The shock wave therapy method is realized with the enPuls device, manufactured by Zimmer MedizinSysteme GmbH (Germany), authorized for therapeutic use by the Federal Service for Supervision of Health and Social Development of the Russian Federation and included in the Register of Medical Devices (registration certificate FS No. 2010/06735 dated May 6, 2010)
Procedures for shock wave therapy for patients with joint diseases, the consequences of fractures, ligament injuries and skeletal muscles are performed using the enPuls device, generating radial shock waves with a maximum kinetic energy in tissues from 60 to 185 mJ, which corresponds to a pneumatic pressure of 1 to 5 bar and with an accurate Adjustable in steps of 10 mJ. The enPuls version 2.0 works on the basis of a noncompressor, ballistic system with an electromagnetic generator. With the aid of a relatively accelerated “projectile” accelerated at the tip and a relatively low collision rate, a special mechanical shock wave is generated-softshot (enPuls wave version 2.0), which is transmitted to the human body through the application head and distributed in tissues.
The mechanical energy is absorbed by the tissue and decreases with increasing distance from the place of energy absorption. Under the influence of mechanical stress in the tissues, reactions are stimulated that promote the improvement of trophic and the stimulation of regenerative processes. The energy is mainly transferred by the momentum volume, rather than the high amplitude and extremely short front, as in similar pneumatic devices. It is assumed that shock waves created in pneumatic devices of radial shock wave therapy with a front duration of about 3.5 ms and usually used energy settings also pass through the tissue without changing the shape of the transmitted wave, since the load is within the modulus of inertia and elasticity of the tissue passed by them.
Otherwise, than with a focused shock wave with a front duration of less than 100 ns, at which there is an intentional increase in the steepness of the wave in the tissue followed by cavitation and tissue destruction, with radial shock waves this is not a potentiating effect, but only the amount of energy that causes the reactive processes .
Due to slowed-down wave growth (about 13.5 ms) and significantly lower maximum amplitude, enPuls version 2.0 prevents a typical feeling of “blows from the whip” of the shock wave, and therefore is easier to tolerate by patients.
Due to slowed-down wave growth (about 13.5 ms) and significantly lower maximum amplitude, enPuls version 2.0 prevents a typical feeling of “blows from the whip” of the shock wave, and therefore is easier to tolerate by patients.
The depth of effective action of such waves is up to 35 mm. The pulse repetition rate is from 1 to 22 imp / s, with three burst modes 4, 8 and 12 pulses. The color touch screen allows you to include seven preset adjustable standard treatment programs and more than 25 illustrated, preset treatment recommendations (protocols). The peculiarity of this model of the device is the presence of a rotary regulator adjusting the level of energy and frequency and the ability to control the tip with a pedal switch.
The device contains an applicator tip 23 cm long and 5 cm in diameter with three replaceable heads, applicators with a diameter of 6, 15 (2 heads) and 25 mm, which provide a large number of dosing options for therapeutic treatment. The applicator tip is an ergonomic manipulator with a long period of operation that is comfortable to hold, does not transmit vibration to the physician’s hand and does not require additional force to press against the surface of the impact.
The focusing head is intended for the treatment of small strongly hardened trigger zones, especially if they are clearly localized or shallow.