Physical mechanisms of shock wave therapy in orthopedics

骨科冲击波治疗的物理机制

基本信息

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
项目类别：
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

项目摘要

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）代表了足底筋膜炎、外上髁炎、肩腱炎、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，对于作用机制尚未达成共识，对于肌肉骨骼结构如何影响能量传播也没有任何了解。该提案研究了冲击波 (SW) 通过肌肉骨骼结构传播的基本影响。空化和剪切的具体作用将被量化并用于优化 ESWT 方案。就如何最好地利用现有技术向骨科医生提出具体建议将是这项研究的主要目标。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通过实验量化空化波和剪切波。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。将使用声学探测器（被动空化探测器、B 型超声波）来测量空化。将使用偏振光学和透明骨模型来测量剪切波。这项工作与公众健康相关，因为目前冲击波疗法被用于治疗多种疾病，例如脚跟疼痛、肘部疼痛、肩部疼痛和臀部疼痛。然而，目前还没有关于冲击波实际上如何导致身体自我修复的研究。通过了解冲击波与骨骼和组织相互作用的基础科学，我们将能够向医生提供有关如何优化这些病症的治疗的建议。