterior cruciate ligament(ACL) reconstruction(ACLR). METHODS: We conducted a randomized, controlled trial involving 72 eligible patients with ACL reconstruction in which we compared two strategies: the experimental group was standard rehabilitation plus rESWT and the control group was standard rehabilitation plus sham rESWT. The outcome was the change from baseline to 24 weeks in the average score on Lysholm knee joint score (LKS), range of motion (ROM), visual analogue scale (VAS) and International Knee Literature Committee (IKDC). RESULTS: Of 36 subjects assigned to rehabilitation plus rESWT, 4 lost to follow up. Of 36 assigned to rehabilitation plus sham rESWT, 5 lost to follow up. The LKS, ROM and IKDC scores of the experimental group were markedly increased at 3 and 6 weeks after treatment (P < 0.001), and the VAS was notably decreased (P < 0.001). However, there were no significant differences in the LKS, ROM, IKDC and VAS between the groups at 24 weeks after treatment (P > 0.05). CONCLUSION: The strategy of rehabilitation plus rESWT had better functional outcomes after ACL reconstruction. As such, our study demonstrates that rESWT is essential for patients with ACL reconstruction. Early use of rESWT can improve joint function, pain relief and ability of daily living. rESWT has a positive effect on the overall rehabilitation of patients.

Comparison of the efficiency of peloidotherapy and extracorporeal shock wave therapies in patients diagnosed with lateral epicondylitis: a prospective, randomized, controlled study.

Various treatment methods are used in the management of lateral epicondylitis (LE); however, there is no universally accepted standard treatment approach. The aim of this study is to compare the effects of peloidotherapy and extracorporeal shock wave therapy (ESWT) on pain, functional status, and quality of life in the treatment of LE. The study was designed as a hospital-based, prospective randomized controlled trial. Ninety patients, with a mean age of 47.30±7.95 (range, 18 to 65 years), diagnosed with chronic (3 months) unilateral LE were included in the study. The patients were randomly divided into two groups. The peloidotherapy group received 15 sessions of peloid therapy for 3 weeks, 5 days a week, while the ESWT group received three sessions of ESWT (1.8 bar, 10.0 Hz, 2000 impulses) for 3 weeks, once a week. The patients were evaluated before treatment, at the end of the treatment, and one month after the treatment. The groups were compared in terms of pain, quality of life, functional status, and handgrip strength. At the end of the treatment and one-month follow-up, statistically significant improvements were observed in all parameters. This study is the first randomized trial comparing peloidotherapy to ESWT as an adjunct to exercise therapy in LE. Both ESWT and peloidotherapy, when added to exercise therapy, showed positive short-term effects on pain, quality of life, functional status, and handgrip strength in primary conservative treatment of chronic LE (p<0.001), and no superiority was found between them in terms of efficacy. Peloidotherapy or ESWT may be preferred in the treatment of lateral epicondylitis, depending on the patient's condition. Peloidotherapy appears to be more advantageous due to its lower side effects and painless nature. ClinicalTrials.gov ID: NCT04748406.

Comparison of effectiveness of extracorporeal shock wave therapy and peloidotherapy in patients with plantar fasciitis: a prospective, randomized, controlled study.

Although peloidotherapy and ESWT are effective treatments for plantar fasciitis, there is no comprehensive research that directly compares their effectiveness. Our study aimed to compare the effectiveness of ESWT and peloidotherapy on pain, quality of life and functional status in individuals diagnosed with plantar fasciitis (PF). A total of 78 patients, aged between 18 and 65 years, diagnosed with PF after a thorough anamnesis and physical examination and experiencing heel pain for at least 3 months or longer and who presented to the Clinic between January 2021 and January 2023, were included in the study. Patients were randomly allocated to two groups. The peloidotherapy group received 15 sessions of peloid therapy five days a week for three weeks, while the ESWT group received three sessions of radial-type ESWT once a week for three weeks. Additionally, all patients were given a home exercise program. All patients were evaluated three times for treatment efficacy. Pain levels were assessed using the Visual Analog Scale (VAS) and Heel Tenderness Index (HTI), functional status and quality of life were assessed using the Foot Ankle Outcome Score (FAOS) and Short Form 36 (SF-36), respectively. In both treatment groups, there was a statistically significant improvement in VAS, HTI, FAOS and SF-36 scores at the end of treatment and during the one-month follow-up, compared to the initial baseline values. A statistically significant difference in favor of peloidotherapy was observed in post-treatment symptom and pain scores (p = 0.046). However, this difference did not persist at the one-month follow-up. Both active treatment methods were similarly effective and no superiority was observed between them (p > 0.05). Peloidotherapy and ESWT treatments, along with a home exercise program, were found to be effective for patients with plantar fasciitis. In the conservative treatment of PF, both peloidotherapy and ESWT can be recommended as effective and reliable options.

Factors associated with resorption of calcific deposits in the shoulder with extracorporeal shock wave therapy.

BACKGROUND: Focused extracorporeal shock wave therapy (FSWT) is effective for treating calcific tendinitis of the shoulder. However, only a few reports exist on the factors related to calcium resorption after FSWT. Thus, this study aimed to investigate the factors associated with calcium resorption. METHODS: In 117 shoulders with chronic calcific rotator cuff tendinitis, FSWT was administered nine times once every 2 weeks (a total of 16 weeks). After nine sessions of FSWT, the shoulders were radiographed and categorized into complete resorption (CR) and incomplete resorption (ICR) groups. Evaluated parameters included age, duration of disease, Gärtner classification, size of calcium deposits, presence of blood flow around calcium deposits using the Doppler function of the ultrasound imaging system, Japanese Orthopaedic Association (JOA) score, University of California at Los Angeles score, disability of the arm, shoulder, and hand (UCLA) score, and tenderness. RESULTS: The CR group included 93 shoulders (79.4%) and the ICR group included 24 shoulders (20.6%). In the two-arm comparison, CR showed significantly longer disease duration (P=.012) and high tenderness (P=.0013). Blood flow around calcium deposits was observed in 79.5% of shoulders in the CR group (P<.0001) and 29.1% in the ICR group. Type 1 Gärtner classification (P=.0009) was observed in 28 shoulders (30.1%) in the CR group and 17 shoulders (70.8%) in the ICR group. The two groups had no significant differences in age, size of calcium deposits, JOA score, or UCLA score. Multiple logistic regression analysis was performed using the following items that showed significant differences: absence of blood flow (odds ratio [OR], 8.51, 95% confidence interval [CI]: 2.24-22.8), Gärtner classification (OR, 5.60, 95%CI: 1.73-13.3), and duration of disease (OR, 1.06, 95%CI: 0.97-1.26). Longer disease duration, Gärtner type 1, and absence of blood flow around calcium deposits resulted in difficulty in calcium resorption. CONCLUSION: Patients with Gärtner type 1 with prolonged disease duration and absence of blood flow around calcium deposits may have difficulty in achieving complete resorption.

Research on the Shock Wave Overpressure Peak Measurement Method Based on Equilateral Ternary Array.

The measurement process of ground shock wave overpressure is influenced by complex field conditions, leading to notable errors in peak measurements. This study introduces a novel pressure measurement model that utilizes the Rankine-Hugoniot relation and an equilateral ternary array. The research delves into examining the influence of three key parameters (array size, shock wave incidence angle, and velocity) on the precision of pressure measurement through detailed simulations. The accuracy is compared with that of a dual-sensor array under the same conditions. Static explosion tests were conducted using bare charges of 0.3 kg and 3 kg TNT to verify the numerical simulation results. The findings indicate that the equilateral ternary array shock wave pressure measurement method demonstrates a strong anti-interference capability. It effectively reduces the peak overpressure error measured directly by the shock wave pressure sensor from 17.73% to 1.25% in the test environment. Furthermore, this method allows for velocity-based measurement of shock wave overpressure peaks in all propagation direction, with a maximum measurement error of 3.59% for shock wave overpressure peaks ≤ 9.08 MPa.