{"id":1414,"date":"2021-12-01T12:33:16","date_gmt":"2021-12-01T11:33:16","guid":{"rendered":"https:\/\/www.djoglobal.eu\/blog_eu\/?p=1414"},"modified":"2021-12-01T12:33:17","modified_gmt":"2021-12-01T11:33:17","slug":"application-guidelines-for-radial-pressure-wave-therapy","status":"publish","type":"post","link":"https:\/\/enovis-medtech.eu\/blog_eu\/?p=1414","title":{"rendered":"Application guidelines for radial pressure wave therapy"},"content":{"rendered":"\n

Radial pressure wave (RPW) therapy can be used on a range of anatomical structures, each requiring different application techniques and parameters. These treatments can be combined in a session depending on the pathology and the condition.<\/p>\n\n\n\n

Treating trigger points with RPW therapy<\/strong><\/h2>\n\n\n\n

RPW therapy can help release trigger points and reduce the associated pain.<\/p>\n\n\n\n

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Patient position<\/strong><\/p>\n\n\n\n

Place the patient in a relaxed position with the affected muscles slightly stretched. Observe the level of pain experienced and reduce the stretch if necessary.<\/p>\n\n\n\n

RPW transmitters<\/strong><\/p>\n\n\n\n

The most commonly used transmitters for trigger point treatment have a diameter of 15 mm or 20 mm, with 20mm myofascial transmitters being the most effective.<\/p>\n\n\n\n

Intensity<\/strong> <\/p>\n\n\n\n

The application pressure for trigger point treatment varies between 1 and 5 bar, depending on the transmitter size and the patient\u2019s rating of pain intensity, which should not exceed grade 5 to 7 on a Visual Analogue Scale.<\/p>\n<\/div>\n\n\n\n

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Frequency<\/strong><\/p>\n\n\n\n

The therapeutic pulse frequency is 4 to 20 Hz. In general, higher frequencies seem to be more tolerable than low frequencies.<\/p>\n\n\n\n

Number of pulses per trigger point<\/strong><\/p>\n\n\n\n

As the objective should be to reduce the patient\u2019s pain by at least half, the number of RPW pulses required depends on the envisaged degree of pain relief. Once the desired pain reduction level has been reached, move on to treat the next trigger point in the same way. Typically the range of shocks will lie between 1,000-2,000.<\/p>\n\n\n\n

Number of pulses per session<\/strong><\/p>\n\n\n\n

This depends on the patient\u2019s condition, but the total number of pulses to be applied can reach 6,000 to 10,000 depending on the treatment surface, divided between local treatment and large-area muscle treatment. It is recommended that no more than 6,000 shocks should be applied over a specific point.<\/p>\n\n\n\n

Area to be targeted<\/strong><\/p>\n\n\n\n

Treat active trigger points as well as satellite trigger points in the area of referred pain. If trigger points cannot be identified, target painful muscle spots. Bear in mind active myofascial trigger points refer distally and may present as an insertional tendinopathy.<\/p>\n\n\n\n

Application technique<\/strong><\/p>\n\n\n\n

Hold the applicator at a right angle to the muscle surface to have the shortest possible distance to the target area. RPW devices with 5 bar of pressure and a good quality 20 mm diameter transmitter have been shown to have a maximal penetration depth of 7.60 mm. Ensure the transmitter stays in close contact with the skin without pressing too hard; firm pressure is only required with inferior handpieces. Treating over bone is not harmful but can cause severe discomfort, so patients should be informed for their consent. Treatment directly over the spine or to the head is contraindicated.<\/p>\n\n\n\n

Treating tendons and tendon insertions with RPW therapy<\/strong><\/h2>\n\n\n\n

Application techniques<\/strong><\/p>\n\n\n\n

Use small circular movements on the pain points along the tendon both medially and laterally using the stamping technique described below.<\/p>\n\n\n\n

Treating muscles with RPW therapy<\/strong><\/h2>\n\n\n\n
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Two different techniques can be used:<\/p>\n\n\n\n