Manganotti Paolo, Amelio Ernesto, Guerra Claudio
Department of Neuroscience, University of Verona, Neurology Section, Azienda Ospedaliera Universitaria Integrata di Verona, Italy.
Muscles Ligaments Tendons J. 2012 Sep 10;2(2):104-7. Print 2012 Apr.
shock waves are defined as a sequence of single sonic pulses largely used in the treatment of bone and tendon diseases and recently on muscular hypertonia in stroke patients. Our purpose is to investigate the short and long term effect of extra-corporeal shock wave therapy (ESWT) on the peripheral nerve conduction and central conductions from the treated muscles in normal human subjects in order to define safety criteria.
we studied 10 patients normal subjects. Motor and sensory nerve conduction velocity and F response from right ipothenar eminence (abductor digiti minimi) of the hand was recorded. Furthermore MEP latency and amplitude and central conduction from the same muscles by transcranial magnetic stimulation was evaluated. In all subjects each neurophysiological measures were monitored before, immediately after, 15 minutes and after 30 minutes from the active ESWT treatment (1600 shots with an energy applied of 0.030 mj/mm(2)).
no significant short or long term changes were noted in sensory and motor peripheral nerve conduction and in central motor conduction in all the subjects evaluated after ESWT.
the ESWT has no effect on sensory and motor peripheral nerve conduction and in central motor conduction. The ESWT using low level of energy represent a safety method for treating the muscles in human subjects without involvement of motor or sensory nervous trunks. Different mechanisms of action of ESWT are discussed.
冲击波被定义为一系列单声脉冲,主要用于治疗骨骼和肌腱疾病,最近也用于治疗中风患者的肌肉张力亢进。我们的目的是研究体外冲击波疗法(ESWT)对正常人体受试者经治疗肌肉的外周神经传导和中枢传导的短期和长期影响,以确定安全标准。
我们研究了10名正常受试者。记录了手部右小鱼际肌(小指展肌)的运动和感觉神经传导速度以及F波反应。此外,通过经颅磁刺激评估了同一肌肉的运动诱发电位潜伏期、波幅和中枢传导。在所有受试者中,在主动ESWT治疗(1600次冲击,施加能量为0.030 mj/mm(2))前、治疗后立即、15分钟和30分钟后监测各项神经生理学指标。
在接受ESWT治疗的所有受试者中,感觉和运动外周神经传导以及中枢运动传导在短期和长期均未发现明显变化。
ESWT对感觉和运动外周神经传导以及中枢运动传导没有影响。使用低能量的ESWT是一种治疗人体肌肉的安全方法,不会累及运动或感觉神经干。文中讨论了ESWT不同的作用机制。