I'm delighted to advise that the video of all the presentations (incuding mine) made at the third http://www.britishshockwaveassociation.com conference in late March is now available to buy. Apologies for the delay in posting due to technical issues.
You will be able to listen to my thoughts on what, in my professional opinion, works and indeed some areas that fail unnecessaryily so. The upper limbs seemingly respond better to ESWT - the particular condition that comes to mind is Lateral Epicondylitis, as you will see in the slide above confirming Yang et al '17 study.
According to the study and my experiences it is important to ensure that:
1. That the energy is delivered to the patient at an average of 3.1 bar [Yang]. The patient that was brought in for me to treat at the BSWA had previously undertaken a course of treatment of RSWT. The patient had an average of 1.5 bar delivered X3 treatments. I believe the energy or lack of was the reason the patient responded poorly to treatment and didn't get the outcome both the practitioner and patient desired. This is not an untypical case.
You will see that I managed to deliver an average of 3 bar to the patient in the video who was clearly not comfortable with the pain but tolerated it. We managed to work through despite being in front of a big audience. I'm now looking forward to hearing how he gets on with further treatments at this level of energy and that he has a successful outcome now.
Link to presentation and treatment.https://vimeo.com/273241291
Link to presentation, please email me and happy to send.
2. Not all shockwave devices deliver the same energy as this study demonstrates. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625004/
For example, some handpieces have been proven to lose a substantial amount of energy into the soft tisses, while using ultrasound gel can also affect energy absorption. I really like the Evo Blue as it does not lose energy irrespective of bar pressure. I loved this great progression of a handpiece from EMS and have produced this video which you may find of interest. https://youtu.be/jg2V8Lercug
3. Lastly, it is important to note that ESWT simply cannot fix every patient. Here's another slide of mine from my presentation. I remember 10 years plus ago, it was fashionable to talk about success outcome rates in percentage terms - PF, MAT etc were always in the high eighties whereas UL was about 70%. Fortunately we've moved on from using percentages as a way of measuring successful outcomes. Now there are recorded research findings that would follow successful treatments - i.e) measuring at three, six and 12 months post treatment.
Finally, I've decided to attach a recent study using EMS Swiss dolorClast which proved enormously popular on my social media channels. Radial shockwave treatment promotes human mesenchymal stem cell self-renewal and enhances cartilage healing.
https://stemcellres.biomedcentral.com/articles/10.1186/s13287-018-0805-5
That's all for this month guys. Happy continued great outcomes for your patients using ESWT.