Chapter 7 Rehabilitation Physical Modalities 161
et al., 2008). The mechanism behind the pain‐
relieving function of ESWT is thought to be due
to increased serotonin activity in the dorsal
horn, and descending inhibition of pain signals
(Rompe et al., 1996; Sems et al., 2006). ESWT has
been used clinically for the treatment of chronic
musculoskeletal conditions such as osteoarthri
tis and tendinopathies, delayed and nonunion
fractures, and chronic wounds (Rompe et al.,
1996; Schaden et al., 2001; Laverty & McClure,
2002; Dahlberg et al., 2005; Sems et al., 2006;
Mueller et al., 2007).
Mueller and colleagues (2007) conducted a
study to evaluate the effects of ESWT on the
pelvic limb function of dogs suffering from cox
ofemoral osteoarthritis. Twenty‐four client‐
owned dogs with coxofemoral osteoarthritis
were investigated; 18 of them received radial
shock wave therapy and six were left untreated
as controls. Force plate analysis on a treadmill
was used to assess the dogs’ pelvic limb func
tion before treatment and 4 weeks after the last
treatment. The ESWT dogs were re‐evaluated 3
and 6 months after treatment. In the ESWT
dogs, differences between the ground reaction
forces exerted by the right and left pelvic limbs
disappeared 4 weeks after treatment; whereas
in the control dogs only the peak vertical force
distribution changed significantly. The signifi
cant improvement in the ESWT dogs was con
firmed by changes in the symmetry indices.
Significant improvements in vertical impulse
and peak vertical force were observed 3 months
after treatment. Researchers concluded that
ESWT is an effective treatment modality for
dogs with coxofemoral osteoarthritis (Mueller
et al., 2007).
Kieves and colleagues (2015) evaluated the
influence of ESWT on radiographic evidence of
bone healing after tibial plateau leveling osteot
omy (TPLO). Forty‐two dogs (50 stifles) that
underwent a TPLO were randomly assigned to
receive either ESWT or sham. Treatments were
delivered to the osteotomy site immediately
postoperatively and a second treatment was
done 2 weeks later. Radiographs were evaluated
by blinded radiologists 8 weeks postoperatively.
Based on 5‐point and 10‐point bone healing
scales, the mean healing scores were signifi
cantly greater in the ESWT group than the sham
group. The researchers determined that ESWT
led to more advanced bone healing after a TPLO.
Gallagher and colleagues (2012) conducted a
study to determine if ESWT after TPLO has a
beneficial effect on patellar ligament inflamma
tion assessed by thickening of the ligament and
ligament fiber disruption. Thirty dogs that had
TPLO had the affected stifle examined by radio
graphs and ultrasonography preoperatively and
4, 6, and 8 weeks after TPLO. At 4 and 6 weeks,
dogs in the treatment group were anesthetized
and treated with ESWT. Patellar ligament thick
ness on a lateral radiographic projection was
measured at ¼, ½, and ¾ of the distance from ori
gin to insertion. Ultrasound images were evalu
ated for patellar ligament disruption and
periligament edema. A significant radiographic
difference between groups was reached at 6 and
8 weeks postoperatively. No significant ultra
sonographic differences were found. Researchers
determined that ESWT decreases the radio
graphic signs of patellar ligament desmitis.
Becker and colleagues (2015) performed a
retrospective study reviewing medical records
of 15 dogs with shoulder lameness that failed
previous conservative management. ESWT was
administered every 3–4 weeks for a total of
three treatments. Short‐term, in‐hospital sub
jective lameness evaluation revealed resolution
of lameness in 3 of 9 dogs, and reduced lame
ness in 6 of 9 dogs available for evaluation 3–4
weeks following the last treatment. Long‐term
lameness score via telephone interview was
either improved or normal in 7 of 11 dogs (64%).
Researchers proposed that ESWT may result in
improved function based on subjective patient
evaluation and did not have any negative side
effects in dogs with lameness attributable to
instability, calcifying, and inflammatory condi
tions of the shoulder.
Webliography
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October 26, 2017).
World Association of Laser Therapy. 2010.
Recommended treatment doses for low level laser
therapy, 904 nm. Available at: http://waltza.
co.za/wp‐content/uploads/2012/08/Dose_
table_904nm_for_Low_Level_Laser_Therapy_
WALT‐2010.pdf (accessed October 26, 2017).