Annotated Bibliography
Results of Extracorporeal Shockwave Therapy Peer Reviewed Research

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Basic Science Articles using Animal models to demonstrate Cause and Effect
Summary: Application of extracorporeal shockwaves to tissue or bone does create a cellular change to promote healing.

Orhan, Z, Ozturan, K, et al. "The effect of extracorporeal shock waves on a rat model of injury to tendo Achilles. A histological and biomechanical study." The Journal of Bone and Joint Surgery. Vol. 86-B, No. 4, May 2004, 613-618.
Results: The effects of extracorporeal shock waves (ESWT) on tendon healing were assessed by observing histological and biomechanical parameters in a rat model of injury to the tendon. Histopathological analysis showed an increase in the number of capillaries and less formation of adhesions in the shockwave group. A significantly greater force was required to rupture the tendon in the shockwave group.

Chen, YJ, Wang, CJ, et al. "Extracorporeal shock waves promote healing of collagenase-induce Achilles tendonitis and increase TGF-ß1 and IGF-I expression." Journal of Orthopaedic Research. 22 (2004)854-861.
Results: A rat study. ESW promotes the increase of TGF-ß1 and IGF-I leading to tendon repair. The increased mitogenic and anabolic responses of tendon tissues bring about the clinical success of ESW treatment in resolving tendonitis.

Wang CJ, Wang FS, Yang KD, Weng LH, Hsu CC, Huang CS, Yang LC. Shockwave Therapy Induces Neovascularization at the Tendon-bone Junction: A Study in Rabbits. Journal of Orthopaedic Research. 21:984-989, 2003.
Results: Animal study with 50 rabbits receiving high-dose shock wave therapy. A microscopic exam of the areas of treatment confirmed that ESWT induces the in-growth of neovascularization associated with early release of angiogenesis-related proteins in the area of shock wave treatment.

Wang, CJ, et al. "Effect of Shock Wave Therapy on Acute Fractures of the Tibia. A Study in a Dog Model." Clinical Orthopaedics and Related Research. Number 387, pp.112-118, 2001.
Results: Animal study with 8 adult dogs. Radiographic findings at 12 weeks statistically showed more callus formations in the treated group. In histologic examinations, there was significantly more cortical bone formation in the treated group at 12 weeks and the bone tissues were thicker, denser, and heavier.

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