Shockwave

[lehughes]

Hi Laurie

Not sure if you will have been seeing the conversations over the last few days about shockwave on the rehab forum. There's been a lot of pointing to the PiezoWave Vet extracorporeal shockwave therapy (ESWT) machine BUT, in the detail of the description of this unit, it says -

"When simultaneously excited by a high-voltage pulse, the piezo-ceramic elements expand briefly along their axis by a few micrometers, creating a pressure wave and subsequent a acoustic wave in the focal volume. This results in an extremely precise and well-defined, small focal volume. This direct focus technology (without reflector) is extremely effective, precise and quiet. The equipment is extremely durable and requires little maintenance."

Just wondering, is this modality that different to the Chattanooga RSWT machine/use? I'm trying to get my head around where the use of my machine fits in with this. I need to re-watch your videos on it, but, hope you don't mind me asking the above too.

Thanks
V

[lehughes]

Hi V,

So the PiezoWave is a ‘focused’ shockwave versus radial.

I did a cut and paste of the info describing the radial shockwave unit that I have - Chattanooga.
The device is a compressed air-operated ballistic shock wave generator. The shock waves in the device are generated with a precision ballistic mechanism in the handpiece. A projectile is accelerated by compressed air. The motion and weight of the projectile produce kinetic energy. When the projectile impacts against an immovable surface, the shock transmitter, this kinetic energy is converted into sound energy. This acoustic pulse is transmitted into the tissue to be treated either directly or via an acoustic impedance adapter (shock wave coupling cushion) with the help of a gel.
These waves are physically classified as radial pressure waves. The applied pressure pulse propagates radially within the tissue and has a therapeutic effect on areas of the tissue near the surface, in particular.

Here’s a slide that sort of talks about the different kinds of shockwave - and more to the point, that there are different ways of creating a Focused shockwave.

Screen Shot 2020-05-31 at 2.22.50 PM.png (165.17 KiB) Viewed 6575 times

I think that the PeizoVet is highly used in vet medicine because their target is to vets, whereas Chattanooga isn’t targeting their marketing to vets.
There aren’t Radial Shockwave companies targeting to vets… but they are HIGHLY used in human medicine because they are not painful.
I always look at things that are targeted primarily ONLY to the vet industry as being a bit suspect (Class 4 laser, up until recently was something ONLY seen in vet medicine.)

So, I’m not sure if I answered your question. But the videos on FourLeg will have my full lecture on the subject - and not be skewed by the fact they are being given by a manufacturer!


Cheers,

Laurie

[David Lane]

I'm also a fan of radial ESWT (although I use a different machine than LEH does). Because I am often using it on arthritic geriatrics, it is particularly important for clients to not need injectable sedation each time, although I do like pre-appointment gabapentin/trazadone to make it less stressful for the patient.

Just in case the focused guys are arguing that radial is inferior, there is this.... https://pubmed.ncbi.nlm.nih.gov/26585999/

[lehughes]

Love it! Thanks for the link!

L