Since, due to operation inguinal hernia, are totally stationary in terms of sports and tomorrow is Sunday and therefore do not want to de-concentrate the athletes who must compete with a post of naked women, I take this opportunity to put this post about the treatment of tendon and not just dell'achilleo through shock waves.
INNOVATION IN THERAPY shock wave
Sergio Rigardo
early 90s, in Germany, began to experiment with specialists in orthopedic extracorporeal lithotripsy, hitherto used for urological applications, for the treatment of orthopedic pathologies. Once you have found and verified in the time the first positive results in specific clinical orthopedic shock wave therapy began to present itself as a viable alternative surgical treatment. The benefits of being able to avoid anesthesia (using low and medium energy values), the maintenance of physical integrity (no interruption), the killing of the costs of the non-surgical procedure, and the possibility of recourse at any time if necessary, meant that the various companies began to develop the first devices for orthopedic applications. Devices which keep the same characteristics of extracorporeal lithotripsy, but at the same time did not have the problems characteristic of the latter: first the unbearable pain caused by the treatment.
In order to solve this problem was taken the way of reducing energy levels while the fire zone, in order to make the pain more bearable, and then accordingly the treatment more tolerable, but maintaining the effectiveness of that. Using
systems are narrowly focused, however, made it necessary to use visualization systems (imaging) to point to the exact treatment area, resulting in inevitable rise in prices of the various devices.
From a clinical standpoint has been found over the years effectiveness of shock wave therapy for various diseases.
disorders treatable with the Shock Wave Therapy for Chronic Pain
bursitis tenosynovitis
microtraumatic (carpal tunnel)
calcific tendinosis of the patellar tendon Plantar Fasciitis Knee
Achillodinia
heel spur heel
impingement syndrome della Spalla
Periartrite Scapolo-Omerale (calcifica e non)
Epicondilite
Epitrocleite
Pseudoartrosi
Ritardo di Consolidazione di Fratture di Segmenti Ossei (dopo l'insuccesso del trattamento chirurgico o dell'uso di apparecchi gessati)
Induratio Penis Plastica
Contratture e stiramenti muscolari
Pubalgia
Patologie in fase di sperimentazione
POA: para osteopatie articolari
Necrosi avascolare della testa del femore
Fissazione di protesi d'anca mobili (non cementate)
In considerazione del fatto che gli studi in corso relativi a queste terapie non sono ancora conclusi, non sono ancora disponibili risultati definitivi; il che porta alla considerazione che soon we can expand the horizons of uses for this type of equipment.
analyzing the shock wave from a technical point of view, one can see that is different from other acoustic waves used in medicine because it is a continuous wave. It is actually made up of high intensity pulses spaced in time, that do not produce any thermal effect.
In Figure (1) one can see that for each pulse there is a rapid increase in pressure, it has a very high peak of a few hundred bar (1 MPa = 10 bar) and then you have a pressure decay to negative values. Figure 1
The phenomenon cavitation, characteristic of shock wave therapy, is closely related to the shape of the pulses illustrati.Grazie just the fact that there is severe depression that reaches negative values, the liquid begins to split and bubble nuclei formed tend to grow. The bubbles thus formed is then invested to turn the other shock waves with consequences that can be likened to a jet of liquid is as if you had liquid projectiles that hit as appropriate calculations, calcifications, etc..
methods of generation of shock waves are different, the most commonly used are:
1) Electro: there is the generation of a shock wave through a spark gives rise to an electric charge inside a chamber containing water, which evaporates as the shock wave that is reflected in the ellipsoid which is the back of camera.Un very important characteristic of this method is the generation of spherical shock wave and non-planar, eg. for the method of generation elettromagnetico.2) Electromagnetic: there is the generation of a shock wave that traveled through a coil of electrical current creates a magnetic field which, in turn, causes the vibrations of a metal diaphragm underwater. The wave that is created requires a focusing lens to be directed (focused) in an area ristretta.3) Piezoelectric: you have the generation of a shock wave through an electric voltage applied to the two sides of a piezoelectric element.
All equipment on the market today use one of these methods of generation, and they all converge in the shock wave so as to concentrate the energy, for the purposes for which they were designed.
is obvious that there are differences, even substantial, among other equipment for shock wave therapy currently available. There are so universally accepted parameters for characterizing and then differentiate.
therapy area defines the area where you can find a therapeutic effect by the shock wave therapy. To define this area is taken as a reference a curve at constant pressure value of 5 MPa (isobaric), which is precisely the minimum value of pressure to have a therapeutic effect by the shock waves. The area of \u200b\u200btreatment is contained in precisely dall'isobara 5 Mpa.
Focal area to define adequately the area of \u200b\u200bfundamental importance in the evaluation of all equipment, we see what are the parameters which define: =
pressure is defined as force divided by area and is usually expressed in units of Mega Pascal or Bar (1 MPa = 10 bars).
Peak pressure = point of maximum pressure that occurs at the center of the area of \u200b\u200btherapy.
= -6 dB represents the curve at constant pressure (isobaric) a value equal to 50% of peak pressure.
Using these parameters so you can get to define the focal zone, ie the area bounded by pressures greater than 50% of peak pressure. Basically it is the area under the curve at constant pressure (isobaric)-6dB.
being clear that they also become the common points of comparison between different systems, you can clearly evaluate the innovations that have followed each other gradually over time. Innovations that will ultimately have some common goals, among which the most important after the effectiveness of treatment are undoubtedly related to the greater tolerance by the patient's pain, especially when you have to use the density energy or even medium alte.Per clarify what is meant by the term high energy density, even for the terms of comparison, consider that as a reference for high-energy means a match with an energy density equal to 0.28 mJ / mm2.
E 'in this context that we must add to the vast extent of equipment shock wave that innovation is mainly based on the possibility of having a much wider area of \u200b\u200btherapy (approximately 10 times).
Being much larger than the area of \u200b\u200beffectiveness of shock waves, it has the advantage of being able to meet primarily to the continuous and uncontrolled involuntary movements of the patient. Movements caused the pain that the patient is subjected during the whole of the meeting and requiring the operator to a continuous control and a possible repositioning of the subject being treated.
fact a fundamental improvements brought about by the fact that this innovation is an area of \u200b\u200bfire treatment and so large, not conveying a high amount of energy over a very narrow, making it much more comfortable treatment. It is thus able to convey to the patient of the shock waves of medium and high energy with a low level of pain bearable and, above all, something absolutely unthinkable shock wave systems with very focused subjecting the patient to unbearable levels of pain already values average energy for the whole time of the session, which normally is about 15-20 minutes.
Another important aspect to consider is that you can do without an ultrasound tracking system, which instead is necessary in almost all of the shock waves, as the area of \u200b\u200btreatment is extremely focused. In contrast, a much larger area of \u200b\u200btreatment (which will also include a much larger focal zone), it becomes more necessary and essential to a targeting system, while maintaining the effectiveness of the equipment that embodies trattamento.Un these innovations both from a technical standpoint, both from the medical point of view (eg l'ORTHOSPEC della Medical Space) risulta di notevole importanza nelle patologie trattabili dalle apparecchiature che utilizzano la terapia ad onde d'urto. Terapia che deve comunque essere considerata come una valida alternativa al trattamento chirurgico vista la sua comprovata (anche se ancora in fase di studio, espansione e perfezionamento) utilità nella cura delle varie patologie prima citate.
Dr. Sergio Rigardo - Responsabile U.O.A. - RRFCasa di Cura Villa Igea - Acqui Terme (AL)
A cura del Servizio di Bioingegneria della OrthoSpace (Divisione Ortopedica della Medical Space S.r.l. Group)
ULTIMO AGGIORNAMENTO PAGINA 30 NOVEMBRE 2002
• ALLENAMENTO ECCENTRICO • bunion • MOTORING - MEDICAL AND SPORTS COLUMN • • BACKBONE KIT • chondropathy • EPICONDYLITIS HUMERAL • Fibromyalgia • hyperkyphosis DORSAL LUMBAR • • hyperlordosis Kinesio Taping Kinesio Taping • SYNDROME AND THE anterior tibial • groin • SPORTS INJURIES IN SPORT MUSCLE myositis ossificans • NEWS • 'THERAPY IN ORDER TO IMPACT OSTEOPOROSIS • • CHRONIC DISEASES locomotor • FOOT IN SKATING PELVIC • Fractures • IN SPORTS INJURY PREVENTION: STRETCHING SHIATSU • groin • Rachialgia SKATING AND SPORTS - GUIDELINES • SYNDROME FEMUR PATELLAR • syndrome anterior tibial compartment syndrome • • NECK SYSTEM BALANCE DM • • SPECIAL spondylolysis SPINE AND SPONDYLOLISTHESIS • TAPING • THERAPY shockwave • TRANSPOSITION Tibial apophysis patellar tendon • DELL'INTERX USE IN SMALL AND KINESIOLOGY TAPING FOR SPORTS INJURIES •
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Sergio Rigardo
early 90s, in Germany, began to experiment with specialists in orthopedic extracorporeal lithotripsy, hitherto used for urological applications, for the treatment of orthopedic pathologies. Once you have found and verified in the time the first positive results in specific clinical orthopedic shock wave therapy began to present itself as a viable alternative surgical treatment. The benefits of being able to avoid anesthesia (using low and medium energy values), the maintenance of physical integrity (no interruption), the killing of the costs of the non-surgical procedure, and the possibility of recourse at any time if necessary, meant that the various companies began to develop the first devices for orthopedic applications. Devices which keep the same characteristics of extracorporeal lithotripsy, but at the same time did not have the problems characteristic of the latter: first the unbearable pain caused by the treatment.
In order to solve this problem was taken the way of reducing energy levels while the fire zone, in order to make the pain more bearable, and then accordingly the treatment more tolerable, but maintaining the effectiveness of that. Using
systems are narrowly focused, however, made it necessary to use visualization systems (imaging) to point to the exact treatment area, resulting in inevitable rise in prices of the various devices.
From a clinical standpoint has been found over the years effectiveness of shock wave therapy for various diseases.
disorders treatable with the Shock Wave Therapy for Chronic Pain
bursitis tenosynovitis
microtraumatic (carpal tunnel)
calcific tendinosis of the patellar tendon Plantar Fasciitis Knee
Achillodinia
heel spur heel
impingement syndrome della Spalla
Periartrite Scapolo-Omerale (calcifica e non)
Epicondilite
Epitrocleite
Pseudoartrosi
Ritardo di Consolidazione di Fratture di Segmenti Ossei (dopo l'insuccesso del trattamento chirurgico o dell'uso di apparecchi gessati)
Induratio Penis Plastica
Contratture e stiramenti muscolari
Pubalgia
Patologie in fase di sperimentazione
POA: para osteopatie articolari
Necrosi avascolare della testa del femore
Fissazione di protesi d'anca mobili (non cementate)
In considerazione del fatto che gli studi in corso relativi a queste terapie non sono ancora conclusi, non sono ancora disponibili risultati definitivi; il che porta alla considerazione che soon we can expand the horizons of uses for this type of equipment.
analyzing the shock wave from a technical point of view, one can see that is different from other acoustic waves used in medicine because it is a continuous wave. It is actually made up of high intensity pulses spaced in time, that do not produce any thermal effect.
In Figure (1) one can see that for each pulse there is a rapid increase in pressure, it has a very high peak of a few hundred bar (1 MPa = 10 bar) and then you have a pressure decay to negative values. Figure 1
The phenomenon cavitation, characteristic of shock wave therapy, is closely related to the shape of the pulses illustrati.Grazie just the fact that there is severe depression that reaches negative values, the liquid begins to split and bubble nuclei formed tend to grow. The bubbles thus formed is then invested to turn the other shock waves with consequences that can be likened to a jet of liquid is as if you had liquid projectiles that hit as appropriate calculations, calcifications, etc..
methods of generation of shock waves are different, the most commonly used are:
1) Electro: there is the generation of a shock wave through a spark gives rise to an electric charge inside a chamber containing water, which evaporates as the shock wave that is reflected in the ellipsoid which is the back of camera.Un very important characteristic of this method is the generation of spherical shock wave and non-planar, eg. for the method of generation elettromagnetico.2) Electromagnetic: there is the generation of a shock wave that traveled through a coil of electrical current creates a magnetic field which, in turn, causes the vibrations of a metal diaphragm underwater. The wave that is created requires a focusing lens to be directed (focused) in an area ristretta.3) Piezoelectric: you have the generation of a shock wave through an electric voltage applied to the two sides of a piezoelectric element.
All equipment on the market today use one of these methods of generation, and they all converge in the shock wave so as to concentrate the energy, for the purposes for which they were designed.
is obvious that there are differences, even substantial, among other equipment for shock wave therapy currently available. There are so universally accepted parameters for characterizing and then differentiate.
therapy area defines the area where you can find a therapeutic effect by the shock wave therapy. To define this area is taken as a reference a curve at constant pressure value of 5 MPa (isobaric), which is precisely the minimum value of pressure to have a therapeutic effect by the shock waves. The area of \u200b\u200btreatment is contained in precisely dall'isobara 5 Mpa.
Focal area to define adequately the area of \u200b\u200bfundamental importance in the evaluation of all equipment, we see what are the parameters which define: =
pressure is defined as force divided by area and is usually expressed in units of Mega Pascal or Bar (1 MPa = 10 bars).
Peak pressure = point of maximum pressure that occurs at the center of the area of \u200b\u200btherapy.
= -6 dB represents the curve at constant pressure (isobaric) a value equal to 50% of peak pressure.
Using these parameters so you can get to define the focal zone, ie the area bounded by pressures greater than 50% of peak pressure. Basically it is the area under the curve at constant pressure (isobaric)-6dB.
being clear that they also become the common points of comparison between different systems, you can clearly evaluate the innovations that have followed each other gradually over time. Innovations that will ultimately have some common goals, among which the most important after the effectiveness of treatment are undoubtedly related to the greater tolerance by the patient's pain, especially when you have to use the density energy or even medium alte.Per clarify what is meant by the term high energy density, even for the terms of comparison, consider that as a reference for high-energy means a match with an energy density equal to 0.28 mJ / mm2.
E 'in this context that we must add to the vast extent of equipment shock wave that innovation is mainly based on the possibility of having a much wider area of \u200b\u200btherapy (approximately 10 times).
Being much larger than the area of \u200b\u200beffectiveness of shock waves, it has the advantage of being able to meet primarily to the continuous and uncontrolled involuntary movements of the patient. Movements caused the pain that the patient is subjected during the whole of the meeting and requiring the operator to a continuous control and a possible repositioning of the subject being treated.
fact a fundamental improvements brought about by the fact that this innovation is an area of \u200b\u200bfire treatment and so large, not conveying a high amount of energy over a very narrow, making it much more comfortable treatment. It is thus able to convey to the patient of the shock waves of medium and high energy with a low level of pain bearable and, above all, something absolutely unthinkable shock wave systems with very focused subjecting the patient to unbearable levels of pain already values average energy for the whole time of the session, which normally is about 15-20 minutes.
Another important aspect to consider is that you can do without an ultrasound tracking system, which instead is necessary in almost all of the shock waves, as the area of \u200b\u200btreatment is extremely focused. In contrast, a much larger area of \u200b\u200btreatment (which will also include a much larger focal zone), it becomes more necessary and essential to a targeting system, while maintaining the effectiveness of the equipment that embodies trattamento.Un these innovations both from a technical standpoint, both from the medical point of view (eg l'ORTHOSPEC della Medical Space) risulta di notevole importanza nelle patologie trattabili dalle apparecchiature che utilizzano la terapia ad onde d'urto. Terapia che deve comunque essere considerata come una valida alternativa al trattamento chirurgico vista la sua comprovata (anche se ancora in fase di studio, espansione e perfezionamento) utilità nella cura delle varie patologie prima citate.
Dr. Sergio Rigardo - Responsabile U.O.A. - RRFCasa di Cura Villa Igea - Acqui Terme (AL)
A cura del Servizio di Bioingegneria della OrthoSpace (Divisione Ortopedica della Medical Space S.r.l. Group)
ULTIMO AGGIORNAMENTO PAGINA 30 NOVEMBRE 2002
• ALLENAMENTO ECCENTRICO • bunion • MOTORING - MEDICAL AND SPORTS COLUMN • • BACKBONE KIT • chondropathy • EPICONDYLITIS HUMERAL • Fibromyalgia • hyperkyphosis DORSAL LUMBAR • • hyperlordosis Kinesio Taping Kinesio Taping • SYNDROME AND THE anterior tibial • groin • SPORTS INJURIES IN SPORT MUSCLE myositis ossificans • NEWS • 'THERAPY IN ORDER TO IMPACT OSTEOPOROSIS • • CHRONIC DISEASES locomotor • FOOT IN SKATING PELVIC • Fractures • IN SPORTS INJURY PREVENTION: STRETCHING SHIATSU • groin • Rachialgia SKATING AND SPORTS - GUIDELINES • SYNDROME FEMUR PATELLAR • syndrome anterior tibial compartment syndrome • • NECK SYSTEM BALANCE DM • • SPECIAL spondylolysis SPINE AND SPONDYLOLISTHESIS • TAPING • THERAPY shockwave • TRANSPOSITION Tibial apophysis patellar tendon • DELL'INTERX USE IN SMALL AND KINESIOLOGY TAPING FOR SPORTS INJURIES •
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