Application of shock wave therapy in the treatment of calcific tendinopathies

Topalović, Ivana; Nešić, Dejan

doi:10.5937/mp73-35808

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Medicinski podmladak

2022, vol. 73, br. 1, str. 7-11

Primena mehaničkog udarnog talasa u lečenju kalcifikovanih tendinopatija

Topalović Ivana^a, Nešić Dejan^b

^aUniverzitet u Beogradu, Medicinski fakultet + Visoka sportska i zdravstvena škola, Beograd
^bUniverzitet u Beogradu, Medicinski fakultet + Univerzitet u Beogradu, Medicinski fakultet, Institut za fiziologiju

e-adresa: ivana177@hotmail.com

Ključne reči: tendinopatija; kalcifikat; mehanički udarni talas; plantarni fascitis; teniski lakat

Sažetak

Tetive povezuju mišiće s kostima. Građene su od kolagena i elastina, snažne su i čvrste i nemaju mogućnost kontrakcije. Njihova čvrstina nam pomaže pri kretanju. Oporavak povreda tetiva je dugotrajan i može trajati i više od šest meseci. Ako pri povredi tetive dođe do izliva krvi, tokom vremena na mestu povrede nastaje kalcifikat i tada nastaje kalcifikantna tendinopatija. Samo postojanje kalcifikata je indikacija za lečenje mehaničkim udarnim talasom (engl. Shock wave). Mehanički udarni talas deluje fokusirano ili radijalno. Razlika između fokusiranih i radijalnih talasa je, pre svega, u njihovoj fizičkoj osnovi. U odnosu na radijalne udarne talase, fokusirani udarni talasi se razlikuju u pogledu terapijske dubine prodiranja u tkivo. Osnovni biološki efekat mehaničkog udarnog talasa je stimulativni. Energija mehaničkog udarnog talasa deluje na ćelijskom nivou tako što u tkivu stimuliše smanjenje inflamacije i bola. Korišćenjem mehaničkog udarnog talasa u terapiji kalcifikovanih tendinopatija dobijen je siguran metod za razbijanje kalcifikata. Mehanički udarni talas se može primeniti na različite načine korišćenjem: različite frekvencije, različitog broja udaraca, kao i različite jačine udaraca prilikom terapije. Izbor parametara za aplikaciju zavisi od toga da li se radi o kalcifikovanoj ili nekalcifikovanoj tendinopatiji. Indikacije za primenu mehaničkog udarnog talasa su: bolno rame, petni trn, plantarni fascitis, teniski lakat, tendinopatija Ahilove tetive, skakačko koleno, tendinitis patele, mialgija, miogeloze i sindrom prenaprezanja mišično-tetivnog sistema. Kontraindikacije za primenu mehaničkog udarnog talsa su: postojanje proteza kolena i kuka, kao i različitog ortopetskog materijala, pejsmejker, i pristustvo hroničnih oboljenja kao što su multipla skleroza, amiotrofična lateralna skleroza ili tumori. Primena mehaničkog udarnog talasa je nova, neinvazivna metoda, jednostavna za primenu, uvek smanjuje bol i praktično je bez neželjenih efekata tokom primene. Ova metoda ima posebnu ulogu u lečenju hroničnih upala bolesnih tetiva, sa kalcifikacijama ili bez njih. Jedina nedoumica u primeni mehaničkog udarnog talasa može biti u broju aplikacija i vremenskoj pauzi između primene dva uzastopna mehanička udarna talasa.

Abstract

Tendons are the soft tissue that connects muscles to bones. They are made of collagen and elastin, they are strong and solid, and have no possibility of contraction. Their strength helps us to move. Recovery of tendon injuries is long-lasting and can take more than six months. If a tendon is shed during a time injury, calcification occurs at the site of the injury and the disease is called calcifying tendinopathy. The very existence of calcifications is an indication for treatment with a mechanical shock wave (Shock wave). Mechanical shock waves can act in focus or radially. The difference between focused and radial waves is primarily in their physical basis. Focused shock waves differ from radial shock waves in terms of therapeutic depth of penetration into the tissue. The basic biological effect of a mechanical shock wave is stimulating. The energy of the mechanical shock wave acts at the cellular level by stimulating the reduction of inflammation and pain in the tissue. Using mechanical shock wave in the treatment of calcified tendinopathies, a safe method for breaking calcifications was obtained. Shock wave can be applied to using: different frequency, different number of strokes, as well as different strength of strokes in their studies. The choice of parameters for the application depends on whether it is calcified or non-calcified tendinopathy. Indications for the use are: painful shoulder, heel spur, plantar fasciitis, tennis elbow, Achilles tendon tendinopathy, jumping knee, patellar tendinitis, myalgia, myogelosis and muscular tendon overstrain syndrome. Contraindications for the use are: the existence of prostheses, knees and hips, as well as various orthopedic material, pacemaker, as well as the presence of chronic diseases such as multiple sclerosis, amyotrophic lateral sclerosis or tumors. The application of a mechanical shock wave is new, non-invasive method, easy to apply, always reduces pain and practically without side effects. This method has a special role in the treatment of chronic inflammation of diseased tendons, with or without calcification. The only dilemma in the application of a mechanical shock wave can be in the number of applications as well as the time break between the applications of two consecutive mechanical shock waves therapy.

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O članku

jezik rada: srpski
vrsta rada: pregledni članak
DOI: 10.5937/mp73-35808
objavljen u SCIndeksu: 12.05.2022.
metod recenzije: dvostruko anoniman

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