Very Low and Low-energetic Extracorporeal Shock Wave Treatment of Spasticity in Children and Adults – A Systematic Review

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Systematic Review | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 03-08 | Karsten Knobloch, Henning Lohse-Busch, Andreas Gohritz, Tomas Nedelka

DOI: 10.13107/jrs.2022.v02.i01.33

Author: Karsten Knobloch [1], Henning Lohse-Busch [2], Andreas Gohritz [3], Tomas Nedelk [4,5]

[1] Department of Sports Medicine, SportPraxis Prof. Knobloch, Hannover, Germany.

[2] Zentrum für Bewegungsstörungen, Rheintalklinik Bad Krozingen, Germany.

[3] Department of Neurology, Universitätsspital Basel, Plastische, Rekonstruktive und Ästhetische Chirurgie, Handchirurgie, Suisse.

[4] Department of Neurology, Charles University in Prague, 2nd Faculty of Medicine, Prague, Czech Republic.

[5] Department of Neurology, Czech Technical University, Faculty of Biomedical Engineering, Kladno, Czech Republic.

Address of Correspondence
Prof. Dr. Karsten Knobloch,
SportPraxis Prof. Knobloch, Heiligerstr. 3, D-30159 Hannover, Germany.
E-mail: professor.knobloch@sportpraxis-knobloch.de

Abstract

Introduction: This systemic review aims to assess the modes and treatment parameters of radial and focused extracorporeal shockwave therapy (ESWT) in spasticity based on the technologies and energy levels involved.
Materials and Methods: 1086 patients from 31 randomized-controlled trials (RCT) or cohort studies are included. 300 children were studied in seven studies (3 RCTs) with two radial and four focused electromagnetic ESWT devices and 14 studies with 443 patients using focused ESWT (electrohydraulic 46 patients, electromagnetic 367 patients, and piezoelectric 30 patients).
Results: In electromagnetic focused ESWT 8 RCTs (n = 323 patients) and three cohort studies (n = 44) used either very low-energetic (0.03–0.05 mJ/mm2) with 1500–2000 shots and 4–5 Hz with 3–5 focused sessions, or low-energetic 0.07–0.12 mJ/mm2 with 1500–2000 shots with 4–5 Hz and 1–3 sessions. The 64 children in the five electromagnetic focused trials were treated with very low-energetic 0.03 mJ/mm2, 1500 shots, and three sessions. 17 studies (n = 687) were using radial technologies with 7 RCTs (n = 349) and ten cohort studies (n = 338). Among the 17 trials, four studies (1 RCT, 3 cohort studies) included 236 children treated with either very low-energetic 0.6–1 bar (two trials) or low-energetic 1.5–3 bar with 5–10 Hz. Energy-wise three radial studies were very low-energetic 0.6–1 bar and 14 studies applied low-energetic radial pressures 1.5–3 bar. Notably, the frequency was mainly 4–8 Hz in the radial studies.
Conclusion: Both, radial and focused very low- to low-energetic ESWT improve function and reduce spasticity significantly. Adverse effects were not noted with the applied very low- to low-energetic device parameters neither among children nor in adults.

Keywords: Spasticity, Extracorporeal shock wave therapy, Extracorporeal shockwave therapy, Children.

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How to Cite this article: Knobloch K, Lohse-Busch H, Gohritz A, Nedelka T | Very Low and Low-energetic Extracorporeal Shock Wave Treatment of Spasticity in Children and Adults–A Systematic Review. | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 03-08.

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An Invitation to the 24th World Congress of the International Society for Medical Shockwave Treatment

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Editorial | Vol 2 | Issue 1 |  Jan – Jun 2022 | page: 01-02 | Tomáš Nedělka1,2,3, Petra Poklopová1,3, Jakub Katolický1,3

DOI: 10.13107/jrs.2022.v02.i01.031

Author: Tomáš Nedělka [1,2,3], Petra Poklopová [1,3], Jakub Katolický [1,3]

[1] Czech Technical University Prague, Faculty of Biomedical Engineering, Prague, Czech Republic.

[2] Charles University Prague, 2nd Medical Faculty, Prague, Czech Republic.

[3] Charles University Prague, 2nd Medical Faculty, Prague, Czech Republic.

Address of Correspondence
Dr. Tomáš Nedělka, M.D., Ph.D,
Bělohorská 416/25, Prague 6, 169 00, Czech Republic.
E-mail: tnedelka@post.cz

Editorial:

The 24th World Congress of the International Society for Medical Shockwave Treatment (ISMST) is finally here! We are very excited to invite you to this wonderful event held in magical Prague, the heart of Europe between the 8th and the 10th of September 2022.

ISMST represents an inclusive communication platform, where top class speakers share their late research and news regarding clinical applications of the shockwave science. The program of this year’s 24th world congress has been uniquely structured to cover key applications of the shockwave therapy, namely, extracorporeal shockwave therapy (ESWT) and radial pressure waves (RPW) technology.

Leading specialists, world known physicians and physiotherapists will share their insights at this highly recognized educational and informative event. The first scientific session, called “New Horizons in Shockwave Medicine,” will be introduced on Friday the 9th by Prof. Johannes Holfeld.
He is the founder and head of Cardiac Regeneration Research Group (CARE) at Innsbruck Medical University, and he will present on the purpose of ESWT in Cardiac Surgery. Prof. Holfeld is also well known for development of shockwave therapy for myocardial regeneration. In addition, Prof. Karsten Knobloch will elaborate on the new horizons in shockwave medicine and discuss the “Brain lymphatic system and its implications for Transcranial Pulse Stimulation in Neurodegenerative Diseases,” which are a novel approach of ESWT use in neurodegenerative diseases and dementia. He will also discuss the topics of ESWT in football and esthetic medicine later in the day. Prof. Knobloch is a board-certified reconstructive and esthetic surgeon, hand surgeon, and general surgeon and also the current president of the German society for extracorporeal shockwave therapy (DIGEST). Another “new horizon” – namely, the dental pathologies – will be presented by Prof. Daniel Moya rom Argentina. There will be other amazing international speakers from USA, Germany, Austria, Taipei, Czech Republic, and Italy taking part of the topic with whom you may discuss your points of interest and this will be followed by a nice cup of coffee and refreshments.

The next sessions will be dedicated to “ESWT and Sports, ESWT in Neurology, ESWT in Skin and ESWT in Urology and Sexual Medicine.” The highlight of ESWT and Sports is the lecture by Prof. Heinz Lohrer who participated as the head team physician of the German Gymnastics Olympic Teams in Barcelona, Atlanta, and Sydney. Prof. Lohrer has won multiple international awards for his research and work. He will share his insights into the use of ESWT in the Olympic games. His presentation will be followed by shockwave specialists from South Korea, Germany, Columbia, Qatar, Malaysia, and UK to name a few. For those interested in Orthopedic Sport Medicine Arthroscopy and a wide range of tendon disorders, Prof. Nicola Maffulli is definitely an important speaker not to be missed.

In the second half of the day, Dr. Tomáš Nedělka, this year’s president of the International Society for Medical Shockwave Therapy congress, wil be presenting about the latest innovations in ESWT in Neurology. Prof. Reiner Mittermayr from Austria and Dr. Irwin Goldstein from USA will be leading the individual topics during the second half of the first day of the congress.

We are going to kick off day two of the ISMST with the topic of “RPW in Physiotherapy,” whereby the leading keynote speaker is also Prof. Heinz Lohrer. Other scientific sessions on the day include “Recent Development in Orthopedics and Traumatology” and “ESWT Pain Management.” Prof. Mittermayr and Prof. Gerdesmeyer will be leading the discussions on those key subjects, whereby all delegates are encouraged to participate in interesting discussions afterward. The day will be concluded by well-known Czech specialist in rehabilitation medicine Dr. Jiří Nedělka, successor of famous professor Janda, sharing more than 20 years of experience in combining Prague School of Manual Medicine and ESWT in various myofascial applications.

We have also prepared for you an instructional certification course (ICC) for medical doctors and physiotherapists, which will be held on September 8, 2022 on the congress site. This 1-day course will enhance your knowledge about the basics of technology, indications, contraindications, and practical application of ESWT and RPW. For your information, these courses are taught by high-ranking international lecturers with great knowledge and experience in ESWT. ICC for physiotherapists is focused on the use of RPW, and the course for physicians covers not only RPW but also focuses on ESWT, which is restricted to physicians use only. This course is certified after completing a final test at the end of the course.

 

Dr. Tomáš Nedělka

Dr. Petra Poklopová

Dr. Jakub Katolický

 

 

How to Cite this article: Nedělka T, Poklopová P, Katolický J. | An invitation to the 24th World Congress of the International Society for Medical Shockwave treatment.  | Journal of Regenerative Science | Jan – Jun 2022; 2(1):01-02.

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Introduction to Bioethics: The Boundary between Research and Clinical Practice

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Special Report | Volume 1 | Issue 1 | JRS December 2021 | Page 48-50 | Graciela Moya. DOI: 10.13107/jrs.2021.v01.i01.025

Author: Graciela Moya [1] 

[1] Department of Bioethics, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Argentina, South America.

 

Address of Correspondence
Dr. Graciela Moya, MD, PhD.
Instituto de Bioética, Pontificia Universidad Católica Argentina, Argentina, South America.
E-mail: gracielamoya@uca.edu.ar

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How to Cite this article: Moya G | Introduction to Bioethics: The Boundary between Research and Clinical Practice | Journal of Regenerative Science | Dec 2021; 1(1): 48-50.

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Multilineage-differentiating Stress-enduring (MUSE) Cells in Orthobiologics: Are they the Future?

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 44-47 | Eduard Alentorn-Geli, Patricia Laiz, Alfred Ferré-Aniorte, Roberto Seijas, David
Barastegui, Pedro Álvarez-Díaz, Xavier Cuscó, Cristina Sánchez, Luís García, Montse García-Balletbó, Ramón Cugat. DOI: 10.13107/jrs.2021.v01.i01.023

Author: Eduard Alentorn-Geli [1,2,3], Patricia Laiz [1,2], Alfred Ferré-Aniorte [1,2], Roberto Seijas [1,2], David Barastegui [1,2,3], Pedro Álvarez-Díaz [1,2,3], Xavier Cuscó [1,2], Cristina Sánchez [1,2], Luís García [1,2], Montse García-Balletbó [1,2], Ramón Cugat [1,2,3]

[1] Instituto Cugat, Hospital Quironsalud. Plaza Alfonso Comín 5-7, Planta -1, 08027 Barcelona, Spain.

[2] Fundación García Cugat, Plaza Alfonso Comín 5-7, Planta -1, 08027 Barcelona, Spain. Barcelona, Spain.

[3] Mutualidad de Futbolistas (Real Federación Española de Fútbol), Delegación catalana. Ronda Sant Pere 19-21, Entresuelo, 08010, Barcelona, Spain.

Address of Correspondence
Dr. Ramón Cugat Bertomeu, MD, PhD,
Instituto Cugat, Plaza Alfonso Comín 5-7, 08023 Barcelona, Spain.
E-mail: ramon.cugat@sportrauma.com

Abstract

Multilineage-differentiating stress-enduring (MUSE) cells are non-tumorigenic pluripotent stem cells with endogenous reparative properties. These cells have a very powerful ability to adapt to global environment changes and are thus stress-tolerant cells. Interestingly, MUSE cells can differentiate into cells representative of all three germ layers. There has been a number of studies demonstrating its powerful regenerative power in several disorders: type-1 diabetes mellitus, myocardial infarction, stroke, glomerular-related kidney diseases, chronic liver failure, and ischemia-reperfusion lung injury. Recent data have also suggested that MUSE cells have significant repair properties for osteochondral lesions. The present article will review what are MUSE cells and how they work, the application of these cells into different disorders, and the studies up-to-date regarding MUSE cells in orthobiologic.

Keywords: Muse cells, stem cells, regenerative, regeneration.

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4. Yamada Y, Wakao S, Kushida Y, Minatoguchi S, Mikami A, Higashi K, et al. S1P-S1PR2 axis mediates homing of muse cells Into damaged heart for long-lasting tissue repair and functional recovery after acute myocardial infarction. Circ Res 2018;122:1069-83.
5. Iseki M, Kushida Y, Wakao S, Akimoto T, Mizuma M, Motoi F, et al. Muse cells, nontumorigenic pluripotent-like stem cells, have liver regeneration capacity through specific homing and cell replacement in a mouse model of liver fibrosis. Cell Transplant 2017;26:821-40.
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15. Yabuki H, Wakao S, Kushida Y, Dezawa M, Okada Y. Human multilineage-differentiating stress-enduring cells exert pleiotropic effects to ameliorate acute lung ischemia-reperfusion injury in a rat model. Cell Transplant 2018;1:963689718761657.
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17. Yamashita T, Kushida Y, Wakao S, Tadokoro K, Nomura E, Omote Y, et al. Therapeutic benefit of Muse cells in a mouse model of amyotrophic lateral sclerosis. Sci Rep 2020;10(1):17102.
18. Toyoda E, Sato M, Takahashi T, Maehara M, Nakamura Y, Mitani G, et al. Multilineage-differentiating stress-enduring (Muse)-like cells exist in synovial tissue. Regen Ther 2019;10:17-26.

 

How to Cite this article: Geli EA, Laiz P, Aniorte AF, Seijas R, Barastegui D, Díaz PÁ, Cuscó X, Sánchez C, García L, Balletbó MG, Ramón Cugat R | Multilineage-differentiating Stress-enduring (MUSE) Cells in Orthobiologics: Are they the Future? | Journal of Regenerative Science | Dec 2021; 1(1): 44-47.

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Plantar Fasciopathy, General Concepts, Shock Wave Treatment and Other Additional Therapeutic Considerations

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 39-43 | Osvaldo Valle Toledo. DOI: 10.13107/jrs.2021.v01.i01.021

Author: Osvaldo Valle Toledo [1]

[1] Department of Orthopedics and Traumatology, Ankle Foot Subspecialist, Ankle-Foot Team, MEDS Clinic, Santiago de Chile.

 

Address of Correspondence
Dr. Osvaldo Valle Toledo, MD,
Department of Orthopedics and Traumatology, Ankle Foot Subspecialist, Ankle-Foot Team, MEDS Clinic, Santiago de Chile.
E-mail: osvaldovalletoledo@yahoo.es

Abstract

Plantar fasciopathy is the most common cause of heel pain. It is a primarily degenerative and mechanical overuse pathology. The plantar fascia fulfills important biomechanical functions in the foot, being its “windlass” mechanism, the most important function in this regard, allowing the foot to act as a single and efficient motor unit during gait. Its clinical and imaging diagnosis is fully defined, being Baxter’s nerve entrapment neuropathy, its most significant differential diagnosis. The elongation exercises constitute the basic treatment, being the extracorporeal shock wave therapy of significant utility, amplified in its effects by the association with the referred therapeutic exercises.

Keywords: Plantar fasciitis, shock waves, fasciopathy.

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How to Cite this article: Toledo OV | Plantar Fasciopathy, General Concepts, Shock Wave Treatment and Other Additional Therapeutic Consideration. | Journal of Regenerative Science | Dec 2021; 1(1): 39-43.

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Fundamentals of the Treatment of Male Erectile Dysfunctions with Low Intensity Shockwaves

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 26-29 | César Eisner, Mauricio Salas, Daniel Moya. DOI: 10.13107/jrs.2021.v01.i01.015

Author: César Eisner [1], Mauricio Salas [2], Daniel Moya [3]

[1] Shockwave Argentina, Buenos Aires, Argentina.

[2] Clínica Instituto de Urología y Sexología, Santiago de Chile, Chile.

[3] Department of Orthopaedics, Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires, Argentina.

Address of Correspondence
Dr. César Eisner, MD
Shockwave Argentina, Buenos Aires, Argentina.
E-mail: : info@shockwaveargentina.com

Abstract

Male erectile dysfunction (ED) is one of the most common problems among men worldwide. No single diagnostic method evaluates all the
variables of this complex condition. To achieve good therapeutic results, it is essential to base the treatment on an accurate diagnosis. Hemodynamic exploration by echo Doppler of the cavernous arteries, especially since the incorporation of intracavernous administration of vasoactive drugs, is a useful tool that allows the evaluation of erectile dysfunction in the arterial phase. It is also considered to be the choice in the assessment of the corporoveno-occlusive mechanism. Different treatment methods are used, being PDE5 (sildenafil and tadalafil), the treatment of the first choice in several conditions. The number of publications of low-intensity extracorporeal shockwave treatment (LI-ESWT) for ED has increased dramatically in recent years. Scientific evidence regarding the application of LI-ESWT for the treatment of erectile dysfunction is still controversial. Inclusion criteria of the studies and the wide variety of treatment protocols have been criticized. On the other hand, most of these studies report encouraging results with no short-term adverse effects, regardless of variation in LI-ESWT setup parameters or treatment protocols.

Keywords: Erectile dysfunction, Linear shock wave, Linear shock wave therapy, Shear wave elastography.

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How to Cite this article: Eisner C, Salas M, Moya D | Fundamentals of the Treatment of Male Erectile Dysfunctions with Low Intensity Shockwaves. | Journal of Regenerative Science | Dec 2021; 1(1): 26-29.

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Non Invasive Phisical Physical Regenerative Therapies: Laser therapy, Mechanism of Action and Results

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 21-25 | W. Leonardo Guiloff , Ondrej Prouza , Dragana Žarković. DOI: 10.13107/jrs.2021.v01.i01.013

Author: W. Leonardo Guiloff [1], Ondrej Prouza [2], Dragana Žarković [2]

[1] Department of Orthopedic Surgery of Davila Clinic, Santiago Chile, Past President Onlat-Achitoc, Santiago, Chile.

[2] Department of Anatomy and Biomechanics, Faculty of Physical Education and Sports, Charles
University, Prague, Czech Republic.

Address of Correspondence
Dr. W. Leonardo Guiloff, MD
Department of Orthopedic Surgery of Davila Clinic, Santiago Chile, Past President Onlat-Achitoc, Santiago, Chile.
E-mail: lguiloff@davila.cl

Abstract

Low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) have emerged as a therapeutic alternative suitable for a wide range of medical conditions. The main advantage of high-intensity laser over LLLT is its ability to deliver a much higher dose in a shorter time while achieving deeper penetration into the affected tissue and producing a thermal effect. Although HILT, provides very satisfactory clinical results, more clinical research is require to justify its massive use.
Keywords: Low-level laser therapy, High-level laser therapy, Biostimulation, Phototherapy.

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How to Cite this article: Guiloff WL, Prouza O, Žarković D | Non-Invasive Physical Regenerative Therapies: Laser therapy, Mechanism of Action and Results. | Journal of Regenerative Science | Dec 2021; 1(1): 21-25.

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The Sports, Ultrasound, Biologics, and Arthroscopy Protocol in the New Era of Orthopaedic Sports Injuries Treatments

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 16-20 | Bernáldez Domínguez Pedro, Dallo Lazzarini Ignacio. DOI: 10.13107/jrs.2021.v01.i01.011

Author: Bernáldez Domínguez Pedro [1], Dallo Lazzarini Ignacio [1]

[1] Department of Orthopaedic Surgery and Sports Medicine, SportMe Medical Center, Unit of Biological Therapies and Ultrasounds, Seville, Spain.

Address of Correspondence
Dr. Bernáldez Domínguez Pedro, MD. PhD
Tabladilla, 2, 41013, Seville, Spain.
E-mail: pedrobernaldez@gmail.com

Abstract

In the new era of sports traumatology, the union of anatomical, biomechanical, and functional knowledge, together with an adequate clinical examination and complemented with ultrasound studies, arthroscopic surgery, and conventional surgery, makes us understand the pathology, in a new and modern way, of the locomotor system, such as the muscle, tendon, ligament, menisci, capsule, synovial membrane, as well as bone and cartilage pathologies. Biological therapies have shown a good result for soft tissue in chronic pathology that can be applied in an ultrasound guided manner to treat tendinopathy of the Achilles, patellar, and quadriceps tendons, also at the elbow and shoulder level. It is striking to highlight the good results of this biological therapy with platelet-rich plasma for degenerative joint diseases in patients with moderate osteoarthritis. In cases in which conservative or biological therapies have not had their effect, we will generally indicate surgery, in most cases arthroscopically if it is joint pathology. This indication will be mandatory, especially in joint instability cases where we will require stabilizing surgery. We emphasize the importance of multidisciplinary teams where there must be a sports doctor, a sports traumatologist, a physiotherapist, a functional trainer, a podiatrist, biomechanics specialist, and other professionals that surround the athlete, such as the nutritionist, the psychologist so that the athlete has comprehensive assistance and is always well cared for. Together, these concepts make a personalized approach named the Sports, Ultrasound, Biologics, and Arthroscopy protocol to improve clinical results, shorten recovery times, and considerably reduce healthcare costs.
Keywords: Sports, Ultrasound, Biologics, Arthroscopy protocol, Sports medicine, Ultrasound-guided therapies, Biological therapies, Arthroscopy.

References:

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How to Cite this article: Pedro BD, Ignacio DL | The Sports, Ultrasound, Biologics, and Arthroscopy Protocol in the New Era of Orthopaedic Sports Injuries Treatments. | Journal of Regenerative Science | Dec 2021; 1(1): 16-20.

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Shockwave Therapy and Anesthesia: What Evidence is there?

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 13-15 | Paulo Roberto Dias Santos, Bruno Schiefer Dos Santos, Nacime Salomao Barbachan Mansur DOI: 10.13107/jrs.2021.v01.i01.009

Author: Paulo Roberto Dias Santos [1], Bruno Schiefer Dos Santos [1], Nacime Salomao Barbachan Mansur [1,2]

[1] Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.

[2] Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, Iowa.

 

Address of Correspondence:
Dr. Nacime Salomao Barbachan Mansur, MD, PhD.
Departamento de Ortopedia e Traumatologia, Disciplina de Ortopedia e Traumatologia, Escola Paulista de Medicina – Universidade Federal de São Paulo, Brazil.
E-mail: nacime@uol.com.br

Abstract

Introduction: The use of anesthetics on extracorporeal shockwave therapy (ESWT) for musculoskeletal disorders is a matter of debate. Although widely performed, especially on focal procedures, its scientific background is sparse. This study aims to review the current evidence
on the use of anesthetics in ESWT.
Methods: A literature review of the PubMed, Web of Science, Embase, EBSCO, and Cochrane Library databases was performed. Studies assessing or comparing the use of any type of anesthetic in any form of shockwave therapy were collected.

Results: After inclusion and exclusion criteria assessment, a total of seven studies were found to directly address the subject and only four were original articles.
Conclusion: The produced evidence is small and lacks methodological quality. These facts support the necessity for new studies using the present technology to determine the real effect of anesthetics on ESWT.

Level of Evidence: Level V. Literature Review

Keywords: Shock waves, Radial pressure waves, Quality standards

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How to Cite this article: Santos PRD, Dos Santos BS, Mansur NSB | Shockwave therapy and anesthesia: What evidence is there? | Journal of Regenerative Science | December 2021;1(1):13-15.

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Quality Standards and Techniques for the Application of Focused Shockwaves and Radial Pressure Waves in Musculoskeletal Disorders

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 9-12 | José Eid, Daniel Moya DOI: 10.13107/jrs.2021.v01.i01.007

Author: José Eid [1], Daniel Moya [2]

[1] Médico Assistente do corpo clínico do Hospital Hcor São Paulo, Brazil.

[2] Department of Orthopaedic, Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires.

Address of Correspondence:
Dr. José Eid, MD.
Médico Assistente do corpo clínico do Hospital Hcor São Paulo, Brazil.
E-mail: j.eid@uol.com.br

Abstract

Focused shockwaves and radial pressure waves are safe and effective if used correctly. Nevertheless, poor results and complications have been described due to missdiagnosis and technical errors. The aim of this review is to introduce the basic principles of quality and technical recommendations for each method.

Keywords: Shock waves, Radial pressure waves, Quality standards

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How to Cite this article: Eid J, Moya D | Quality Standards and Techniques for the Application of Focused Shockwaves and Radial Pressure Waves in Musculoskeletal Disorders. | Journal of Regenerative Science | December 2021; 1(1): 9-12.

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