Physical mechanisms of shock wave therapy in orthopedics

骨科冲击波治疗的物理机制

• 批准号: 7492240
• 负责人: Thomas Matula
• 金额: $ 36.25万
• 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/7492240
• 关键词: Abbreviations; Acoustics; Affect; Air; Area; Arts; Basic Science; Behavior; Bone Surface; Bone Tissue; Characteristics; Clinical; Computer software; Condition; 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; Personal Satisfaction; Physicians; Physiologic pulse; Plantar Fasciitis; Procedures; Protocols documentation; Public Health; Pulse taking; Quality of life; Rate; 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; detector; improved; in vivo; light scattering; particle; polarized light; programs; repaired; research study; shear stress; simulation; size; 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）：体外冲击波疗法（ESWT）代表了底部筋膜炎，外侧上con炎，肩部肌腱炎，非工会以及骨科医学其他区域的潜在重要治疗方式。 ESWT也是对对保守治疗反应不佳的患者的手术替代方法。但是，对作用机理尚无共识，也没有对肌肉骨骼结构如何影响能量传播的任何理解。该提案研究了通过肌肉骨骼结构进行冲击波（SW）传播的基本影响。空化和剪切的特定作用将被量化并用于优化ESWT协议。对骨科医生的具体建议，就如何最好地使用当前技术是这项研究的主要目标。我们有三个具体的目标。首先是通过肌肉骨骼结构量化SW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。建模工作将导致对剪切应力和空化行为的预测。我们的其他两个目的是实验量化气蚀和剪切波。这些研究将用于验证建模工作，并作为指导建模工作的向量。空化将使用声检测器（被动气态探测器，B模式超声）测量。剪切波将使用极化光学和透明骨模型测量。这项工作与公共卫生有关，因为目前正在使用冲击波疗法来治疗各种疾病，例如脚跟疼痛，肘部疼痛，肩膀疼痛和髋部疼痛。但是，没有关于冲击波实际导致人体修复自身修复的研究。通过了解与骨骼和组织的冲击波相互作用的基本科学，我们将能够向医生提供有关如何优化其对这些疾病的治疗方法的建议。