Biological effects of extracorporeal shockwave therapy in tendons: A systematic review
- Daniela Poenaru
- Miruna Ioana Sandulescu
- Delia Cinteza
Affiliations: Department of Rehabilitation, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania, Doctoral School, Clinical Pharmacology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Published online on: December 29, 2022 https://doi.org/10.3892/br.2022.1597
Copyright: © Poenaru
et al. This is an open access article distributed under the
terms of Creative
Commons Attribution License.
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Extracorporeal shockwave therapy was initially used for kidney stone disintegration and its application was then extended to calcific tendinitis. The therapeutic field expanded and included numerous types of tendinopathies, from shoulder to plantar fascia. The clinical benefits were documented in trials and the effects and mechanisms were studied on models including animal and human tendons. The present systematic review outlines a large spectrum of biological effects. First, an optimal dose is adapted for each species and each tendon; exceeding the optimal dose may lead to structural injury. Furthermore, the biological effects may be grouped into neovascularization induction, cellularity and extracellular matrix changes, metalloprotease and cytokine modulation, as well as lubricin production. As a result, the remodeled tendon displays improved biomechanical properties to resist stress.