沖擊波治療骨肌疾病

讓疼痛遠(yuǎn)離我和我的家人沖擊波治療儀手柄表面，高能流密度surface,highED0,35mJ/mm2深度，低能流密度depth,lowED

探頭Transmitter在組織中傳播spreads

in

thetissueED:能流密度ED:energyfluxdensity有效治療范圍

RadialExtension絕對(duì)禁忌癥ABSOLUTECONTRAINDICATIONS

妊娠Pregnancy血栓癥thrombosis血凝固紊亂（血友病）coagulationdisorders(haemophilia)腫瘤疾病tumourdiseases急性炎癥acuteinflammation目標(biāo)治療區(qū)膿腫pusfocusinthetargetarea相對(duì)禁忌癥RELATIVECONTRAINDICATIONS

抗凝血?jiǎng)┦褂谜?，特別是苯丙香豆素（維生素K拮抗劑）

useofanticoagulants,especiallymarcumar(vitaminkantagonist)有多發(fā)性神經(jīng)病的糖尿病

polyneuropathyincaseofdiabetesmellitus可的松治療結(jié)束六周后才能使用體外沖擊波治療

cortisonetherapyupto6weeksbeforefirstESWTtreatment風(fēng)濕性疾病

rheumaticdisease腫脹swelling變紅reddening血腫haematomas瘀點(diǎn)petechiae灼傷般疼痛感painlikesunburn治療初期病情惡化firstworsening副作用SIDEEFFECTS

沖擊波治療的益處BenefitsofShockWaveTreatment

幾次治療后，疼痛即得到緩解/減輕

painrelief/reductionafterafewtreatingsessions

治療依從性好

thecomplianceisverygood

治療后病人能直接感受到第一療效

thepatientscanfeelfirsteffectsdirectlyafterthetreatment

能治療復(fù)雜癥狀及相關(guān)適應(yīng)癥

treatmentofcomplexsymptoms/indicationspossible治療結(jié)締組織

treatmentofconnectivetissue活化淋巴系統(tǒng)

activationoflymphaticsystem大面積治療

treatmentoflargeareaspossible作用于神經(jīng)系統(tǒng)（門控制、疼痛記憶）

effectsonthenervoussystem(gatecontrol,painmemory?)沖擊波治療的益處

BenefitsofShockWaveTreatment經(jīng)典適應(yīng)癥CLASSICINDICATIONS經(jīng)典適應(yīng)癥ClassicIndications

Calcifictendonitis/shoulderpain鈣化性肌腱炎/肩痛Achillodynia跟腱痛Plantarfasciitis足底筋膜炎Ulnarhumeralepicondylitis

肱骨內(nèi)上踝炎Tibialstresssyndrome脛骨壓力癥候群Radialhumeralepicondylitis

肱骨外上髁炎Trochanterictendonitis

轉(zhuǎn)子肌腱炎Patellartendonitis髕腱炎治療方法PROTOCOL

查找主要痛點(diǎn)和其他痛點(diǎn)lookforthemainandotherpainpoints

與病人密切交談closedialoguewiththepatient

生物反饋biofeedback2000次發(fā)散式?jīng)_擊波radialshocks2000

多數(shù)學(xué)派的治療方法protocolofthemoststudies

傳統(tǒng)派oldschool新派：聯(lián)合療法，治療扳機(jī)點(diǎn)

new:combinedtherapy,triggerpoints治療方法PROTOCOL

治療間隔：5-7天

interval 5–7days

治療次數(shù)：3-5次

sessions 3–5

最晚在第5次治療后進(jìn)入休息期

breaklatestafter5thsession

鈣化肌腱炎/肩痛Calcifictendonitis/Shoulderpain前期超聲或X線定位/決定治療區(qū)域與深度Preliminaryultrasoundor

x-raylocalization/determinationofpenetrationdepthandtreatmentarea在皮膚上標(biāo)記出治療區(qū)域Markingoftherapeuticwindowontheskin在90%的例子中，旋轉(zhuǎn)套的岡上肌腱感染，需要治療。Inapprox.90%ofthecases

thesupraspinatustendonoftherotatorcuffisaffectedandhastobetreated鈣化肌腱炎/肩痛Calcifictendonitis/Shoulderpain鈣化肌腱炎/肩痛Calcifictendonitis/Shoulderpain鈣化肌腱炎/肩痛Calcifictendonitis/Shoulderpain鈣化肌腱炎/肩痛Calcifictendonitis/Shoulderpain肱骨內(nèi)上髁炎R(shí)adialhumeralepicondylitis–DDTreatmentinterval:5-7days

治療間隔：5-7天Supinepatientpositioning–Flexionofelbowjointapprox.30to40degree,supinationposition.R-SW(R15)applicationatthetendoninsertion.

病人仰臥位–肘關(guān)節(jié)彎曲大約30-40度，手心向上。R-SW(R15)應(yīng)用于腱附著端。Supinepatientpositioning–Extensionofelbowjoint,supinationposition.Smoothing

offorearmmuscleswithD20-S.

病人仰臥位–肘關(guān)節(jié)外展，手心向上。用D20-S按摩前臂肌肉。

肱骨內(nèi)上髁炎Ulnarhumeralepicondylitis僅使用發(fā)散性沖擊波療法Onlyradialshockwavetherapy肱骨內(nèi)上髁炎Ulnarhumeralepicondylitis病人仰臥位---肘關(guān)節(jié)外展。用V-ACTOR按摩鄰近肌肉。Supinepatientpositioning–

Extensionofelbowjoint.SmoothingofsurroundingmuscleswiththeV-ACTOR。Preliminaryultrasound/

x-rayforlocalization,

determinationofpenetration

depth

前期超聲或X線定位，確定治療深度Markingoftherapyregion

標(biāo)記治療區(qū)域轉(zhuǎn)子肌腱炎TrochantericTendonitisESWTNewTreatmentGuide轉(zhuǎn)子肌腱炎TrochantericTendonitis–DDPatellartendonitis(Jumper’sKnee)髕骨肌腱炎（跳躍膝）Preliminaryultrasound/

x-rayforlocalization,

determinationofpenetration

depth

前期超聲或x線定位，確定治療深度Markingoftherapyregion

標(biāo)記治療區(qū)域髕骨肌腱炎（跳躍膝）Patellartendonitis(Jumper’sKnee)Treatmentinterval:5-7days

治療間隔：5-7天Supinepatientpositioningwiththekneeonahalfroll.Fixationofpatellarzonewithacuff.R-SW(R15)applicationatthepatella(tip,basis)andtibialtendoninsertion.

病人仰臥位，膝蓋置于半圓柱形物上。用一條繃帶固定髕骨區(qū)。R-SW(R15)應(yīng)用于髕骨（尖部、底部）及脛骨腱附著端。Supinepatientpositioningwiththekneeonahalfroll.Fixationofpaellarzonewithacuff.SmoothingofadjacentmuscleswithD20.

病人仰臥位，膝蓋置于半圓柱形物上。用一條繃帶固定髕骨區(qū)。用D20按摩相鄰肌肉。髕骨肌腱炎Patellartendonitis(Jumper’sKnee)僅使用發(fā)散式?jīng)_擊波療法OnlyradialshockwavetherapyPreliminaryultrasound/x-ray

前期超聲/X線定位Markingoftherapyregion

標(biāo)記治療區(qū)域脛骨壓力綜合征（脛骨疲勞性骨膜炎）Tibialstresssyndrome(Shinsplint)ESWTNewTreatmentGuideTreatmentinterval:5-7days

治療間隔：5-7天Supinepatientpositioningwithkneeonahalfroll.R-SWapplication.

病人仰臥位，膝蓋置于半圓柱形物上。使用R-SW。脛骨壓力綜合征（脛骨疲勞性骨膜炎）

Tibialstresssyndrome(Shinsplint)僅使用發(fā)散式?jīng)_擊波療法Onlyradialshockwavetherapy跟腱痛AchillodyniaPreliminaryultrasound/x-ray前期超聲/x線定位Markingoftherapyregion標(biāo)記治療區(qū)域跟腱痛Achillodynia跟腱痛Achillodynia足底筋膜炎PlantarfasciitisPreliminaryultrasound/x-ray

前期超聲/x線定位Localizationofpainpointswith

bio-feedback

根據(jù)人體生物反饋定位痛點(diǎn)Markingoftherapyregion

標(biāo)記治療區(qū)域足底筋膜炎，跟骨骨刺Plantarfasciitis,HeelSpur足底筋膜炎，跟骨骨刺Plantarfasciitis,HeelSpur足底筋膜炎，跟骨骨刺Plantarfasciitis,HeelSpur研究Studies

2000次沖擊波，治療3次，一周一次2000,3sessions,1/week跟骨骨刺HeelSpur

發(fā)散式?jīng)_擊波，2000次，治療3次，1周1次RSW,2000,3sessions,1/week

肱骨外上髁炎HERRSW,5sessions,1/weekRSW,2000,3sessions,1/week發(fā)散式?jīng)_擊波，2000次，治療3次，1周1次肩袖鈣化性肌腱炎

CalcificTendinitisofRotatorCuff

鈣化性肌腱炎，聚焦式?jīng)_擊波

TendinosisCalcarea,FSW

夾擠綜合癥，聚焦式?jīng)_擊波

ImpingementSyndrome,FSW

發(fā)散式?jīng)_擊波，治療5次，1周1次RSW,5sessions,1/week

疼痛治療

Sports-InducedDiseases

肌筋膜疼痛綜合癥Myofascialpainsyndrome扳機(jī)點(diǎn)治療Triggerpointtreatment

肌筋膜疼痛綜合征Myofascialpainsyndrome可用RSWT成功治愈的骨科適應(yīng)癥

OrthopaedicindicationswhichcanbetreatedsuccessfullywithRSWT上位及低位頸部綜合征UpperandlowerCervical-Syndrome肩周痛Periarticularshoulderpain前臂屈伸肌腱炎Tendomyosisintheextensorandflexorregionoftheforearm上踝病變Epicondylopathy背痛Dorsalgia(Backpain)臀肌痛Glutealgia

內(nèi)收肌疼痛Painintheadductormuscles

股屈伸肌痙攣Shorteningsinthefemoralflexorandextensormuscles

小腿筋膜間室綜合征Peronealcompartmentsyndrome脛前綜合征Tibialanteriorsyndrome

脛骨壓力綜合征（脛骨疲勞性骨膜綜合征）Tibialstresssyndrome(Shinsplint)伴有/不伴有跟腱痛的小腿肌肉萎縮ShorteningofthecalfmusclewithandwithoutAchillodynia

跖骨痛Metatarsalgia肌筋膜疼痛綜合征Myofascialpainsyndrome

可用RSWT成功治愈的骨科適應(yīng)癥

OrthopaedicindicationswhichcanbetreatedsuccessfullywithRSWT肌筋膜疼痛綜合征Myofascialpainsyndrome治療長(zhǎng)度Lengthoftreatment

取決于肌肉刺激的持續(xù)范圍和時(shí)間Dependingontheextentanddurationofthemuscleirritation早期疼痛可經(jīng)過1-2次治療成功治愈。Earlystagecomplaintscanbetreatedsuccessfullywith1-2treatmentssessions

多數(shù)案例中，痛點(diǎn)的緩解/解除需要4-8次治療（一周1—2次治療）Inmostcasesseveraltreatmentsessions(4-8)arerequiredtorelease/eliminate

thepainpoints(1-2treatments/week).建議盡早采用扳機(jī)點(diǎn)治療Itisrecommendedtostarttriggerpointtreatmentatthemostpossibleearlystage肌筋膜疼痛綜合征Myofascialpainsyndrome沖擊波治療的優(yōu)點(diǎn)Benefitsofshockwavetherapy促進(jìn)組織再生Strongregenerativeeffectonthetissue可深入組織治療，而不傷皮膚Penetratedeepinsidethetissuewithoutharmingtheskin因此沖擊波操作方便，易于重復(fù)治療?？杀淮蠖鄶?shù)患者接受。Thereforeshockwavetherapycanbeeasilyrepeatedandiswelltoleratedbymostpatients.

超聲波掃描術(shù)Sonography

給病