沖擊波疼痛治療匯總課件

1、RSWT WORKSHOP體外沖擊波療法RSWT WORKSHOP體外沖擊波療法有效治療范圍Radial ExtensionHandpiece 手柄表面，高能流密度surface, high ED0,35 mJ/mm2深度，低能流密度depth, low ED 探頭Transmitter在組織中傳播spreads in the tissueED: 能流密度ED: energy flux density有效治療范圍Radial ExtensionHandpi生物效應Biological effects聲學邊界的能量釋放Energy release at acoustic boundaries空化

2、作用Cavitation 增加細胞壁的通透性Increase of cell wall permeability刺激微循環(huán)（血液、淋巴）Stimulation of Microcirculation (Blood, Lymph) 釋放P物質(zhì)Release of Substance P 減少非髓鞘神經(jīng)Reduction of unmyelinated nerves釋放一氧化氮（血管舒張，細胞新陳代謝增加，血管新生，抗炎作用）Release of Nitric oxide (vasodilation, increased cell metabolism, neoangogenesis, anti-

3、inflammatory effect)抗菌作用Antibacterial effect 刺激生長因子（血管、骨骼、膠原蛋白新生）Stimulation of Growth factors (neogenesis of vessels, bone, collagen)刺激干細胞Stimulation of Stem cells 生物效應Biological effects聲學邊界的能量釋絕對禁忌癥ABSOLUTE CONTRAINDICATIONS妊娠Pregnancy血栓癥thrombosis血凝固紊亂（血友?。ヽoagulation disorders (haemophilia)腫瘤疾病t

4、umour diseases 急性炎癥acute inflammation目標治療區(qū)膿腫pus focus in the target area絕對禁忌癥妊娠Pregnancy相對禁忌癥RELATIVE CONTRAINDICATIONS抗凝血劑使用者，特別是苯丙香豆素（維生素K拮抗劑） use of anticoagulants, especially marcumar (vitamin k antagonist)有多發(fā)性神經(jīng)病的糖尿病 polyneuropathy in case of diabetes mellitus可的松治療結(jié)束六周后才能使用體外沖擊波治療 cortisone the

5、rapy up to 6 weeks before first ESWT treatment風濕性疾病 rheumatic disease相對禁忌癥腫脹swelling變紅reddening血腫haematomas瘀點petechiae灼傷般疼痛感pain like sunburn治療初期病情惡化first worsening副作用SIDE EFFECTS腫脹swelling副作用沖擊波治療的益處Benefits of Shock Wave Treatment 幾次治療后，疼痛即得到緩解/減輕 pain relief/ reduction after a few treating sessio

6、ns 治療依從性好 the compliance is very good 治療后病人能直接感受到第一療效 the patients can feel first effects directly after the treatment 能治療復雜癥狀及相關適應癥 treatment of complex symptoms/ indications possible沖擊波治療的益處 幾次治療后，疼痛即得到緩解/減輕沖擊波治療的益處Benefits of Shock Wave Treatment治療結(jié)締組織 treatment of connective tissue活化淋巴系統(tǒng) activat

7、ion of lymphatic system大面積治療 treatment of large areas possible作用于神經(jīng)系統(tǒng)（門控制、疼痛記憶） effects on the nervous system (gate control, pain memory?)沖擊波治療的益處Benefits of Shock Wav經(jīng)典適應癥CLASSIC INDICATIONS經(jīng)典適應癥經(jīng)典適應癥Classic Indications Calcific tendonitis/ shoulder pain鈣化性肌腱炎/肩痛Achillodynia 跟腱痛Plantar fasciitis 足底

8、筋膜炎Ulnar humeral epicondylitis肱骨內(nèi)上踝炎Tibial stress syndrome脛骨壓力癥候群Radial humeral epicondylitis肱骨外上髁炎Trochanteric tendonitis轉(zhuǎn)子肌腱炎Patellar tendonitis髕腱炎經(jīng)典適應癥Calcific tendonitis/ shou治療方法 PROTOCOL 查找主要痛點和其他痛點look for the main and other pain points 與病人密切交談close dialogue with the patient 生物反饋biofeedback 2

9、000次發(fā)散式?jīng)_擊波 radial shocks 2000 多數(shù)學派的治療方法protocol of the most studies 傳統(tǒng)派old school新派：聯(lián)合療法，治療扳機點 new: combined therapy, trigger points治療方法 PROTOCOL 查找主要痛點和其他痛點loo治療方法PROTOCOL治療間隔：5-7天 interval5 7days治療次數(shù)：3-5次 sessions3 5最晚在第5次治療后進入休息期 break latest after 5th session治療方法治療間隔：5-7天 鈣化肌腱炎/肩痛Calcific tendon

10、itis/Shoulder pain前期超聲或X線定位/決定治療區(qū)域與深度Preliminary ultrasound orx-ray localization/ determination of penetration depth and treatment area在皮膚上標記出治療區(qū)域Marking of therapeutic window on the skin在90%的例子中，旋轉(zhuǎn)套的岡上肌腱感染，需要治療。In approx. 90% of the casesthe supraspinatus tendon of the rotator cuff is affected and

11、has to be treated 鈣化肌腱炎/肩痛前期超聲或X線定位/決定治療區(qū)域與深度Pre鈣化肌腱炎/肩痛Calcific tendonitis/Shoulder pain鈣化肌腱炎/肩痛鈣化肌腱炎/肩痛Calcific tendonitis/Shoulder pain鈣化肌腱炎/肩痛鈣化肌腱炎/肩痛Calcific tendonitis/Shoulder pain鈣化肌腱炎/肩痛鈣化肌腱炎/肩痛Calcific tendonitis/Shoulder pain鈣化肌腱炎/肩痛Calcific tendonitis /Shoulder pain 鈣化性肌腱炎/肩痛Sessions 治療次

12、數(shù)Energy 能級(bar)Pulses/ session 每次治療使用脈沖數(shù)Freq 頻率(Hz)Trans-mitter 探頭Supraspinatus tendon 岡上肌腱1. Pain points 痛點3 51.8 4.01500 300012 15R15, DI152. Muscles 肌肉1.8 3.02000 300015 21D20-STreatment interval: 5 - 7day 治療間隔：5 -7天病人仰臥位 R-SW應用 于腹外側(cè)位Supine patient positioning R-SW application in ventrolateral po

13、sition 鈣化性肌腱炎/肩痛Calcific tendonitis/Shoulder pain 僅使用發(fā)散性沖擊波療法Only with radial shock wave therapyCalcific tendonitis /ShoulderTenderness in the region of thelateral epicondyle確定上踝側(cè) 位區(qū)柔軟度Greatest tension is elicited withthe elbow in extension, forearmin pronation, and wrist in flexion肘部外展、前臂轉(zhuǎn)至手掌向下、腕關節(jié)

14、彎曲，造成最大張力狀態(tài)Preliminary ultrasound/x-ray for localization ofepicondyle 前期上踝超聲或x線定位Marking of therapy region 標記治療區(qū)域 肱骨外上踝炎Radial humeral epicondylitisTenderness in the region of th肱骨內(nèi)上髁炎Radial humeral epicondylitis DD肱骨內(nèi)上髁炎Radial humeral epicondylRadial humeral epicondylitis 肱骨外上髁炎Sessions 治療次數(shù)Energy

15、能級(bar)Pulses/session 每次治療使用脈沖數(shù)Freq 頻率(Hz)Transmitter 探頭Tendon insertion (painful spot) 腱附著端（痛點）1. Pain points 痛點5 81.8 4.01500 300012 15R151.8 3.02000 300015 21D20-SAdjacent upper arm and forearm muscles鄰近的上臂與前臂的肌肉2. Muscles 肌肉Treatment interval: 5 - 7 days 治療間隔： 5 - 7天病人仰臥位 肘部彎曲大約130度，手掌向下。R-SW（R1

16、5）應用于腱附著端。接著使用D20-S治療鄰近的上臂與前臂的肌肉。肱骨外上髁炎Radial humeral epicondylitis 僅使用發(fā)散性沖擊波療法Only with radial shock wave therapy Radial humeral epicondylitis 肱病人仰臥位-肘關節(jié)外展。用V-ACTOR按摩鄰近肌肉。Supine patient positioning Extension of elbow joint. Smoothing of surrounding muscles with the V-ACTOR. 肱骨外上髁炎Radial humeral epi

17、condylitisESWT New Treatment Guide病人仰臥位-肘關節(jié)外展。肱骨外上髁炎ESWT New TPreliminary ultrasound/x-ray for localization of epicondyle 前期上髁超聲或x線定位Marking of therapy region 標記治療區(qū)域肱骨內(nèi)上髁炎Ulnar humeral epicondylitis ESWT New Treatment GuidePreliminary ultrasound/x-ray Ulnar humeral epicondylitis 肱骨內(nèi)上髁炎Sessions 治療次數(shù)E

18、nergy 能級(bar)Pulses/session 每次治療使用脈沖數(shù)Freq 頻率(Hz)Transmitter 探頭Tendon insertion (painful spot) 腱附著端1. Pain points 痛點5 81.8 4.01500 300012 15R15Adjacent upper arm and forearm muscles鄰近的上臂與前臂的肌肉2. Muscles 肌肉1.8 3.02000 300015 21D20-STreatment interval: 5 - 7 days 治療間隔：5 - 7 天Supine patient positioning

19、Flexion of elbow joint approx. 30 to 40 degree, supination position. R-SW (R15) application at the tendon insertion. 病人仰臥位 肘關節(jié)彎曲大約30-40度，手心向上。R-SW(R15)應用于腱附著端。Supine patient positioning Extension of elbow joint, supination position. Smoothing of forearm muscles with D20-S.病人仰臥位 肘關節(jié)外展，手心向上。用D20-S按摩前臂

20、肌肉。 肱骨內(nèi)上髁炎Ulnar humeral epicondylitis僅使用發(fā)散性沖擊波療法Only radial shock wave therapy Ulnar humeral epicondylitis 肱骨肱骨內(nèi)上髁炎Ulnar humeral epicondylitis病人仰臥位-肘關節(jié)外展。用V-ACTOR按摩鄰近肌肉。Supine patient positioning Extension of elbow joint. Smoothing of surrounding muscles with the V-ACTOR。肱骨內(nèi)上髁炎Ulnar humeral epicondy

21、liPreliminary ultrasound/x-ray for localization,determination of penetrationdepth 前期超聲或X線定位，確定治療深度Marking of therapy region 標記治療區(qū)域轉(zhuǎn)子肌腱炎Trochanteric Tendonitis ESWT New Treatment GuidePreliminary ultrasound/x-ray 轉(zhuǎn)子肌腱炎Trochanteric Tendonitis DD轉(zhuǎn)子肌腱炎Trochanteric Tendonitis Trochanteric tendonitis 轉(zhuǎn)子肌腱

22、炎Sessions 治療次數(shù)Energy 能級(bar)Pulses/session 每次治療使用脈沖數(shù)Freq 頻率(Hz)Transmitter 探頭Tendon insertion 腱附著端1. Pain points 痛點6 82.8 3.52000 300015 21R15, DI15Adjacent muscles 相關肌肉2. Muscles 肌肉2.0 3.52000 400021D20-S, D35-STreatment interval: 5 - 7 days 治療間隔： 5 - 7天Lateral patient positioning Smoothing of asso

23、ciated muscles with D35.病人側(cè)臥位 用D35按摩相關肌肉。Lateral patient positioning R-SW application (DI15) on the tip of the trochanter, M. piriformis and associated muscles.病人側(cè)臥位 R-SW（DI15）應用于轉(zhuǎn)子尖、梨狀肌及相關肌肉。轉(zhuǎn)子肌腱炎 Trochanteric Tendonitis 僅使用發(fā)散式?jīng)_擊波療法Only radial shock wave therapy Trochanteric tendonitis 轉(zhuǎn)子肌腱炎SPatell

24、ar tendonitis (Jumpers Knee) 髕骨肌腱炎（跳躍膝）Preliminary ultrasound/x-ray for localization,determination of penetrationdepth 前期超聲或x線定位，確定治療深度Marking of therapy region 標記治療區(qū)域Patellar tendonitis (Jumpers 髕骨肌腱炎（跳躍膝）Patellar tendonitis (Jumpers Knee)髕骨肌腱炎（跳躍膝）Patellar tendonitis 髕骨肌腱炎Sessions 治療次數(shù)Energy 能級(ba

25、r)Pulses/session 每次治療使用脈沖數(shù)Freq 頻率(Hz)Transmitter 探頭Patella, tibial tendon insertion 髕骨、脛骨腱附著端1. Pain points 痛點6 82.8 3.52000 300015 21R15, DI15Adjacent muscles 相鄰肌肉2. Muscles 肌肉2.0 3.52000 400021D20-S, D35-STreatment interval: 5 - 7 days 治療間隔：5 - 7 天Supine patient positioning with the knee on a half

26、 roll. Fixation of patellar zone with a cuff. R-SW (R15) application at the patella (tip, basis) and tibial tendon insertion.病人仰臥位，膝蓋置于半圓柱形物上。用一條繃帶固定髕骨區(qū)。R-SW(R15)應用于髕骨（尖部、底部）及脛骨腱附著端。Supine patient positioning with the knee on a half roll. Fixation of paellar zone with a cuff. Smoothing of adjacent m

27、uscles with D20.病人仰臥位，膝蓋置于半圓柱形物上。用一條繃帶固定髕骨區(qū)。用D20按摩相鄰肌肉。髕骨肌腱炎Patellar tendonitis (Jumpers Knee) 僅使用發(fā)散式?jīng)_擊波療法Only radial shock wave therapy Patellar tendonitis 髕骨肌腱炎Sessi Preliminary ultrasound/ x-ray 前期超聲/X線定位 Marking of therapy region 標記治療區(qū)域脛骨壓力綜合征（脛骨疲勞性骨膜炎）Tibial stress syndrome (Shin splint) ESWT N

28、ew Treatment Guide Preliminary ultrasound/ x-rayTibial stress syndrome 脛骨壓力綜合征Sessions 治療次數(shù)Energy 能級(bar)Pulses/session 每次治療使用脈沖數(shù)Freq 頻率(Hz)Transmitter 探頭Medial, inner edge of shin bone 脛骨內(nèi)緣1. Pain points 痛點6 82.8 3.52000 300015 21R15, DI15Adjacent muscles 相鄰肌肉2. Muscles 肌肉2.0 3.52000 400021D20-S, D

29、35-STreatment interval: 5 - 7 days 治療間隔：5 - 7 天Supine patient positioning with knee on a half roll. R-SW application.病人仰臥位，膝蓋置于半圓柱形物上。使用R-SW。脛骨壓力綜合征（脛骨疲勞性骨膜炎） Tibial stress syndrome (Shin splint)僅使用發(fā)散式?jīng)_擊波療法Only radial shock wave therapy Tibial stress syndrome 脛骨壓力綜合征跟腱痛AchillodyniaPreliminary ultras

30、ound / x-ray 前期超聲/x線定位Marking of therapy region 標記治療區(qū)域跟腱痛Preliminary ultrasound / x-跟腱痛Achillodynia跟腱痛跟腱痛Achillodynia跟腱痛足底筋膜炎Plantar fasciitisPreliminary ultrasound/ x-ray 前期超聲/x線定位Localization of pain points withbio-feedback 根據(jù)人體生物反饋定位痛點Marking of therapy region 標記治療區(qū)域足底筋膜炎Plantar fasciitisPrelimin

31、足底筋膜炎，跟骨骨刺Plantar fasciitis, Heel Spur足底筋膜炎，跟骨骨刺Plantar fasciitis, H足底筋膜炎，跟骨骨刺Plantar fasciitis, Heel Spur足底筋膜炎，跟骨骨刺足底筋膜炎，跟骨骨刺Plantar fasciitis, Heel Spur足底筋膜炎，跟骨骨刺Plantar fasciitis, HPlantar fasciitis 足底筋膜炎Sessions 治療次數(shù)Energy 能級(bar)Pulses/session 每次治療使用脈沖數(shù)Freq 頻率(Hz)Transmitter 探頭Acute and chronic

32、 pain 急性與慢性疼痛1. Pain points 痛點3 - 52.0 3.03000 350012 15R15, DI152. Muscles 肌肉1.8 3.02000 300015 21D20-SAbdominal patient position with foot on a half roll. R-SW (DI15) application. Localization of patients with bio-feedback.病人腹臥們，腳置于半圓柱形物上。使用R-SW(DI15)。利用生物反饋進行痛點定位。Treatment interval: 5 - 7 days 治療

33、間隔： 5 - 7天足底筋膜炎Plantar fasciitis 僅使用發(fā)散式?jīng)_擊波療法Only radial shock wave therapy Plantar fasciitis 足底筋膜炎Session研究Studies研究Improvement %改善度RSW發(fā)散式?jīng)_擊波2 month2個月55.26 month6個月72.912 month12個月84.02000次沖擊波，治療3次，一周一次2000, 3 sessions, 1/ week跟骨骨刺Heel SpurImprovement %改善度RSW發(fā)散式?jīng)_擊波2 m肱骨外上髁炎HERImprovement %改善度Verum沖

34、擊波治療組Control對照組1 week1周73284 weeks4周634852 weeks52周81發(fā)散式?jīng)_擊波，2000次，治療3次，1周1次RSW, 2000, 3 sessions, 1/ week肱骨外上髁炎HERImprovement %改善度Ver肩袖鈣化性肌腱炎Calcific Tendinitis of Rotator Cuff%Pain free 無疼痛感Improvement有明顯改善Unchanged無變化Worse惡化4 weeks 4周25.7 54.314.25.73 month 3個月5014.330.710.76 month 6個月59.325.914.8

35、012 month 12個月80.319.2RSW, 5 sessions, 1/ weekCalcium deposit % 鈣沉積Gone鈣化消失Disintegration分解No Change無變化4 weeks 4周17.620.961.53 month 3個月44.86.948.36 month 6個月65.34.430.412 month 12個月7525RSW, 2000, 3 sessions, 1/ week 發(fā)散式?jīng)_擊波，2000次，治療3次，1周1次肩袖鈣化性肌腱炎Calcific Tendinitis o鈣化性肌腱炎，聚焦式?jīng)_擊波Tendinosis Calcarea

36、, FSWAfter 1 year1年之后反饋Recalcification再鈣化5 %OP骨質(zhì)疏松5 %Resorption骨吸收90 %鈣化性肌腱炎，聚焦式?jīng)_擊波Tendinosis Calca夾擠綜合癥，聚焦式?jīng)_擊波Impingement Syndrome, FSWFollow up追蹤觀察Verum 沖擊波治療組Placebo安慰劑組Mid中期75.4 % good 良好52.3 %Long term長期80.7 %40.9 %夾擠綜合癥，聚焦式?jīng)_擊波Impingement SyndrSports-Induced Diseases1 yearfollow up1年后反饋Achillod

37、ynia跟腱痛Patella tip syndrome髕骨尖綜合征Tibialis anterior syndrome脛前綜合征Pain free 疼痛消失60 %40 %58.8 %Improvement 有改善12.5 %24.4 %17.7 %No change 無明顯變化27.5 %35.6 %23.5 %發(fā)散式?jīng)_擊波，治療5次，1周1次RSW, 5 sessions, 1/ weekSports-Induced Diseases1 yearA肌筋膜疼痛綜合癥Myofascial pain syndrome扳機點治療Trigger point treatment肌筋膜疼痛綜合癥扳機點治

38、療肌筋膜疼痛綜合征Myofascial pain syndrome可用RSWT成功治愈的骨科適應癥 Orthopaedic indications which can be treated successfully with RSWT 上位及低位頸部綜合征Upper and lower Cervical-Syndrome肩周痛Periarticular shoulder pain前臂屈伸肌腱炎Tendomyosis in the extensor and flexor region of the forearm 上踝病變Epicondylopathy背痛Dorsalgia (Back pain

39、)臀肌痛Glutealgia肌筋膜疼痛綜合征Myofascial pain syndro肌筋膜疼痛綜合征Myofascial pain syndrome可用RSWT成功治愈的骨科適應癥 Orthopaedic indications which can be treated successfully with RSWT 內(nèi)收肌疼痛Pain in the adductor muscles 股屈伸肌痙攣Shortenings in the femoral flexor and extensor muscles 小腿筋膜間室綜合征Peroneal compartment syndrome脛前綜合征T

40、ibial anterior syndrome 脛骨壓力綜合征（脛骨疲勞性骨膜綜合征）Tibial stress syndrome (Shin splint)伴有/不伴有跟腱痛的小腿肌肉萎縮Shortening of the calf muscle with and without Achillodynia 跖骨痛Metatarsalgia肌筋膜疼痛綜合征Myofascial pain syndro肌筋膜疼痛綜合征Myofascial pain syndrome治療長度Length of treatment取決于肌肉刺激的持續(xù)范圍和時間Depending on the extent and d

41、uration of the muscle irritation早期疼痛可經(jīng)過1-2次治療成功治愈。Early stage complaints can be treated successfully with 1 - 2 treatments sessions 多數(shù)案例中，痛點的緩解/解除需要4-8次治療（一周12次治療）In most cases several treatment sessions (4 - 8) are required to release/eliminate the pain points (1 -2 treatments / week).建議盡早采用扳機點治療It

42、 is recommended to start trigger point treatment at the most possible early stage肌筋膜疼痛綜合征治療長度取決于肌肉刺激的持續(xù)范圍和時間Dep肌筋膜疼痛綜合征Myofascial pain syndrome 沖擊波治療的優(yōu)點Benefits of shock wave therapy 促進組織再生Strong regenerative effect on the tissue可深入組織治療，而不傷皮膚Penetrate deep inside the tissue without harming the skin

43、因此沖擊波操作方便，易于重復治療。可被大多數(shù)患者接受。Therefore shock wave therapy can be easily repeated and is well tolerated by most patients.肌筋膜疼痛綜合征Myofascial pain syndro 超聲波掃描術(shù)Sonography 給病人提供最安全的治療方案 Gives the patients the most possible treatment safety 可識別不可采用ESWT治療的結(jié)構(gòu)改變（例如腫瘤） Structural modifications which must not b

44、e treated with RSWT (e.g. tumors) will be recognized肌筋膜疼痛綜合征Myofascial pain syndrome 沖擊波治療前的診斷Diagnostics before shock wave therapy 超聲波掃描術(shù)Sonography肌筋膜疼痛綜合征Myofa上位及低位頸部綜合征Upper and lower Cervical-Syndrome 臂痛、背痛、頭痛with brachialgia, dorsalgia and cephalgia 上位及低位頸部綜合征Upper and lower CervTrapezius muscl

45、e 斜方肌 Trapezius muscle 斜方肌Sessions治療次數(shù)Energy 能級(bar)Pulses/session 每次治療使用脈沖數(shù)Freq 頻率(Hz)Trans-mitter 探頭Total pulses / treatment 每療程總脈沖數(shù)1. Pain points 痛點4 81.2 3.04000 - 6000 10 15R15, D20-SPulses / trigger point 每扳機點脈沖數(shù)2. Pain points 痛點1.2 3.0300 - 100010 15R15, D20-SSmoothing muscles over large area

46、 大面積肌肉按摩3. Muscles 肌肉1.2 2.8200010 21 R15, D20-SRecommended treatment: radial. 使用發(fā)散式治療上位及低位頸部綜合征Upper and lower Cervical-Syndrome臂痛、背痛、頭痛with brachialgia, dorsalgia and cephalgiaTrapezius muscle 斜方肌 Trapezius半棘肌/夾肌，C3以下Semispinalis/Splenius muscle, caudal C3 上位及低位頸部綜合征Upper and lower Cervical-Syndro

47、me 臂痛、背痛、頭痛with brachialgia, dorsalgia and cephalgia 半棘肌/夾肌，C3以下Semispinalis/Spleni半棘肌/夾肌，C3以下Semispinalis/Splenius muscle caudal C3 Semispinalis muscle 半棘肌Sessions治療次數(shù)Energy 能級(bar)Pulses/session 每次治療使用脈沖數(shù)Freq 頻率(Hz)Trans-mitter 探頭Total pulses / treatment 每療程總脈沖數(shù)1. Pain points 痛點4 81.2 2.44000 6000

48、 10 15R15, D20-SPulses / trigger point 每扳機點脈沖數(shù)2. Pain points 痛點1.2 2.4300 100010 15R15, D20-SSmoothing muscles over large area 大面積肌肉按摩3. Muscles 肌肉1.2 2.2100010 21R15, D20-SRecommended treatment: Radial 使用發(fā)散性治療上位及低位頸部綜合征Upper and lower Cervical-Syndrome 臂痛、背痛、頭痛with brachialgia, dorsalgia and cephal

49、gia 半棘肌/夾肌，C3以下Semispinalis/Spleni三角肌Deltoid muscle 肩周痛Periarticular shoulder pain 三角肌Deltoid muscle 肩周痛Periartic三角肌Deltoid muscle Deltoid muscle 三角肌Sessions治療次數(shù)Energy 能級(bar)Pulses/session 每次治療使用脈沖數(shù)Freq 頻率(Hz)Trans-mitter 探頭Total pulses / treatment 每療程總脈沖次數(shù)1. Pain points 痛點4 81.2 3.04000 6000 10 15

50、R15, D20-SPulses / trigger point 每扳機點脈沖數(shù)2. Pain points 痛點1.2 3.0300 100010 15R15, D20-SSmoothing muscles over large area 大面積肌肉按摩3. Muscles 肌肉1.2 2.8100010 21R15, D20-SRecommended treatment: Focused and radial. 使用發(fā)散式治療。肩周痛Periarticular shoulder pain 三角肌Deltoid muscle Deltoid muscforearm muscles 前臂肌Se

51、ssions治療次數(shù)Energy 能級(bar)Pulses/session 每次治療使用脈沖數(shù)Freq 頻率(Hz)Trans-mitter 探頭Total pulses / treatment 每療程總脈沖次數(shù)1. Pain points 痛點4 81.2 2.64000 6000 10 15R15, D20-SPulses / trigger point 每扳機點脈沖數(shù)2. Pain points 痛點1.2 2.6300 100010 15R15, D20-SSmoothing muscles over large area 大面積肌肉按摩3. Muscles 肌肉1.2 2.4200010 21R15, D20-SRecommended tr