d’Agostino 2015 | Biological effects
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d'Agostino MC, Craig K, Tibalt E, Respizzi S. Shock wave as biological therapeutic tool: From mechanical stimulation to recovery and healing, through mechanotransduction. Int J Surg. 2015 Dec;24(Pt B):147-53.
Review article. • The mechanical stimulus of shockwaves is a trigger that activates a series of cellular events that have a positive effect on cell metabolism and cell cycle. • Basic science has shown that shockwaves induce proliferation, migration and differentiation of stem cells, which significantly contribute to tissue healing and regeneration. • Tenocytes are very sensible to mechanical stimulations. • Bone cells are also sensible to mechanotransduction - shockwaves are an important therapeutic tool for enhancing osteoregenerative processes. The clinical efficacy of shockwaves in bone healing is tightly related to its ability to induce neovascularization and matrix remodelling “in vivo”. • There is increasing evidence that shockwaves act as “immunomodulator” in wound healing and tissue regeneration, mainly through an anti-inflammatory strategy. • Some experimental studies have shown that shockwaves could reduce capsule formation and may induce fibrotic tissue remodelling/resorption - they help restoration of tissue integrity. • Shockwaves can also interfere with the nervous system and neurophysiological processes and produce an analgesic effect, and also reduce hypertonia in spastic muscles.
Key message Through the principle of 'mechanotransduction', shockwaves can positively influence the chain of biological reactions that lead tissue regeneration and healing.
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