In cell culture, the cellular responses on Day 6 and Day 18, and matrix mineralization (Day 35) of human periosteal cells after stimulated by ESW, LIPUS and ESW+LIPUS treatments were studied. Our results showed that LIPUS only exerted transiently beneficial effects on Day 6, but no effect was observed on Day 18. In contrast, ESW inhibited the differentiation on Day 6, and then exerted a time-delayed stimulation effect on cellular response and matrix mineralization. Data of the ESW+LIPUS showed that it was mainly under ESW effects, but LIPUS might impact the beneficial effect of ESW on Day 18, leading to reduced ALP and matrix mineralization. The potentials of the osteocytes to function as mechanosensors and signal relay were also investigated with untreated periosteal cells that separately received conditioned medium from MLO-Y4 osteocyte-like cells, which received the ESW LIPUS and ESW+LIPUS treatments. The periosteal cells showed stimulated proliferation in the ESW+LIPUS and ESW groups, indicating that the stimulus of ESW was transferred in the conditioned medium. / In conclusion, although our in vivo and in vitro findings did not support our hypothesis of the beneficial effects of combined treatment, but ESW had been shown to improve BMD and bone microarchitecture in osteoporotic bone, by stimulation of osteogenic activities in osseous cells. ESW might potentially be developed as treatment for osteoporosis. Our study also indicated that stimulation of osteogenic activities may be the direct interaction of ESW on osteoblast/periosteal cells, or indirectly through biochemical signals relayed by the osteocytes which acted as mechanosensors. / Osteoporosis is a bone disorder with decreased bone mass and deteriorated microarchitecture, leading to increased fracture risk. By using non-invasive biophysical interventions that stimulate osteogenesis, i.e. extracorporeal shockwave (ESW) and low-intensity pulsed ultrasound (LIPUS), may reduce bone loss effectively. We hypothesized that the combined treatment of ESW and LIPUS might produce synergistic effects on osteoporotic bone. The aim of this study was to investigate the efficacy of using ESW treatment alone and combined treatment of ESW and LIPUS to increase bone mineral acquisition on intact osteoporotic bone in vivo, and to investigate their underlying mechanisms in vitro. / Ten osteoporotic goats were used and divided into ESW and ESW+LIPUS groups (n=5). The ESW group received shockwave at calcaneus, distal radius, and femoral condyle on the left limbs once per month. The ESW+LIPUS group also received ESW treatment monthly and LIPUS for 6 day/week. The opposite limbs served as contralateral control. After nine months, percentage BMD changes, mineral apposition rate, trabecular thickness in treatment sites were found higher than that of controls in both groups. Cumulatively increase of serum bone-specific alkaline phosphatase indicated that the improvements were due to the increased osteogenic activities in bone. Of all parameter, no significant difference was found between the ESW+LIPUS and ESW groups. / by Tam Kam Fai. / "August 2006." / Adviser: Kwok Sui Leung. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1550. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 156-184). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Objectives: To compare optical values in the osteotomy gap created after a Tibial Tuberosity Advancement (TTA) treated with autogenous cancellous bone graft (ACBG), extracorporeal shock wave therapy (ESWT), a combination of ACBG and ESWT, and absence of both ACBG and ESWT using densitometry. Methods: Dogs presenting for surgical repair of a cranial cruciate ligament rupture were randomly assigned to one of four groups; TTA with ACBG (TTA-G), TTA with ACBG and ESWT (TTA-GS), TTA with ESWT (TTA-S), and TTA with no additional therapy (TTA-O). Mediolateral radiographs at 0, 4 and 8 weeks after surgery were evaluated to compare healing of the osteotomy gap via densitometry. An analysis of variance (ANOVA) statistical analysis was used to compare the densitometric values between groups. Results: At 4 weeks after surgery, a significant difference in osteotomy gap density was noted between TTA-GS (8.4 millimeters of Aluminum equivalent [mmAleq]) and TTA-S (6.1mmAleq), and between TTA-GS (8.4 mmAleq) and TTA-O (6.4 mmAleq). There were no significant differences noted between groups at the 8 week recheck. Clinical Significance: There were no significant differences in the osteotomy gap density at 8 weeks after surgery regardless of the treatment modality used. The combination of ACBG and ESWT may lead to increased density of the osteotomy gap in the first 4 weeks after surgery. Densitometry using an aluminum step wedge is a feasible method for comparison of bone healing after TTA in dogs. / Master of Science

Ischemic heart disease (IHD) is one of leading morbidity and mortality caused worldwide. Along with medical treatment currently there are two main methods of coronary revascularisation – percutaneous coronary intervention (PCI) and aortocoronary bypass surgery (ACBS). New heart revascularisation methods are under development, which are to be applied for routine practice in the future. One of methods stimulating angiogenesis is cardiac shock wave therapy (CSWT). CSWT is new reconstructive / regeneration treatment method offering alternative for revascularisation, as use of steam cells for such purposes is still in the stage of trials. Low frequency mechanical waves are used for CSWT. Their effect results in improved heart perfusion and development of blood vessels' network. Such waves for the first time in medicine were applied about 20 years ago for renal stones fragmentation. This treatment method has been recently applied in clinics worldwide and only few of them obtained some experience in this area. CSWT, along with medical and invasive treatment methods for patients with severely advanced ischemic heart disease, in Santariškių Clinics of Vilnius University Hospital was introduced in 2008. / MSBT– tai naujas atkuriamojo/ regeneracinio gydymo būdas, galintis tapti revaskuliarizacijos alternatyva, nes kamieninių ląstelių pritaikymas tokiais tikslais tebėra tiriamas. MSBT metu naudojamos žemo dažnio mechaninės bangos, kurioms veikiant, pagerinama širdies perfuzija ir sukuriamas kraujagyslių tinklas. Tokios bangos pirmą kartą medicinoje buvo pritaikytos inkstų akmenims skaldyti maždaug prieš 20 metų . MSBT tyrimai pradėti atlikti su pacientais, kuriems diagnozuota labai pažengusi išeminė širdies liga, lydima III−IV klasės krūtinės anginos(KA) pagal Kanados klasifikaciją (CCS), yra trijų vainikinių arterijų liga, kartais su kairės vainikinės arterijos kamieno stenoze. Šiems pacientams anksčiau atliktos angioplastikos ir stentavimo procedūros arba viena ar kelios aortokoronarinių jungčių suformavimo operacijos, tačiau KA atsinaujino, todėl nuolatos skiriamos maksimalios toleruojamos nitratų dozės. Tačiau krūtinės anginos epizodai kartojasi kelis kartus per dieną minimalaus fizinio krūvio metu ar net ramybėje. Pasaulyje šis gydymo metodas tik pradedamas taikyti ir pirminės patirties sukaupta tik nedaugelyje klinikų. Iki 2008m. VUL Santariškių klinikose išemine širdies liga (IŠL) sergantys pacientai buvo gydomi standartiniais metodais: medikamentais, PKI ir vainikinių arterijų apeinamųjų jungčių suformavimo operacija. 2008 m. Vilniaus universiteto ligoninės Santariškių klinikose labai pažengusia išemine širdies liga sergančių pacientų gydymui, be medikamentinio ir... [toliau žr. visą tekstą]

MSBT– tai naujas atkuriamojo/ regeneracinio gydymo būdas, galintis tapti revaskuliarizacijos alternatyva, nes kamieninių ląstelių pritaikymas tokiais tikslais tebėra tiriamas. MSBT metu naudojamos žemo dažnio mechaninės bangos, kurioms veikiant, pagerinama širdies perfuzija ir sukuriamas kraujagyslių tinklas. Tokios bangos pirmą kartą medicinoje buvo pritaikytos inkstų akmenims skaldyti maždaug prieš 20 metų . MSBT tyrimai pradėti atlikti su pacientais, kuriems diagnozuota labai pažengusi išeminė širdies liga, lydima III−IV klasės krūtinės anginos(KA) pagal Kanados klasifikaciją (CCS), yra trijų vainikinių arterijų liga, kartais su kairės vainikinės arterijos kamieno stenoze. Šiems pacientams anksčiau atliktos angioplastikos ir stentavimo procedūros arba viena ar kelios aortokoronarinių jungčių suformavimo operacijos, tačiau KA atsinaujino, todėl nuolatos skiriamos maksimalios toleruojamos nitratų dozės. Tačiau krūtinės anginos epizodai kartojasi kelis kartus per dieną minimalaus fizinio krūvio metu ar net ramybėje. Pasaulyje šis gydymo metodas tik pradedamas taikyti ir pirminės patirties sukaupta tik nedaugelyje klinikų. Iki 2008m. VUL Santariškių klinikose išemine širdies liga (IŠL) sergantys pacientai buvo gydomi standartiniais metodais: medikamentais, PKI ir vainikinių arterijų apeinamųjų jungčių suformavimo operacija. 2008 m. Vilniaus universiteto ligoninės Santariškių klinikose labai pažengusia išemine širdies liga sergančių pacientų gydymui, be medikamentinio ir... [toliau žr. visą tekstą] / Ischemic heart disease (IHD) is one of leading morbidity and mortality caused worldwide. Along with medical treatment currently there are two main methods of coronary revascularisation – percutaneous coronary intervention (PCI) and aortocoronary bypass surgery (ACBS). New heart revascularisation methods are under development, which are to be applied for routine practice in the future. One of methods stimulating angiogenesis is cardiac shock wave therapy (CSWT). CSWT is new reconstructive / regeneration treatment method offering alternative for revascularisation, as use of steam cells for such purposes is still in the stage of trials. Low frequency mechanical waves are used for CSWT. Their effect results in improved heart perfusion and development of blood vessels' network. Such waves for the first time in medicine were applied about 20 years ago for renal stones fragmentation. This treatment method has been recently applied in clinics worldwide and only few of them obtained some experience in this area. CSWT, along with medical and invasive treatment methods for patients with severely advanced ischemic heart disease, in Santariškių Clinics of Vilnius University Hospital was introduced in 2008.

Background: Spasticity is a common symptom post-stroke which causes vast complications regarding important daily functions among patients. This manifests as a resistance in the muscle during a velocity-dependent passive motion and is commonly evaluated by using the Modified Ashworth Scale (MAS). Extra corporeal shock wave therapy (ESWT) is a relatively novel way to treat spasticity, with promising results. Purpose: The aim of the current study was to investigate the scientific evidence of ESWT as treatment regarding spasticity and function among patients with prolonged stroke. Methods: The purpose was tackled by conducting a literature review of randomized controlled trials with MAS as outcome measurement. PubMed was searched for relevant studies followed by a quality assessment through the PEDro Scale. The reliability of the evidence was assessed with the use of GRADEstud.  Results: The quality of the included articles was mainly deemed as good with eight of nine articles receiving a PEDro Score of 6 or higher. This review found generally positive effects from ESWT regarding spasticity with MAS as the outcome measurement. The results regarding function were equivocal. The reliability of the results was graded as very low due to the methodological heterogeneity of the included studies. Conclusion: ESWT showed positive results regarding spasticity and function, although the reliability of the evidence was considered very low. More research is inquired to further explore the potential effects of ESWT on spasticity and function among post-stroke patients. This could potentially increase the reliability of the evidence regarding ESWT as a treatment option. / Bakgrund: Spasticitet är ett vanligt förekommande funktionsnedsättande centralt symptom bland patienter med stroke och har tendens att öka med tiden efter insjuknandet. Spasticitet manifesteras i form av ett ökat muskelmotstånd vid hastighetsberoende passivt rörelseuttag och bedöms oftast med Modified Ashworth Scale (MAS). Stötvågsterapi (ESWT) är en relativt ny behandlingsmetod och visats ha en lovande effekt mot spasticitet.   Syfte: Syftet med arbetet har varit att undersöka det vetenskapliga underlaget för ESWT som behandling för spasticitet och funktion hos individer med långvarig stroke. Metod: Arbetets syfte har angripits genom en systematisk narrativ litteraturstudie. Sökning av relevanta studier gjordes i databasen PubMed och skulle uteslutande vara randomiserade kontrollerade studier med MAS som utfallsmått. Studierna utvärderades gällande risk för snedvridning genom PEDro Scale. Tillförlitligheten i evidensen av effekterna av ESWT har bedömts med GRADEstud.  Resultat: Arbetets urval bedömdes ha låg risk för snedvridning då åtta av nio artiklar fick ≥ 6 poäng på PEDro Scale. ESWT sågs övergripligt ha positiva effekter på spasticitet mätt med MAS, både som isolerad och kombinerad behandling. Gällande funktion var resultaten mer tvetydiga. Dock bedömdes tillförlitligheten gällande evidensen för effekterna som mycket låg pga. genomlöpande heterogenitet bland studierna gällande design och urval.   Slutsatser: Övergripligt visade ESWT-behandling ha en positiv effekt på spasticitet och funktion. Tillförlitligheten i evidensen bedömdes dock som mycket låg. Mer forskning efterfrågas i att belysa effekterna av ESWT på patienter med stroke för att uppnå högre tillförlitlighet.

Diplomová práce Účinky rázové vlny v léčbě tendinopatie Achillovy šlachy 1 Abstract This thesis focuses on the observation of the effects of low-energetic focused extracorporeal shock wave therapy (ESWT) in the treatment of Achilles tendinopathy. The theoretical part summarizes the current knowledge of anatomical, histological, kinesiological and biomechanical aspects of Achilles tendon (AT), as well as pathological processes, which can be described as Achilles tendinopathy, their differential diagnosis and treatment options. Last but not least, we present up-to-date information on the physical principles and biological effects of ESWT, not only in the treatment of AT diseases. The main goal of our research was to determine the effectiveness of low-energetic focused ESWT in the treatment of Achilles tendinopathy in comparison to the placebo group. The subject of observation was not only changes in clinical manifestations, but also possible changes in the morphology of AT using ultrasonography (USG). Methods: A total of 20 patients with symptomatic Achilles tendinopathy was included in the study, while only 18 of them completed the entire program, and therefore only the results of these patients were evaluated. They were randomly divided into two groups in 1:1 ratio. Group A was treated by ESWT with...

This thesis assesses the effectiveness of shock wave therapy for dysfunctional disorders of the musculoskeletal system. While we are well aware of the physical principles and history of shock wave generators, opinion differs on the treatment effectiveness mechanisms. The theoretical part of this work explains the effects of shock waves on various types of tissue, the differentiation of the cells, and the analgetic effect of therapy. It summarizes the indications, side effects and contraindications of shock wave therapy. The research part of this thesis deals with the effectiveness of shock wave therapy at the Department of Rehabilitation and Sports Medicine at the Motol University Hospital, which specialises in various musculoskeletal disorders. This thesis evaluates the correlation between the effectiveness of shock wave therapy and length of time the patient has experienced difficulties before undergoing treatment. This thesis also reviews whether the number of treatment applications has the capability to influence the outcome of therapy. The study is controlled by a control group of 22 patients. The total effectiveness of shock wave therapy is p = 1,12*10-10 . The shock wave therapy effectiveness of patients with heel spur is p = 0,00176. The shock wave therapy effectiveness of patients with...

A doença aterosclerótica coronariana tem um grande impacto na morbidade e mortalidade em todo mundo. A terapia cardíaca com ondas de choque consiste em uma nova opção potencial para o tratamento de pacientes com doença coronariana crônica e angina refratária. No presente estudo, avaliamos os efeitos das ondas de choque na mecânica do ventrículo esquerdo, avaliados pela ecocardiografia com speckle tracking, assim como nos sintomas clínicos e isquemia miocárdica em pacientes com angina refratária. Estudamos, prospectivamente, 19 pacientes com angina refratária submetidos à terapia com ondas de choque com 3 sessões de tratamento por semana, realizados na primeira, quinta e nona semanas, totalizando 9 semanas de tratamento. A mecânica do ventrículo esquerdo foi avaliada por meio da determinação do strain longitudinal global e segmentar. A perfusão miocárdica foi analisada por cintilografia de perfusão miocárdica com Tecnécio-99m Sestamibi, para determinação do summed stress score (SSS). Parâmetros clínicos foram mensurados pelo escore de angina da Canadian Cardiovascular Society (CCS), escore de insuficiência cardíaca da New York Heart Association (NYHA) e qualidade de vida pelo Seattle Angina Questionnaire (SAQ). Todos os dados foram mensurados antes do início do tratamento e 6 meses após a terapia com ondas de choque. Os nossos resultados demonstraram que as ondas de choque não ocasionaram efeitos colaterais importantes e os pacientes apresentaram melhora significativa dos sintomas. Antes do tratamento, 18 (94,7%) pacientes se apresentavam com angina CCS classe III ou IV, e 6 meses após houve redução para 3 (15,8%) pacientes (p = 0,0001), associada à melhora no SAQ (38,5%; p < 0,001). Treze (68,4%) pacientes estavam em classe funcional III ou IV da NYHA antes do tratamento, com redução significativa para 7 (36,8%); p = 0,014. Nenhuma alteração foi observada no SSS global basal no acompanhamento de 6 meses (15,33 ± 8,60 versus 16,60 ± 8,06, p = 0,155) determinado pela cintilografia miocárdica. No entanto, houve redução significativa no SSS médio dos segmentos isquêmicos tratados (2,1 ± 0,87 pré versus 1,6 ± 1,19 pós-terapia, p = 0,024). O strain longitudinal global do ventrículo esquerdo permaneceu inalterado (-13,03 ± 8,96 pré versus -15,88 ± 3,43 pós-tratamento; p = 0,256). Também não foi observada alteração significativa no strain longitudinal segmentar do ventrículo esquerdo pela ecocardiografia com speckle tracking. Concluímos que a terapia com ondas de choque é um procedimento seguro para tratamento de pacientes com angina refratária, que resulta em melhor qualidade de vida, melhora na perfusão miocárdica dos segmentos tratados e preservação da mecânica ventricular esquerda / Coronary atherosclerotic disease represents a major impact on morbidity and mortality worldwide. Cardiac shock wave therapy is a new potential option for the treatment of patients with chronic coronary disease and refractory angina. In the present study, we sought to determine the effects of shock wave therapy on the left ventricular mechanics, evaluated by speckle tracking echocardiography, as well as on myocardial perfusion and symptoms of patients with refractory angina. We prospectively studied 19 patients undergoing shock wave therapy with 3 sessions per week, on the 1st, 5th and 9th weeks, for a total of 9 weeks of treatment. The left ventricular mechanics was evaluated by global longitudinal strain using the speckle tracking echocardiography. Myocardial perfusion was assessed by myocardial scintigraphy with Technetium-99m Sestamibi, for determination of summed stress score (SSS). Clinical parameters were evaluated by the Canadian Cardiovascular Society (CCS) angina score, New York Heart Association (NYHA ) heart failure score and quality of life by the Seattle Angina Questionnaire (SAQ). All data were measured prior to the treatment and 6 months after shock wave therapy. Our results demonstrated that shock wave therapy did not cause significant side effects and improved symptoms. Before treatment, 18 patients (94.7%) had CCS class III or IV angina, and 6 months later there was a reduction to 3 (15.8%), p = 0.0001, associated with improvement in SAQ ( 38.5%, p < 0.001). Thirteen (68.4%) were in NYHA class III or IV before treatment, with a significant reduction to 7 (36.8%); p = 0.014. No change was observed in the global SSS at 6-months follow-up (from 15.33 ± 8.60 baseline to 16.60 ± 8.06 post-treatment, p = 0.155). However, there was a significant reduction in the mean SSS of the treated ischemic segments (2.1 ± 0.87 pre versus 1.6 ± 1.19 post therapy, p = 0.024). The global longitudinal strain remained unchanged (-13.03 ± 8.96 pre versus -15.88 ± 3.43 6 months post-treatment, p = 0.256). In the same way, no significant difference was observed in the longitudinal strain of the left ventricular segments. We concluded that shock wave therapy is a safe procedure for the treatment of patients with refractory angina, resulting in better quality of life, improved myocardial perfusion of the treated segments, and preservation of left ventricular mechanics

A doença aterosclerótica coronariana tem um grande impacto na morbidade e mortalidade em todo mundo. A terapia cardíaca com ondas de choque consiste em uma nova opção potencial para o tratamento de pacientes com doença coronariana crônica e angina refratária. No presente estudo, avaliamos os efeitos das ondas de choque na mecânica do ventrículo esquerdo, avaliados pela ecocardiografia com speckle tracking, assim como nos sintomas clínicos e isquemia miocárdica em pacientes com angina refratária. Estudamos, prospectivamente, 19 pacientes com angina refratária submetidos à terapia com ondas de choque com 3 sessões de tratamento por semana, realizados na primeira, quinta e nona semanas, totalizando 9 semanas de tratamento. A mecânica do ventrículo esquerdo foi avaliada por meio da determinação do strain longitudinal global e segmentar. A perfusão miocárdica foi analisada por cintilografia de perfusão miocárdica com Tecnécio-99m Sestamibi, para determinação do summed stress score (SSS). Parâmetros clínicos foram mensurados pelo escore de angina da Canadian Cardiovascular Society (CCS), escore de insuficiência cardíaca da New York Heart Association (NYHA) e qualidade de vida pelo Seattle Angina Questionnaire (SAQ). Todos os dados foram mensurados antes do início do tratamento e 6 meses após a terapia com ondas de choque. Os nossos resultados demonstraram que as ondas de choque não ocasionaram efeitos colaterais importantes e os pacientes apresentaram melhora significativa dos sintomas. Antes do tratamento, 18 (94,7%) pacientes se apresentavam com angina CCS classe III ou IV, e 6 meses após houve redução para 3 (15,8%) pacientes (p = 0,0001), associada à melhora no SAQ (38,5%; p < 0,001). Treze (68,4%) pacientes estavam em classe funcional III ou IV da NYHA antes do tratamento, com redução significativa para 7 (36,8%); p = 0,014. Nenhuma alteração foi observada no SSS global basal no acompanhamento de 6 meses (15,33 ± 8,60 versus 16,60 ± 8,06, p = 0,155) determinado pela cintilografia miocárdica. No entanto, houve redução significativa no SSS médio dos segmentos isquêmicos tratados (2,1 ± 0,87 pré versus 1,6 ± 1,19 pós-terapia, p = 0,024). O strain longitudinal global do ventrículo esquerdo permaneceu inalterado (-13,03 ± 8,96 pré versus -15,88 ± 3,43 pós-tratamento; p = 0,256). Também não foi observada alteração significativa no strain longitudinal segmentar do ventrículo esquerdo pela ecocardiografia com speckle tracking. Concluímos que a terapia com ondas de choque é um procedimento seguro para tratamento de pacientes com angina refratária, que resulta em melhor qualidade de vida, melhora na perfusão miocárdica dos segmentos tratados e preservação da mecânica ventricular esquerda / Coronary atherosclerotic disease represents a major impact on morbidity and mortality worldwide. Cardiac shock wave therapy is a new potential option for the treatment of patients with chronic coronary disease and refractory angina. In the present study, we sought to determine the effects of shock wave therapy on the left ventricular mechanics, evaluated by speckle tracking echocardiography, as well as on myocardial perfusion and symptoms of patients with refractory angina. We prospectively studied 19 patients undergoing shock wave therapy with 3 sessions per week, on the 1st, 5th and 9th weeks, for a total of 9 weeks of treatment. The left ventricular mechanics was evaluated by global longitudinal strain using the speckle tracking echocardiography. Myocardial perfusion was assessed by myocardial scintigraphy with Technetium-99m Sestamibi, for determination of summed stress score (SSS). Clinical parameters were evaluated by the Canadian Cardiovascular Society (CCS) angina score, New York Heart Association (NYHA ) heart failure score and quality of life by the Seattle Angina Questionnaire (SAQ). All data were measured prior to the treatment and 6 months after shock wave therapy. Our results demonstrated that shock wave therapy did not cause significant side effects and improved symptoms. Before treatment, 18 patients (94.7%) had CCS class III or IV angina, and 6 months later there was a reduction to 3 (15.8%), p = 0.0001, associated with improvement in SAQ ( 38.5%, p < 0.001). Thirteen (68.4%) were in NYHA class III or IV before treatment, with a significant reduction to 7 (36.8%); p = 0.014. No change was observed in the global SSS at 6-months follow-up (from 15.33 ± 8.60 baseline to 16.60 ± 8.06 post-treatment, p = 0.155). However, there was a significant reduction in the mean SSS of the treated ischemic segments (2.1 ± 0.87 pre versus 1.6 ± 1.19 post therapy, p = 0.024). The global longitudinal strain remained unchanged (-13.03 ± 8.96 pre versus -15.88 ± 3.43 6 months post-treatment, p = 0.256). In the same way, no significant difference was observed in the longitudinal strain of the left ventricular segments. We concluded that shock wave therapy is a safe procedure for the treatment of patients with refractory angina, resulting in better quality of life, improved myocardial perfusion of the treated segments, and preservation of left ventricular mechanics

Diplomová práce Hodnocení krátkodobého efektu aplikace rázové vlny na MTrP Abstract This thesis concerns the application of radial extracorporeal shockwave therapy into muscular trigger points. It's location is derived from the descending part of trapezius muscle on the side of the dominant upper extremity. The performance analysis is based on using partially double-blind placebo-controlled, randomized clinical trial. The effects of the therapy were investigated in 28 subjects divided into experimental and control groups and objectively manifested by measuring the pressure pain threshold. Furthermore, the measuring of the active range of motion of the cervical spine, and the measuring of the maximal voluntary wrist and third finger flexion (measured before and after the therapy). After the therapy, the pressure pain threshold value of the trigger point located in trapezius muscle increased on average from 199 to 295 kPa (p = 0,025). The cervical spine lateral flexion increased on average by 3 degrees towards to the side of non-dominant upper extremity (p = 0,045). This study also investigates the pressure pain threshold value changes of 7 reference points placed remotely from the area of the application. After the shockwave therapy, the pressure pain threshold values of these reference points increased on...