{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:02:23Z","timestamp":1785841343800,"version":"3.56.0"},"reference-count":77,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,9,22]],"date-time":"2024-09-22T00:00:00Z","timestamp":1726963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFMK"],"abstract":"<jats:p>Background: Chronic lateral epicondylitis (LE), also known as tennis elbow, affects 1\u20133% of the population, primarily those over 40 years old. Most cases resolve with conservative treatments, but some require more advanced interventions. Extracorporeal shockwave therapy (ESWT) has emerged as a non-surgical treatment option, utilizing either low- or high-energy levels to alleviate pain and improve function. Objective: This study aimed to compare the efficacy of low-energy versus high-energy ESWT in the treatment of chronic LE, focusing on pain relief and functional improvement. Methods: A retrospective observational study was conducted including patients treated for chronic LE between 2021 and 2024. Participants were divided into two groups: low-energy ESWT (0.10 mJ\/mm2) and high-energy ESWT (0.20 mJ\/mm2). Both groups received 2400 pulses at a frequency of 6 Hz once a week for three weeks. Pain and functional outcomes were measured using a visual analog scale (VAS) and the Patient-Rated Tennis Elbow Evaluation Questionnaire (PRTEE) at the baseline, three months (T1), and six months (T2) post-treatment. Results: Forty-six patients participated, with 24 in the low-energy group and 22 in the high-energy group. Baseline demographics and clinical characteristics were similar across groups. At T1 and T2, the low-energy group showed significantly greater reductions in the VAS scores (T1: 4.45 \u00b1 0.8 vs. 3.6 \u00b1 1.7, p = 0.04; T2: 3.2 \u00b1 1.2 vs. 2.1 \u00b1 1.1, p = 0.004) and PRTEE scores (T1: 34.3 \u00b1 6.9 vs. 26.8 \u00b1 11.9, p = 0.03; T2: 25.3 \u00b1 6 vs. 17.6 \u00b1 9, p = 0.005). Significant treatment\u2013time interactions were observed for both the VAS and PRTEE scores, indicating sustained improvements in the low-energy group. Conclusions: Low-energy ESWT was more effective than high-energy ESWT in treating chronic LE, providing greater and longer-lasting pain relief and functional improvement. These findings suggest that low-energy ESWT should be preferred in clinical practice for managing this condition. Future research should focus on larger sample sizes and randomized controlled trials to confirm these results and explore the underlying mechanisms of differential efficacy between energy levels.<\/jats:p>","DOI":"10.3390\/jfmk9030173","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T03:36:38Z","timestamp":1727062598000},"page":"173","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["High Versus Low-Energy Extracorporeal Shockwave Therapy for Chronic Lateral Epicondylitis: A Retrospective Study"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2658-4860","authenticated-orcid":false,"given":"Gabriele","family":"Santilli","sequence":"first","affiliation":[{"name":"Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome \u201cForo Italico\u201d, 00135 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Ioppolo","sequence":"additional","affiliation":[{"name":"Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Mangone","sequence":"additional","affiliation":[{"name":"Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Agostini","sequence":"additional","affiliation":[{"name":"Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0204-9831","authenticated-orcid":false,"given":"Andrea","family":"Bernetti","sequence":"additional","affiliation":[{"name":"Department of Biological and Environmental Science and Technologies, University of Salento, 73100 Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Forleo","sequence":"additional","affiliation":[{"name":"Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Cazzolla","sequence":"additional","affiliation":[{"name":"Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8886-0755","authenticated-orcid":false,"given":"Anna Camilla","family":"Mannino","sequence":"additional","affiliation":[{"name":"Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Fricano","sequence":"additional","affiliation":[{"name":"Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Franchitto","sequence":"additional","affiliation":[{"name":"Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome \u201cForo Italico\u201d, 00135 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0354-894X","authenticated-orcid":false,"given":"Samanta","family":"Taurone","sequence":"additional","affiliation":[{"name":"Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome \u201cForo Italico\u201d, 00135 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonello","family":"Ciccarelli","sequence":"additional","affiliation":[{"name":"Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome \u201cForo Italico\u201d, 00135 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0947-9711","authenticated-orcid":false,"given":"Marco","family":"Paoloni","sequence":"additional","affiliation":[{"name":"Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s00590-021-03181-z","article-title":"Lateral epicondylitis of the elbow: An up-to-date review of management","volume":"33","author":"Ahmed","year":"2023","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_2","first-page":"391","article-title":"Lateral epicondylitis of the elbow","volume":"1","author":"Barco","year":"2017","journal-title":"EFORT Open Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.jht.2021.05.005","article-title":"Lateral epicondylosis: A literature review to link pathology and tendon function to tissue-level treatment and ergonomic interventions","volume":"34","author":"Bynum","year":"2021","journal-title":"J. Hand Ther."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1302\/0301-620X.81B5.0810926","article-title":"Extensor carpi radialis brevis","volume":"81-B","author":"Greenbaum","year":"1999","journal-title":"J. Bone Jt. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.jhsa.2013.11.036","article-title":"Joint capsule attachment to the extensor carpi radialis brevis origin: An anatomical study with possible implications regarding the etiology of lateral epicondylitis","volume":"39","author":"Nimura","year":"2014","journal-title":"J. Hand Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1007\/s00256-020-03693-5","article-title":"Practical ultrasonographic technique to precisely identify and differentiate tendons and ligaments of the elbow at the level of the humeral epicondyles: Anatomical study","volume":"50","author":"Omoumi","year":"2021","journal-title":"Skelet. Radiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"131","DOI":"10.3233\/BMR-2012-0328","article-title":"Lateral epicondylitis: A review of the literature","volume":"25","author":"Waseem","year":"2012","journal-title":"J. Back Musculoskelet. Rehabil."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1136\/oemed-2012-101341","article-title":"Self-reported physical exposure association with medial and lateral epicondylitis incidence in a large longitudinal study: Table 1","volume":"70","author":"Descatha","year":"2013","journal-title":"Occup. Environ. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1016\/j.arthro.2019.01.048","article-title":"Is There a Relation Between Lateral Epicondylitis and Total Cholesterol Levels?","volume":"35","author":"Lee","year":"2019","journal-title":"Arthroscopy"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Factor, S., Snopik, P.G., Albagli, A., Rath, E., Amar, E., Atlan, F., and Morag, G. (2023). The \u201cSelfie Test\u201d: A Novel Test for the Diagnosis of Lateral Epicondylitis. Medicina, 59.","DOI":"10.3390\/medicina59061159"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.jht.2021.02.002","article-title":"Diagnostic accuracy of examination tests for lateral elbow tendinopathy (LET)\u2014A systematic review","volume":"35","author":"Karanasios","year":"2021","journal-title":"J. Hand Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.2214\/AJR.10.5769","article-title":"Utility of sonographic measurement of the common tensor tendon in patients with lateral epicondylitis","volume":"196","author":"Lee","year":"2011","journal-title":"Am. J. Roentgenol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1148\/radiol.2371040784","article-title":"Lateral epicondylitis of the elbow: US findings","volume":"237","author":"Levin","year":"2005","journal-title":"Radiology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.jhsa.2010.11.040","article-title":"The reliability and validity of magnetic resonance imaging in the assessment of chronic lateral epicondylitis","volume":"36","author":"Walton","year":"2011","journal-title":"J. Hand Surg. Am."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"227","DOI":"10.5397\/cise.2019.22.4.227","article-title":"Current trends for treating lateral epicondylitis","volume":"22","author":"Kim","year":"2019","journal-title":"Clin. Shoulder Elb."},{"key":"ref_16","first-page":"2038","article-title":"A randomized controlled trial of extracorporeal shock wave therapy for lateral epicondylitis (tennis elbow)","volume":"35","author":"Staples","year":"2008","journal-title":"J. Rheumatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/S0736-0266(03)00104-9","article-title":"Shock wave therapy induces neovascularization at the tendon\u2013bone junction. A study in rabbits","volume":"21","author":"Wang","year":"2003","journal-title":"J. Orthop. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1007\/s00402-008-0663-1","article-title":"Biological effects of extracorporeal shockwave in bone healing: A study in rabbits","volume":"128","author":"Wang","year":"2008","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/j.orthres.2003.10.013","article-title":"Extracorporeal shock waves promote healing of collagenase-induced Achilles tendinitis and increase TGF-beta1 and IGF-I expression","volume":"22","author":"Chen","year":"2004","journal-title":"J. Orthop. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s00441-011-1258-7","article-title":"Extracorporeal shockwave-induced expression of lubricin in tendons and septa","volume":"346","author":"Zhang","year":"2011","journal-title":"Cell Tissue Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Yao, G., Chen, J., Duan, Y., and Chen, X. (2020). Efficacy of extracorporeal shock wave therapy for lateral epicondylitis: A systematic review and meta-analysis. Biomed Res. Int., 2020.","DOI":"10.1155\/2020\/2064781"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1080\/00913847.2019.1599587","article-title":"Shock-wave therapy versus corticosteroid injection on lateral epicondylitis: A meta-analysis of randomized controlled trials","volume":"47","author":"Xiong","year":"2019","journal-title":"Physician Sportsmed."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.2522\/ptj.20110252","article-title":"Extracorporeal shock-wave therapy for supraspinatus calcifying tendinitis: A randomized clinical trial comparing two different energy levels","volume":"92","author":"Ioppolo","year":"2012","journal-title":"Phys. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1016\/j.apmr.2014.01.033","article-title":"Is extracorporeal shock wave therapy clinical efficacy for relief of chronic, recalcitrant plantar fasciitis? A systematic review and meta-analysis of randomized placebo or active-treatment controlled trials","volume":"95","author":"Yin","year":"2014","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1177\/0269215506069244","article-title":"Comparison of different energy densities of extracorporeal shock wave therapy (ESWT) for the management of chronic heel pain","volume":"21","author":"Chow","year":"2007","journal-title":"Clin. Rehabil."},{"key":"ref_26","first-page":"78","article-title":"High-Energy Flux Density Extracorporeal Shock Wave Therapy Versus Traditional Physical Therapy Modalities in Myofascial Pain Syndrome: A Randomized-controlled, Single-Blind Trial","volume":"35","year":"2019","journal-title":"Turk. J. Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e11432","DOI":"10.1097\/MD.0000000000011432","article-title":"High- versus low-energy extracorporeal shock-wave therapy for myofascial pain syndrome of upper trapezius: A prospective randomized single blinded pilot study","volume":"97","author":"Park","year":"2018","journal-title":"Medicine"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Tassinari, R., Cavallini, C., Olivi, E., Facchin, F., Taglioli, V., Zannini, C., Marcuzzi, M., and Ventura, C. (2022). Cell Responsiveness to Physical Energies: Paving the Way to Decipher a Morphogenetic Code. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23063157"},{"key":"ref_29","first-page":"CD005468","article-title":"TNF-alpha inhibitors for ankylosing spondylitis","volume":"4","author":"Maxwell","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Taheri, P., Emadi, M., and Poorghasemian, J. (2017). Comparison the Effect of Extra Corporeal Shockwave Therapy with Low Dosage Versus High Dosage in Treatment of the Patients with Lateral Epicondylitis. Adv. Biomed. Res., 6.","DOI":"10.4103\/2277-9175.207148"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/j.pmrj.2018.05.007","article-title":"Effect of Shockwave Treatment for Management of Upper and Lower Extremity Musculoskeletal Conditions: A Narrative Review","volume":"10","author":"Reilly","year":"2018","journal-title":"PM R"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e088","DOI":"10.5435\/JAAOSGlobal-D-17-00088","article-title":"Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults","volume":"2","author":"Delgado","year":"2018","journal-title":"JAAOS Glob. Res. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1197\/j.jht.2006.10.003","article-title":"Validation of the Patient-Rated Tennis Elbow Evaluation Questionnaire","volume":"20","author":"Rompe","year":"2007","journal-title":"J. Hand Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/S0736-0266(02)00013-X","article-title":"Extracorporeal shock wave therapy for lateral epicondylitis\u2014A double blind randomized controlled trial","volume":"20","author":"Speed","year":"2002","journal-title":"J. Orthop. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"5900","DOI":"10.21608\/ejhm.2023.309946","article-title":"Extracorporeal Shock Wave Therapy versus Local Corticosteroid Injection and Platelet-Rich Plasma in The Treatment of Supraspinatus Tendinopathy","volume":"92","author":"Ganeb","year":"2023","journal-title":"Egypt. J. Hosp. Med."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Testa, G., Vescio, A., Perez, S., Petrantoni, V., Mazzarella, G., Costarella, L., and Pavone, V. (2020). Functional Outcome at Short and Middle Term of the Extracorporeal Shockwave Therapy Treatment in Lateral Epicondylitis: A Case-Series Study. J. Clin. Med., 9.","DOI":"10.3390\/jcm9030633"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.2522\/ptj.20110398","article-title":"Cross-cultural adaptation and measurement properties of the italian version of the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire","volume":"92","author":"Cacchio","year":"2012","journal-title":"Phys. Ther."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"46","DOI":"10.53350\/pjmhs202317546","article-title":"Comparison of Extracorporeal Shockwave and High-Intensity Laser in Treating Chronic Plantar Fasciitis","volume":"17","author":"Riaz","year":"2023","journal-title":"Pak. J. Med. Health Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1057\/jt.2009.5","article-title":"The correlation coefficient: Its values range between +1\/\u22121, or do they?","volume":"17","author":"Ratner","year":"2009","journal-title":"J. Target. Meas. Anal. Mark."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.edurev.2010.12.001","article-title":"Eta squared and partial eta squared as measures of effect size in educational research","volume":"6","author":"Richardson","year":"2011","journal-title":"Educ. Res. Rev."},{"key":"ref_41","unstructured":"(2024, September 17). Available online: https:\/\/shockwavetherapy.org\/wp-content\/uploads\/2024\/01\/ISMST-Guidelines-for-ESWT-_-engl-20240103.pdf."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1177\/02692155211006860","article-title":"Clinical effectiveness of shockwave therapy in lateral elbow tendinopathy: Systematic review and meta-analysis","volume":"35","author":"Karanasios","year":"2021","journal-title":"Clin. Rehabil."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/s00296-023-05525-w","article-title":"Comparative analysis of the therapeutic effects of extracorporeal shock wave therapy and high-intensity laser therapy in lateral epicondylitis: A randomised clinical trial","volume":"44","author":"Sen","year":"2024","journal-title":"Rheumatol. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"84","DOI":"10.3928\/01477447-20100104-09","article-title":"Autologous blood and corticosteroid injection and extracoporeal shock wave therapy in the treatment of lateral epicondylitis","volume":"33","author":"Ozturan","year":"2010","journal-title":"Orthopedics"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1007\/s00167-017-4691-7","article-title":"Does Kinesiotaping improve pain and functionality in patients with newly diagnosed lateral epicondylitis?","volume":"26","author":"Eraslan","year":"2018","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/PHM.0000000000000547","article-title":"Efficacy of radial extracorporeal shock wave therapy on lateral epicondylosis, and changes in the common extensor tendon stiffness with pretherapy and posttherapy in real-time sonoelastography: A randomized controlled study","volume":"96","author":"Yang","year":"2017","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1302\/0301-620X.86B2.14253","article-title":"Extracorporeal shock-wave therapy in the management of chronic soft-tissue conditions","volume":"86","author":"Speed","year":"2004","journal-title":"J. Bone Jt. Surg. Br. Vol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1007\/s00167-012-2009-3","article-title":"ESWT for tendinopathy: Technology and clinical implications","volume":"21","author":"Zwerver","year":"2013","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1016\/j.apmr.2012.02.023","article-title":"Comparative effectiveness of focused shock wave therapy of different intensity levels and radial shock wave therapy for treating plantar fasciitis: A systematic review and network meta-analysis","volume":"93","author":"Chang","year":"2012","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Fatima, A., Ahmad, A., Gilani, S.A., Darain, H., Kazmi, S., and Hanif, K. (2022). Effects of High-Energy Extracorporeal Shockwave Therapy on Pain, Functional Disability, Quality of Life, and Ultrasonographic Changes in Patients with Calcified Rotator Cuff Tendinopathy. BioMed Res. Int., 2022.","DOI":"10.1155\/2022\/1230857"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jse.2007.03.023","article-title":"Extra- corporeal shock wave therapy for calcifying tendinitis of the shoulder","volume":"17","author":"Hsu","year":"2008","journal-title":"J. Shoulder Elbow Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s00256-007-0297-3","article-title":"Extracorporeal shock wave treatment for shoulder calcific tendonitis: A systematic review","volume":"36","author":"Mouzopoulos","year":"2007","journal-title":"Skelet. Radiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1007\/s00256-004-0849-8","article-title":"Extracorporeal shock wave therapy in calcific tendinitis of the shoulder","volume":"33","author":"Peters","year":"2004","journal-title":"Skelet. Radiol."},{"key":"ref_54","first-page":"196","article-title":"Extra- corporal shock wave therapy for calcifying tendinitis of the shoulder","volume":"321","author":"Rompe","year":"1995","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2573","DOI":"10.1001\/jama.290.19.2573","article-title":"Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: A randomized controlled trial","volume":"290","author":"Gerdesmeyer","year":"2003","journal-title":"JAMA"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1302\/0301-620X.89B3.18249","article-title":"High-energy extracorporeal shock-wave therapy for calcifying tendinitis of the rotator cuff: A randomised trial","volume":"89","author":"Albert","year":"2007","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1097\/00003086-200106000-00015","article-title":"Effect of shock wave therapy on acute fractures of the tibia: A study in a dog model","volume":"387","author":"Wang","year":"2001","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"6839","DOI":"10.1016\/j.febslet.2005.11.023","article-title":"Nitric oxide mediates anti-inflammatory action of extracorporeal shock waves","volume":"579","author":"Ciampa","year":"2005","journal-title":"FEBS Lett."},{"key":"ref_59","first-page":"168","article-title":"Ultrasound Measurements of the ECRB Tendon Shows Remarkable Variations in Patients with Lateral Epicondylitis","volume":"8","author":"Keijsers","year":"2020","journal-title":"Arch. Bone Jt. Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1053\/j.ctep.2004.04.008","article-title":"Extracorporeal shock wave therapy: Theory and equipment","volume":"2","author":"McClure","year":"2003","journal-title":"Clin. Tech. Equine Pract."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.arthro.2004.01.002","article-title":"The supraspinatus footprint: An anatomic study of the supraspinatus insertion","volume":"20","author":"Ruotolo","year":"2004","journal-title":"Arthroscopy"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1121\/1.396119","article-title":"Anisotropy of the ultrasonic backscatter of myocardial tissue: II. Measurements in vivo","volume":"83","author":"Madaras","year":"1988","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1177\/016173469802000303","article-title":"Effects of tissue anisotropy on the spectral characteristics of ultrasonic backscatter measured with a clinical imaging system","volume":"20","author":"Holland","year":"1998","journal-title":"Ultrason. Imaging"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1259\/bjr.74.878.740183","article-title":"The use of beam angulation to overcome anisotropy when viewing human tendon with high frequency linear array ultrasound","volume":"74","author":"Connolly","year":"2001","journal-title":"Br. J. Radiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.2106\/00004623-200410000-00013","article-title":"Electrohydraulic high-energy shock-wave treatment for chronic plantar fasciitis","volume":"86","author":"Ogden","year":"2004","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"665","DOI":"10.5535\/arm.2012.36.5.665","article-title":"The effect of extracorporeal shock wave therapy on myofascial pain syndrome","volume":"36","author":"Jeon","year":"2012","journal-title":"Ann. Rehabil. Med."},{"key":"ref_67","first-page":"931","article-title":"Repetitive low-energy shock wave application without local anesthesia is more efficient than repetitive low- energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis","volume":"23","author":"Rompe","year":"2005","journal-title":"J. Orthop. Res."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/0022-4804(90)90109-F","article-title":"Effect of shock waves on the healing of partial-thickness wounds in piglets","volume":"49","author":"Haupt","year":"1990","journal-title":"J. Surg. Res."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Holsapple, J.S., Cooper, B., Berry, S.H., Staniszewska, A., Dickson, B.M., Taylor, J.A., Bachoo, P., and Wilson, H.M. (2021). Low Intensity Shockwave Treatment Modulates Macrophage Functions Beneficial to Healing Chronic Wounds. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22157844"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1007\/s00402-003-0598-5","article-title":"The effects of extracorporeal shock waves on the rat Achilles tendon: Is there a critical dose for tissue injury?","volume":"124","author":"Orhan","year":"2003","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/1471-2474-9-75","article-title":"A systematic review with procedural assessments and meta-analysis of low level laser therapy in lateral elbow tendinopathy (tennis elbow)","volume":"9","author":"Bjordal","year":"2008","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1089\/pho.2012.3240","article-title":"Meta-analysis of pain relief effects by laser irradiation on joint areas","volume":"30","author":"Jang","year":"2012","journal-title":"Photomed. Laser Surg."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1089\/pho.2008.2470","article-title":"Low level laser treatment of tendinopathy: A systematic review with meta-analysis","volume":"28","author":"Tumilty","year":"2010","journal-title":"Photomed. Laser Surg."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1002\/pri.1606","article-title":"The efficacy of low-level laser therapy for shoulder tendinopathy: A systematic review and meta-analysis of randomized controlled trials","volume":"20","author":"Haslerud","year":"2015","journal-title":"Physiother. Res. Int."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"238","DOI":"10.23736\/S0025-7826.22.04048-0","article-title":"Laser and thermal therapy in athletes\u2019 tennis elbow: An observational study","volume":"75","author":"Agostini","year":"2022","journal-title":"Med. Sport"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"e17403","DOI":"10.7717\/peerj.17403","article-title":"Multimodal sensorimotor assessment of hand and forearm asymmetries: A reliability and correlational study","volume":"12","author":"Andersen","year":"2024","journal-title":"PeerJ"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Dom\u00e9nech-Garc\u00eda, V., Pecos-Mart\u00edn, D., Blasco-Abad\u00eda, J., Bellosta-L\u00f3pez, P., and L\u00f3pez-Royo, M.P. (2024). Placebo and nocebo effects of per-cutaneous needle electrolysis and dry-needling: An intra and inter-treatment sessions analysis of a three-arm randomized double-blinded controlled trial in patients with patellar tendinopathy. Front. Med., 11.","DOI":"10.3389\/fmed.2024.1381515"}],"container-title":["Journal of Functional Morphology and Kinesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2411-5142\/9\/3\/173\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:02:08Z","timestamp":1760112128000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2411-5142\/9\/3\/173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,22]]},"references-count":77,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["jfmk9030173"],"URL":"https:\/\/doi.org\/10.3390\/jfmk9030173","relation":{},"ISSN":["2411-5142"],"issn-type":[{"value":"2411-5142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,22]]}}}