Is Shock Wave Application Effective on Various Chronic Wounds in the Geriatric Population? Preliminary Clinical Study

Abstract

Robert Dymarek,1 Izabela Kuberka,2 Karolina Walewicz,3 Jakub Taradaj,4 Joanna Rosińczuk,5 Mirosław Sopel6 1Department of Physiotherapy, Wroclaw Medical University, Wroclaw, Poland; 2Division of Anaesthetic and Surgical Nursing, Wroclaw Medical University, Wroclaw, Poland; 3Medical Institute, Jan Grodek State University in Sanok, Sanok, Poland; 4Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland; 5Division of Internal Medicine Nursing, Wroclaw Medical University, Wroclaw, Poland; 6Faculty of Medicine, Wrocław University of Science and Technology, Wroclaw, PolandCorrespondence: Robert Dymarek, Department of Physiotherapy, Wroclaw Medical University, Chałubińskiego 3, Wroclaw, 50-368, Poland, Tel [phone], Email [email protected]: Extracorporeal shock wave therapy (ESWT) is a beneficial adjunct modality for chronic wounds. Limited research has been conducted on pressure ulcers (PUs), while the majority of studies have focused on diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs). This study aimed to evaluate the short-term effects of radial ESWT in older adults with chronic wounds.Patients and Methods: This study involved a total of 31 wounds: PUs (n=22), VLUs (n=7), and DFUs (n=2). A single radial ESWT was performed with 300 + 100 shocks per cm2, pressure of 2.5 bar, energy of 0.15 mJ/mm2, and frequency of 5 Hz. Assessments using digital planimetry and clinical methods, utilizing the Wound Bed Score (WBS) and the Bates-Jansen Wound Assessment Tool (BWAT) were performed before the radial ESWT application (M0) and one week after (M1).Results: A significant wound decrease in planimetry was noted (pre-ESWT vs post-ESWT), with wound area from 9.4 cm2 to 6.2 cm2, length from 6.4 cm to 3.9 cm, and width from 2.8 cm to 2.1 cm (p< 0.001). Additionally, a substantial clinical improvement was noted in both the WBS with a 31.25% increase and the BWAT with a 20.00% increase (p< 0.001). It was also found a significant correlation between the planimetric and clinical outcomes for both tools: WBS (r=− 0.446, p=0.012) and BWAT (r=0.327, p=0.073).Conclusion: The ESWT application yields substantial immediate clinical effects that support the healing of chronic wounds in older adults. Even a single ESWT session can prove to be clinically effective and beneficial in the management of chronic wounds.Keywords: extracorporeal shockwave therapy, wound healing, older adults, clinical assessment, pressure ulcer, venous ulcer, diabetic foot ulcer

Keywords

• extracorporeal shockwave therapy
• wound healing
• older adults
• clinical assessment
• pressure ulcer
• venous ulcer
• diabetic foot ulcer