Physical mechanisms of shock wave therapy in orthopedics

骨科冲击波治疗的物理机制

• 批准号: 7659638
• 负责人: Thomas Matula
• 金额: $ 37万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7659638
• 关键词: Abbreviations; Acoustics; Affect; Air; Area; Arts; Basic Science; Behavior; Bone Surface; Bone Tissue; Characteristics; Clinical; Computer software; Consensus; Data; Devices; Dorsal; Elbow; Fasciitis, Plantar, Chronic; Fiber Optics; Fracture; Frequencies; Goals; Heel; Hip Pain; Hot Spot; Image; In Vitro; Injury; Lateral; Lead; Lithotripsy; Location; Measures; Medial; Medicine; Methodology; Modality; Modeling; Musculoskeletal; Musculoskeletal Diseases; Myofascial Pain Syndromes; Operative Surgical Procedures; Optics; Orthopedics; Pain; Patient Preferences; Patients; Physicians; Physiologic pulse; Plantar Fasciitis; Procedures; Protocols documentation; Public Health; Quality of life; Recommendation; Research; Research Personnel; Role; Shapes; Shock; Shoulder; Shoulder Pain; Site; Skin; Skin Tissue; Skin Ulcer; Speed; Stress; Structure; Surface; Techniques; Technology; Tendinitis; Tennis Elbow; Testing; Theoretical model; Tissues; Training; Treatment Protocols; Ultrasonography; Width; bone; bone geometry; detector; improved; in vivo; light scattering; particle; polarized light; programs; repaired; research study; shear stress; simulation; success; tool; vector

DESCRIPTION (provided by applicant): Extracorporeal shock wave therapy (ESWT) represents a potentially important treatment modality for plantar fasciitis, lateral epicondylitis, shoulder tendonitis, non-unions, and other areas in orthopedics. ESWT is also an alternative to surgery for patients who do not respond well to conservative treatments. However, there is no consensus on the mechanism of action, nor is there any understanding of how musculoskeletal structures affect energy propagation. This proposal examines the basic effects of shock wave (SW) propagation through musculoskeletal structures. The specific roles of cavitation and shear will be quantified and used to optimize ESWT protocols. Specific recommendations to orthopedic physicians on how best to use current technology will be a major goal of this research. We have three specific aims. The first is to quantify SW propagation through musculoskeletal structures. We will use state-of-the-art finite volume techniques to predict how musculoskeletal structures impede and deflect acoustic energy propagation. The modeling effort will lead to predictions of shear stress and cavitation behavior. Our other two aims are to experimentally quantify cavitation and shear waves. These studies will be used to validate the modeling effort, and to serve as vectors for directing the modeling effort. Cavitation will be measured using acoustic detectors (passive cavitation detectors, B-mode ultrasound). Shear waves will be measured using polarization optics and transparent bone models. This effort is relevant to the public health because currently, shock wave therapy is being used to treat a variety of conditions, such as heel pain, elbow pain, shoulder pain, and hip pain. However, there is no research into how the shock waves actually cause the body to repair itself. By understanding the basic science of shock wave interaction with bones and tissues, we will be able to provide recommendations to physicians on how to optimize their treatments of these conditions.

描述（由申请人提供）：体外冲击波治疗（ESWT）代表了足底筋膜炎、外上髁炎、肩肌腱炎、骨不连和骨科其他领域的潜在重要治疗方式。对于保守治疗效果不佳的患者，ESWT也是手术的替代方案。然而，对作用机制没有共识，也没有任何关于肌肉骨骼结构如何影响能量传播的理解。该建议检查冲击波（SW）通过肌肉骨骼结构传播的基本影响。将量化空化和剪切的具体作用，并用于优化ESWT方案。本研究的一个主要目标是向骨科医生提供关于如何最好地使用当前技术的具体建议。我们有三个具体目标。第一个是量化SW通过肌肉骨骼结构的传播。我们将使用最先进的有限体积技术来预测肌肉骨骼结构如何阻碍和偏转声能传播。建模工作将导致剪切应力和空化行为的预测。我们的另外两个目标是实验量化空化和剪切波。这些研究将用于验证建模工作，并作为指导建模工作的矢量。将使用声学探测器（被动空化探测器、B型超声）测量空化。将使用偏振光学器件和透明骨模型测量剪切波。这一努力与公共卫生有关，因为目前，冲击波疗法被用于治疗各种疾病，如足跟痛、肘痛、肩痛和髋痛。然而，目前还没有研究表明冲击波是如何使身体自我修复的。通过了解冲击波与骨骼和组织相互作用的基础科学，我们将能够为医生提供关于如何优化这些条件的治疗的建议。