def,ok detalle

Historia

Winform Medical Engineering diseña y

fabrica tecnologías médicas para el

mercado de la medicina no invasiva y la

estética desde 1993. Nuestra gama de

productos incluye tecnologías como

láseres , ondas de choque , Ultrasonido

y Tecar se han combinado con la

terapia de fitocompuestos de alta

titulación de origen vegetal.

1993 Nace Studiomed, la semilla

germinal de Winform,fundada por

Franco Pizzochero empresario

milanés e Antonietta Polesello,

empresaria veneciana

2000 Nace Winform, empresa

propiedad del grupo. Se producen

en laboratorios especializados

ifitocompuestos, compañeros

indisolubles de los aparatos

2005 Winform abre su oficina en el

extranjero y síse expande por toda

Europa y el mundo.

2022 Winform presenta

PhormaBeauty , la marca dedicada

al mundo de la estética y

FarmaJALUX , la marca dirigida a

fitocompuestos de alta titulación

para el mercado de medicina de

rehabilitación y medicina estética.

Misión

Nuestra Misión es mejorar el bienestar

psico-físico del individuo : desde hace

30 años diseñamos tecnologías cada

vez más sofisticadas, pero a la vez

accesibles y fáciles de usar, a los que

acudirán acompañar al practicante y al

cliente en el proceso de curación.

Mediante el estudio de la patología

ofrecemos una terapia innovadora,

eficaz pero sobre todo no invasivo ,

manteniendo siempre la atención en la

calidad de vida del cliente.

Winform Ingeniería Médica

Winform Medical Engineering es el

departamento principal de la empresa

que se se especializa en el diseño,

fabricación y comercialización de

dispositivos médicos para los mercados

de rehabilitación y medicina estética.

En el transcurso de 30 años de

Investigación y Desarrollo y

conocimientos técnicos, el equipo

formado por ingenieros, biólogos y

médicos siempre están perfeccionando

tecnologías innovadoras e

desempeñándose, obteniendo

excelentes resultados para sus clientes,

ganando también varias patentes a

nivel europeo.

En los últimos años nacen los

"Métodos": asociaciones de dispositivos

médicos y fitocompuestos

específicamente diseñados para

obtener los mejores resultados en el

campo médico y reducir a la mitad los

tiempos de recuperación y tratamiento.

Winform crea una marca totalmente

dedicada a los fitocompuestos:

FarmaJALUX . Desde el principio del

desarrollo de los primeros dispositivos,

Winform decidió diseñar y crear

diferentes fitocompuestos de alta

titulación, o cremas o geles específicos

para tratamientos concebidos a partir

de un origen vegetal, poniendo a

disposición del profesional todos los

beneficios de los principios activos,

permitiéndote tener una concentrado

de puro bienestar para tu cuerpo.

Winform crea una marca totalmente

dedicada a los fitocompuestos:

FarmaJALUX . Desde el principio del

desarrollo de los primeros dispositivos,

Winform decidió diseñar y crear

diferentes fitocompuestos de alta

titulación, o cremas o geles específicos

para tratamientos concebidos a partir

de un origen vegetal, poniendo a

disposición del profesional todos los

beneficios de los principios activos,

permitiéndote tener una concentrado

de puro bienestar para tu cuerpo.

30 años de experiencias en tus manos

El know-how obtenido en 30 años de

experiencia se pone a disposición en

completamente gratuito

Los practicantes de cualquier nivel

profesional tendrán a su disposición la

literatura electrónica . dispensación

científica para comprender plenamente

las características de cada tecnología. La

academia de formación Winform ,

compuesta por expertos de la industria

como fisioterapeutas, ortopedistas,

médicos deportivos y médicos estéticos,

darán la oportunidad de conocer el lado

práctico y la experiencia acumulada en

décadas de actividad, permitiéndole

acompañar al cliente en el proceso de

curación.

Transdermal delivery

Transdermal delivery is a technique that

allows the transport through the skin of

medium-low molecular weight active

ingredients in the intra and extracellular

spaces, limiting interactions with the

bloodstream.

This route of administration allows a

controlled release of the substance,

that is, the molecule can be made

available for a long period of time, from

a few hours to several days, thanks to

the reserve role played by the

integument.

Any incompatibilities with the active

ingredients of the drug are also

minimized, the potential toxicological

risks associated with the use of more

classic routes of administration (such as

gastro-intestinal or intravenous for

example), the aggression of intestinal

flora associated with the orally use and

the hepatic first pass effect, in which a

large portion of the active ingredient is

absorbed, transported to the liver and

metabolized by the liver enzymes,

inactivating it.

The stratum corneum is the most

superficial one of the skin barriers

against the intake of external material

and constitutes a real obstacle to the

transdermal diffusion of active

pharmacological and cosmetic

principles. Physiologically, only a small

number of molecules with low

molecular weight and high lipophilicity

is suitable to pass through the stratum

corneum (highly hydrophobic), to reach

the treatment target and thus perform

the relevant therapeutic action, while

the majority of hydrophilic molecules

cannot “passively” cross the barrier of

the integument and they remain thus

superficial. Furthermore, if some of

these molecules were able to penetrate

at the epidermal level, they would risk

to be prematurely degraded by the

epidermal enzymes, thus further

reducing their bioavailability.

At the base of these considerations and

of the remark that the cutaneous route

was an innovative means of

pharmacological administration (with

great benefits), over the years several

methods of transdermal delivery of

molecules have been developed. The

research on the first generation of

delivery systems focused primarily on

adapting the physicochemical

properties of drugs to allow their

transcutaneous intake.

The molecules for transdermal delivery

were specifically selected or modified

so that they presented a specific

partition coefficient and a low

molecular weight, to facilitate their

diffusion through the skin barrier.

Regarding the second generation of

delivery systems, they focused on

increasing skin’s permeability to the

drug through the use of chemical

“facilitators” and specific stimulation

means (external conductive forces):

chemical facilitators and emulsions with

nano-carriers allowed the solubilization

of drugs and simplified the permeability

of the drug, while the intervention of

external forces (which used heat,

electricity and non-cavitation

ultrasounds) provided the final

propulsive pulse for the entrance of

macromolecules through the skin.

Third generation research and

developments have adopted slightly

invasive methods in which a

microscopic destruction of the

epidermis (radiofrequency and ablative

lasers, microneedles) was foreseen,

temporarily interrupting the stratum

corneum in some of its portions to

allow penetration of the drug.

The latest generation has focused on

the development of devices for

transdermal assisted delivery, using

machines specifically designed to allow

the maximum adaptation Biological

effects to the tissues of the patients and

personalizing the therapy on the base

of the needs / necessities / pathology

found in the subject (the devices for

delivery of Winform fully fall into this

category).

Among the different transdermal

delivery systems still available on the

market and used in the clinical

environment

(iontophoresis,

sonophoresis, microneedling, ablative

lasers and radiofrequencies) the latest

generation devices optimize the

benefits provided by this method which

are countless:

allows a controlled and

biosustainable (for the organism)

release of the drug;

promotes patient compliance due to

its non-invasiveness and being a

painless method;

it is a good alternative to the

administration of oral or injective

drugs (transmuscular, intravenous,

etc.);

requires lower drug dosages

compared to oral administration;

non-invasiveness allows repeated

administration of the drug on the

same body are in a forecast of

medium and long term treatments;

thanks to a shorter diffusion

pathway to vascular networks, it is

possible to avoid secondary effects

due to digestion and metabolism of

the drug (first pass hepatic

metabolism)

General biological effects

of transdermal delivery

The therapeutic indications vary on the

basis of the active principle that we

choose to convey and on the specific

technology of the device used. The

general actions of transdermal delivery

optimize, in terms of healing and

functional recovery times, the

treatment performances and are

described as follows:

anti-inflammatory action; • analgesic

action;

anti-edema action;

biostimulating action;

decontracting action;

anti-fatigue,draining and

decongestant (venous) action

Transdermal delivery

of Winform

Winform transdermal delivery devices

exploit a patented and unique method

to allow active ingredient molecules to

cross the epidermal layer. For the

success of the treatment it is also

important to carry out a prophylaxis

passage to therapy, that is, the

application on the skin of a specific

product: San C. San C is an ozonized

detergent that allows the removal of

the hydrolipidic film overlying the

stratum corneum, reducing it and

promoting the availability of the active

substance that you want to convey.

During the treatment, the

macromolecules of the active principle

pass through the stratum corneum

moving between the keratocytes thanks

to the thrust induced by the movement

of electrolytic charges in the body. Once

past this outer layer of the skin, the

substance has the ability to penetrate

intracellularly through the transient

opening of the transmembrane

channels.

This occurs because at a period of deep

polarization, by means of a high

frequency signal, a release one follows

to induce the phenomenon of

electroporation of the tissues and

therefore the drug delivery. In addition

to the high frequency carrier current, a

modular current with a frequency of

10Hz also emerges as a result. Winform

“transdermal delivery” treatment

combines the main signal of the deep

endothermic treatment (signal

delivered in packets of pulses) with

appropriate pause periods, which allow

the drug to be conveyed. In addition,

the continuous exchange between the

modulation of the signal and the

moments of rest allow to keep the

opening of the porosities longer. The

transfer efficiency of the molecules of

active principle depends on the

characteristics of the molecule (weight,

size and charge), the characteristics of

the electrical pulse (amplitude,

duration, n° of pulses, frequency) and

the combination with

the diathermic physical principle and its

intrinsic physical characteristics. The

molecules of active principle that do not

pass the cell membrane remain

available at the tissue level in the

dermis (the reserve capacity of the

tegument is exploited) and enter at the

cellular level when the cellular

metabolism requires it, through an

increase in the Na+/K+ pump activity

and relevant opening of specific

channels.

Ultrasound and Diathermy synergy:

Winform method

in the clinical and rehabilitation field

WINFORM device able to deliver,

through synchronous emission, the

therapeutic agents of these three

technological families: • TECAR (biostimulation

and water recovery); •

TRANSDERMAL Delivery (chemical and

pharmacological action); •

ULTRASOUND (metabolic and structural

effect);

This synergy is able to meet major

therapeutic needs in rehabilitation,

orthopaedics, traumatology and sports

medicine, with a view to reducing and

eliminating painful symptoms, restoring

damaged tissues (bio-stimulation) and

obtaining rapid functional recovery

(and, in the case of athletes,

accelerating their return to play). The

treatment is effective and safe not only

for patients but for operators as well

since, thanks to control systems, the

return of excess power to the

handpiece is avoided.

THE COMPOUNDS USED IN PHYSIOTHERAPY

In the following pages we report some notes about the main properties attributed to some functional substances. This information does not

change or supplement the intended use of the device which is precisely defined in the “intended use” section of each manual.

Those information must be regarded as purely informative.

THE NECESSARY MOLECULES

HYALURONIC ACID

Hyaluronic acid is a molecule naturally produced by our body and

present in multiple areas such as skin, cartilage, tendons and

synovial fluid that fills the joint cavities.

It has the functions of lubricating, protecting the cartilage from

mechanical damage and shocks, preventing the entry of viruses and

bacteria, reducing pain and accelerating repair processes.

HYALURONIC ACID

In the joints, the high molecular weight hyaluronic acid acts as a lubricant, absorbs

mechanical stress and creates a spongy matrix that prevents the spread of

inflammatory cytokines and pathogens such as viruses and bacteria.

One of the most important effects of treatments with hyaluronic acid at medium

molecular weight is its protective effect against the cells responsible for the

production and regeneration of cartilage and producing collagen, hyaluronic acid ,

proteoglycans and glycoproteins.

Hyaluronic acid increases cell proliferation because it binds CD44 receptors decreasing

their death by apoptosis.

OZONE

Ozone is used for its proven anti-inflammatory and painrelieving

effect.

In the joint capsule, it can stimulate fibroblastic repair,

promote a new growth of cartilage and induce an

endogenous antioxidant effect, also resulting in an increase

in the supply of oxygen to the tissues.

VITAMIN C

Vitamin C contributes to the normal formation of

collagen useful in the pathologies of the joints for its

chondroprotective or protective effects of articular

cartilage.

Ascorbic acid (vitamin C) is also a useful antioxidant

that, according to researchers, plays an antiinflammatory

role.

HYALURONIC ACID

Hyaluronic acid is a molecule naturally produced by our organism and present in multiple area such as on the

skin, in the cartilage, in the tendons and in the synovial fluid that fills the articular cavities. It has the functions of

lubricating, protecting cartilage from mechanical damage and shocks, prevent the entry of viruses

and bacteria, reduce pain and accelerate repair processes.

In the joints we find hyaluronic acid with high molecular weight:

• acts as a lubricant in the synovial fluid, thus protecting the articular cartilage;

• its dense “net” traps and retains pathogens or proinflammatory molecules;

• binds cell receptors by stimulating the synthesis of new hyaluronic acid.

One of the most important effects of treatments with hyaluronic acid at medium molecular weight is its

protective effect towards the cells responsible for the production and regeneration of cartilage and that produce

collagen, hyaluronic acid, proteoglycans and glycoproteins.

Hyaluronic acid increases cell proliferation because it binds CD44 receptors by decreasing their death by

apoptosis.

OZONE

Ozone is used for its proven anti-inflammatory and painkiller effect.

It is able to stimulate fibroblastic repair in the joint capsule, promote a new growth of cartilage and

induce an endogenous antioxidant effect also leading to an increase in the supply of oxygen to the

tissues.

VITAMIN C

Vitamin C contributes to the forming of new collagen, useful in joints diseases for its protective chondroprotective

effects (i.e. joint cartilage protection).

Ascorbic acid (vitamin C) is also a useful antioxidant that, according to researchers, plays an antiinflammatory

role.

TriJALUX

Trijalux® by Winform, a preparation based on stabilized oxygen-ozone, hyaluronic

acid and vitamin C in a single dose of 3 ml, is conveyed thanks to the device.

1 session per week was performed for three weeks for a total of 3 sessions.

Twenty-six subjects (12 males and 14 females) between 35 and 78 years of age were

observed and found to be suffering from osteoarticular and degenerative tendon

pathologies, both clinically diagnosed and with the helpof ultrasound. Some

assessment of vascularization through a color doppler ultrasound was included as

well.

The extent of pain was assessed by an operator independent from the therapist

who performed the survey, on a semi-quantitative scale of 1 to 4 (none, mild,

moderate, severe) measuring pain at rest, on local palpation, in passive and active

movement. In addition, each subject was evaluated on a visual analogue scale

(VAS) of 0 to 10, where 0 meant no pain when moving and 10 meant unbearable

pain that made movement impossible.

The functional damage was assessed with the Steinbrocker index adjusted to each

activity, that is:

1. Unlimited daily activities.

2. The most demanding jobs are affected and impaired.

3. Daily activity is severely impaired.

4. The patient cannot carry out his or her daily.

The statistical evaluation of the data was done with non-parametric methods since

the distribution was not normal but asymmetrical. Therefore, medians and

percentiles were used for the description of the data.

In addition, the chi² test was used for comparison of proportional data.

RESULTS

Tendinopathies involved epicondylitis, rotator cuff tendinopathies, Achilles tendon

and patellar tendon.

The chronic degenerative forms treated were gonarthrosis, coxarthrosis, and

scapulo-humeral arthrosis. Most of the subjects reported a reduction in pain and

improvement in function at the end of the treatment.

DEVIL’S CLAW

Several properties have been associated with this plant, including the anti-rheumatic one that acts

through the reduction of inflammation and pain associated with it.

MSM (methylsulfonylmethane)

has the characteristic of incorporating and transporting sulfur into the body, a molecule widespread in the

human body and in the articular cartilage. It is therefore believed that its integration can stabilize cell

membranes then slow or stop the loss of damaged cells and induce the stimulation of

cartilage synthesis.

HYALURONIC ACID

acts as a lubricant, dampens mechanical stresses and creates a spongy matrix that prevents the spread of

inflammatory cytokines and pathogens such as viruses and bacteria.

One of the most important effects of hyaluronic acid treatments is its chondro-protective effect.

GLUCOSAMINE

is an important natural precursor of essential components of articular cartilage (proteoglycans and

glycosaminoglycans, GAG), which helps to maintain the cartilage intact. It exist in different forms and

glucosamine sulfate is the most efficient because the sulfate group is essential for the formation of molecular

bonds.

CHONDROITIN SULPHATE

is part of a protein that gives elasticity to cartilage and has the ability to help slow down its rupture and restore

growth to better cushion the joints. This molecule is more effective when used in combination with

glucosamine.

CALENDULA (Marigold)

is a phytohomolecola derived from the flower of a Mediterranean plant widely used for its soothing and

painkiller properties associated mainly with a reduction of inflammation and increased

production of collagen and fibrin.

PHYTIC ACID

has a fundamental role in the treatment of diseases that affect the joints because it allows other active

molecules to act on joints free from mineral deposits and free radicals, responsible, in most,

of the progress and worsening of inflammation. Anti-inflammatory, chondro-protectorive and viscosupplemental

functions are better when the joint has been purified.

The N-FI Method was born to play a supporting and alternative role to joint infiltration:

knee, shoulder and ankle.

The N-FI Method uses pulsed R.F. and the Ultrasonic Pressure Wave as carrier to the

ozonated hyaluronic acid molecules and with stable vitamin C.

The N-FI method in these 2 years has given clinical responses on muscle injuries,

reducing healing times and increasing the quality of healing (no relapses).

In addition, it was applied with excellent results on inflammations, justifying the cost of

EUR 13 per session, against the cost of EUR 1 per session of an anti-inflammatory.

Combate la contractura y la fatiga

muscular. Su formulación lo hace apto

para uso tópico en forma de

automasaje descontracturante y

también para la recuperación tras el

ejercicio físico.

Es un producto en gel a base de

sustancias funcionales de plantas para

usar en combinación con dispositivos

electromédicos para diatermia y

administración transdérmica para

mejorar la suavidad y la conductividad

durante el tratamiento

LA GARRA DEL DIABLO:está indicado

para dolores óseos y musculares,

hematomas, periartritis y tendinitis.

ÁRNICA MONTANA:tiene una acción

descongestionante, analgésica y

antiinflamatoria. EXTRACTOS DE

AGUJA DE PINO PLATA:tienen una

acción relajante muscular.

Ingredientes: agua, dimetilsulfona,

glicerina, alcohol, mentol, aceite de

semilla de ricinus communis, aceite de

soja de glicina, aceite de germen de

zea mays, extracto de harpagophytum

procumbens, extracto de árnica

montana,

extracto de resina de boswellia serrata,

acetato de tocoferilo, palmitato de

retinilo, aceite de semilla de helianthus

annuus , aceite de hoja de ramita de

pinus sylvestris, aceite de hierba de

lavandula angustifolia, goma xantana,

maltodextrina, carbómero, ácido

sórbico, fitato de sodio, tocoferol,

alcohol bencílico, alcanfor, benzoato de

sodio, polisorbato 60, diacetato de

glutamato tetrasódico, sorbato de

potasio, etoxidiglicol, hidróxido de sodio

y potasio , sílice, limoneno, linalol,

geraniol.

Está indicado para contusiones,

contracturas, distensiones y desgarros

musculares. Es un producto en gel a

base de sustancias funcionales de

plantas para usar en combinación con

dispositivos electromédicos para

diatermia y administración

transdérmica para mejorar la suavidad

y la conductividad durante el

tratamiento.

BROMELINA:tiene un efecto analgésico

debido a la capacidad de reducir la

inflamación y el edema de los tejidos.

LA GARRA DEL DIABLO:está indicado

para dolores óseos y musculares,

hematomas, periartritis y tendinitis.

BOSWELLIA:está indicado para

problemas articulares como

reumatismo, artritis reumatoide y

gotosa.


EDTA disódico, sulfato de glucosamina,

alcohol, maltodextrina, triglicérido

caprílico / cáprico, poligliceril-2

dipolihidroxiestearato, lauril glucósido,

extracto de harpagophytum

procumbensnica, bromelina, extracto

de fruta de ananas sativus, extracto de

aceatus, extracto de raíz montana flor

de centella asiática / extracto de hoja /

tallo, pantenol, glicerina,

extracto de resina de boswellia

serrata, tetraisopalmitato de ascorbilo,

extracto de hoja de hedera helix,

extracto de hipérico perforatum,

extracto de flor de caléndula

officinalis, carbómero, ácido cítrico,

alcohol bencílico, mentol, benzoato de

sodio, cloruro de potasio, hidróxido de

sodio , sorbato de potasio, sílice

Producto en gel a base de sustancias

funcionales de plantas para usar en

combinación con dispositivos

electromédicos para diatermia y

administración transdérmica para

mejorar la suavidad y la conductividad

durante el tratamiento.

ÁRNICA MONTANA:tiene una acción

descongestionante, analgésica y

antiinflamatoria. BOSWELLIA:está

indicado para problemas articulares

como reumatismo, artritis reumatoide

y gotosa. LA GARRA DEL DIABLO:está

indicado para dolores óseos y

musculares, hematomas, periartritis y

tendinitis.


laureth-9, alcohol, hidroxipropil guar,

triglicérido caprílico/cáprico, extracto

de harpagophytum procumbens,

extracto de árnica montana, extracto

de corteza de aesculus

hippocastanum, extracto de

helichrysum italicum, glicerina,

pantenol, extracto de flor de caléndula

officinalis,

extracto de boswellia serrata ,

tetraisopalmitato de ascorbilo, goma

xantana, maltodextrina, sorbitol,

sorbato de potasio, diacetato de

glutamato tetrasódico, benzoato de

sodio, alcohol bencílico, ácido cítrico,

cloruro de potasio, sílice

La formulación a base de manzanilla,

hiedra y vid roja favorece la

microcirculación y ejerce una acción

calmante y antioxidante

descontracturante.

Gel profesional de alta titulación para

el tratamiento de edemas y

contracturas y para la recuperación

funcional postentrenamiento o

partido.

MANZANILLA:tiene propiedades

astringentes, reequilibrantes,

antiinflamatorias y calmantes gracias a

las cuales también se puede utilizar

para el tratamiento de pieles sensibles

o con diversos problemas.

HIEDRA:La hiedra es conocida desde

hace mucho tiempo por sus eficaces y

beneficiosas propiedades sedantes,

depurativas y antiespasmódicas.

Ejerce una excelente acción como

anestésico, antineurálgico y calmante,

en particular en caso de hipertensión y

excitación nerviosa, favorece la

recuperación muscular después del

entrenamiento. Por último, la acción

astringente, vasoconstrictora y

antiedema facilita la reabsorción de

los líquidos que se estancan en los

tejidos

VID ROJA:su extracto es rico en

bioflavonoides (antocianidinas y

proantocianidinas), y tiene una intensa

actividad antioxidante y

antiinflamatoria. Su acción más

importante es la tónica y

vasoprotectora, de cuidado del

sistema circulatorio, donde influyen

positivamente en la permeabilidad

vascular, previniendo edemas e

hinchazones.

Ingredientes: agua, propilenglicol,

extracto de flor de chamomilla

recutita, extracto de hoja de hedera

helix, extracto de hoja de vitis vinifera,

cloruro de sodio, carbómero, alcohol

bencílico, deshidroacetato de sodio,

edta disódico, parfum, poligliceril-6

caprilato, poligliceril-4 caprato,

hidróxido de sodio .

N-FI ELECTROPORATIONEVOLUTION

FROM 2006 TO 2021

WINFORM’S STUDIES ON ELECTROPORATION

IN UROLOGY

Idroelettroforesi transdermia nel trattamento della malattia di la Peyronie

A.Gavazzi, T.Cai, N.Mondaini, E.Meliani, E.Sarti, U.Farina, A.Costanzi, F.Melone, R.Bartoletti

Servizio Andrologia, U.O. Urologia, Ospedale S.Maria Annunziata, Università di Firenze

Giornale Italiano di Medicina Sessuale e Riproduttiva, Vol.13, N.52, Giugno 2006

Idroelettroforesi transdermica e vitamina e (Peironimev) nel trattamento della malattia di

La Peyronie: studio osservazionale

A. Gavazzi, N. Mondaini, T. Cai, E. Meliani, E. Sarti, A. Bongini, A. Costanzi, U. Farina, F.Melone, R. Bartoletti (Firenze)

Roma, 22 - 28 settembre 2008, Auditorium Parco Della Musica

Congresso del centenario, Cento anni di Urologia, Cento anni di SIU

IN PHYSIOTHERAPY AND REHABILITATION

Tendinopatia ad evoluzione fibro-calcifica: trattamento conservativo con

l’elettroveicolazione transdermica

Mondardini Dott.Paolo, Tanzi Dott.Riccardo e Verardi Dott.Luciano

Laboratorio di terapia fisica strumentale, Istituto di Medicina dello Sport di Bologna, Centro Interuniversitario di Studi e Ricerche in Medicina

dello Sport.

IN PHYSIOTHERAPY AND REHABILITATION

Sistema endoterapico in associazione al sistema infiltrativo transdermico nel trattamento di traumi distrattivi al

gastrocnemio interno nel calciatore

A.Pastore

Studio medico “Avicenna” Marghera, Venezia, Italia

Congresso Isokinetic 2011

Diatermia con trasferimento trascutaneo di farmaci anti-infiammatori non steroidei nel trattamento delle patologie

muscolo-tendinee da sport

G.P.Ganzit, M.Abano, P.Astegiano

Istituto di Medicina dello Sport FMSI, Turin – Italy

Medicina dello Sport, Vol.67, No.1, Marzo 2014

Ossigeno ozono terapia transdermica, innovazione terapeutica conservativa della retrazione fascia tricipitale e

avampiede.

Studio osservazionale nel runner.

Dr. A. PASTORE, Associazione Medico Sportiva, VENEZIA

Dr. R. CARDELLI, Arcobaleno, Ambulatorio di Fisiochinesiterapia e Terapia Fisica Imola e Castel San Pietro Terme, BOLOGNA

7° CONGRESSO I.S.Mu.L.T. , ROMA, 1-2 Dicembre 2017

IN AESTHETIC MEDICINE

- Trattamento non invasivo del melasma - Utilizzo di un sistema di veicolazione transdermica a rilascio rapido

Sandro Colaiuda, Claudia Capogrossi, Maria Caterina Fortuna, Fabio Colaiuda, Alfredo Rossi Università degli Studi di Roma “La Sapienza”, Dipartimento di

Malattie Cutanee-Veneree e Chirurgia Plastica-Ricostruttiva, Direttore: Prof. Stefano Calvieri 2/2010 hi.tech dermo

- Trattamento non invasivo delle striae rubrae - Sistema di veicolazione transdermica a rilascio rapido

Alfredo Rossi, Fabio Colaiuda, Maria Caterina Fortuna, Paolo Greco, Elisabetta Scali, Alessandro Iorio Università degli Studi di Roma “La Sapienza”, Dipartimento

di malattie cutanee e veneree e chirurgia plastica ricostruttiva, Direttore: Prof.S.Calvieri 5/2010 hi.tech dermo

- Trattamento non invasivo delle rughe del volto - Sistema di veicolazione transdermica a rilascio rapido

Alfredo Rossi, Maria Caterina Fortuna, Fabio Colaiuda, Elisabetta Scali, Paolo Greco, Alessandro Iorio, Victor Desmond Mandel, Valentina Garelli

Università degli Studi di Roma, “La Sapienza”, Dipartimento di malattie cutanee e veneree e chirurgia plastica ricostruttiva, Direttore: Prof.S.Calvieri

6/2010 hi.tech dermo

- Combined Use of Monopolar Radiofrequency and Transdermal Drug Delivery in the Treatment of Melasma

Norma Cameli, MD, PhD, Elva Abril, MD, Maria Mariano, MD, and Enzo Berardesca, MD, PhD* 2014 by the American Society for Dermatologic Surgery, Inc.,

Published by Lippincott Williams & Wilkins, ISSN: 1076-0512, Dermatol Surg 2014;40:748–755 ·DOI: 10.1111/dsu.0000000000000029

SCIENTIFIC LITERATURE

AS REFERENCE ON

ELECTROPORATION

ELECTROPORATION IN THE TREATMENT OF SKIN

CANCER

ELECTROCHEMOTHERAPY

Electrochemotherapy is a new generation technique used in the treatment of benign and

malignant tumors in different body areas.

It involves the combination of two strategies, namely the method of electroporation

combined with the pharmacological treatment of the tumor.

The data collected so far have proved to be very satisfactory, so that it is sometimes used as a

substitute for classical chemotherapy and surgery in the treatment of oncological diseases.

This technique is based, as already mentioned, on electroporation, or the application at local

level of short electrical impulses, which make temporarily and reversibly permeable the

outer membrane (plasma membrane - PM) of the cells.

This promotes the entry into the PM of cytotoxic anticancer drugs, which promote cell

death.

With traditional drug therapy, however, antineoplastic drugs only poorly permeate cells,

and show poor selectivity for malignant cells to healthy cells.

With electroporation applied only locally in the area affected by the tumor, the

penetration of the drug will be selectively higher for neoplasia, with concentrations up to

eight thousand times higher, thus improving the cytotoxic effect limited to the tissues

exposed to the impulses themselves.

In this way the cancerous lesion absorbs more chemotherapy, saving the healthy tissues.

It is therefore easy to understand, that this allows a reduction in doses of medication,

reducing the possibility of side effects and hospitalization. The method works for

both systemically and locally administered drugs.

THE RESULT

The treatment can be repeated several times, and also can be applied to extended areas or

metastases, with success rates around 70%.

It can be performed under both general and local anesthesia, and this flexibility allows it to be

used even for the most delicate clinical cases.

In addition, it is indicated in cases not eligible for surgery for technical reasons (due to the

spread of the disease), but also aesthetic in some facial tumors.

ELECTROPORATION IN THE CREATION OF

GENETICALLY MODIFIED PLANTS

It is used in the creation of genetically modified plants.

These are plants produced by a cell in which a gene from another species (or kingdom) has been

inserted in order to allow them to develop characteristics that they could never spontaneously

acquire (gain or loss of a specific function).

DIRECT GENE TRANSFER WITH CHEMICAL-PHYSICAL

SYSTEMS

Electroporation, through the use of electric current pulses that create transient pores in the plasma

membrane through which DNA can penetrate inside the protoplast.

THE 5 ACTION OF N-FI METHOD

1. The technology plays the role of carrier, completing an intra and extracellular path.

2. The method produces sequentially: edema, inflammation, fibroblast stimulation, myofascial tissue

hydration, modifying the extra cellular matrix.

3. OZONE: reduction of temperature, opening of the microcirculation, antiinflammatory

and vascularizing action, detoxifying action.

4. VITAMIN C: antioxidant and anti-inflammatory action.

5. HYALURONIC ACID with triple molecular weight: lubricates, protects cartilage, reduces pain and

accelerates repair processes.

WINFORM

TECHNOLOGICAL

EVOLUTION

LOW ENERGY ELECTROPORATION

Electroporation acts directly on the skin, transiently increasing the permeability of tissues. This

occurs when in a cell, through an electrical impulse, a transmembrane potential is generated

between 0.5 and 1.5 volts.

The double lipid layer of the cell is subjected to a temporary rearrangement, with the formation of

aqueous channels in the cell membrane, generally called electropores.

This alteration allows the cell membrane to become more permeable to a wide variety of

hydrophilic molecules that, otherwise, would not be able to enter the cell.

Once formed, such electropores remain open for a long period in relation to the pulse length,

typically from a few seconds to minutes.

ELECTROPORATION WITH

CONTACT

RADIOFREQUENCY

MONOPHASIC/ENDOGENOUS

• Tecar CRV

• Tecar BOX THREE

It is not only a matter of pushing the molecules beyond the skin,

but also of preparing the deep tissue to receive them and

spread them optimally (by osmosis and by concentration gradients).

THE BEST CARRIER AND BIOSTIMULANT FOR

JOINT/FIBROCALCIFIC TISSUES

WINFORM OFFERS A UNIQUE AND PATENTED TECHNOLOGICAL SOLUTION

A. A pulsed medium wave R.F. current to use its effect on the gel-sol change of ECM(available

water).

B. A 10 Hz modulated current for the opening of cellular transient channels(electroporation).

C. A pressure wave to use the effect of phonophoresis but, above all, to increase the diffusion of the

molecules carried on the ECM thanks to the mechanical pressure generated.

OBSERVATIONAL STUDY

TRANSDERMAL-CONVEYED OXYGEN OZONE, HYALURONIC ACID AND

VITAMIN C, CONSERVATIVE THERAPEUTIC INNOVATION IN THE

TREATMENT

OF OSTEOARTICULAR AND TENDON PATHOLOGIES.

Dottor P. Cavalieri, Dottoressa A. Brighi, Dottor C. Pezzi, Dottoressa M. Marinelli, M. Rossi

PURPOSE

Presentation of a new innovative therapeutic protocol in the treatment of

osteoarticular and degenerative tendon pathologies through the use of Trijalux®

gelbased solution with transdermal conveyed ozone, hyaluronic acid and vitamin C.

Aimed at the treatment of the aforementioned pathologies, in order to reduce pain

and functional impairment.

INTRODUCTION

The degenerative processes of tendons and articular cartilage are resistant to many forms

of medical and physical treatment.

The restoration of normal function is hindered by the persistence of chronic pain, impaired

movement and the subsequent worsening of its function.

The purpose of the therapy is to reduce pain, inflammation and oedema.

Treatments can be based on heat, cold, electricity, manual therapy, low energy laser

therapy and shock waves.

The effects of controlled energy include an increased extension of collagen tissue, reduced

pain and increased local blood flow.

Generally, diathermy and ultrasound are used to transfer energy into the deeper

layers. These two methods both possess thermal and non-thermal properties. The

latter can trigger cellular and extracellular stimuli in the stages of inflammation and

repair. There are scientific observations that highlight the potential increase in the

activity of fibroblasts and macrophages, an increase in micro-perfusion and cell

permeability in relation to the acoustic beam and cavitation, increase in mast cell

degranulation and release of chemo tactical factors and histamine (Tendon injuries.

Basic science and clinic medicine. Maffulli et al).

The trans-cutaneous transport of molecules has also been used for a

long time, in the attempt to increase efficiency by avoiding the passage

to the gastric level and the first passage to the liver. The application of

appropriate modulated electric currents enhances the diffusion of

molecules through the skin, directly on the site of action, speeding up

the pharmacological kinetics.

The purpose of this work is to take into consideration a series of

subjects with osteoarticular and degenerative insertional tendons

pathologies, in order to evaluate the effectiveness of a method that

includes the use of a device for the simultaneous administration of

diathermy, ultrasound and transdermal delivery of a specific product

based on hyaluronic acid, oxygen ozone and vitamin C.

Figure 1: Comparison of the 25° percentile, median and 75° percentile values of the VAS scale in

active pain

If we look at the final judgment (see table III) we see that none of the subjects

treated deems the treatment poor and therefore ineffective. There are no

statistically significant differences between patient and doctor judgment. The

tolerability of the treatment was judged to be more than satisfactory in 96.15% of

cases.

CONCLUSIONS

The most significant effects of the protocol with WINFORM® TECAR SIN and the

transdermal delivery of Trijalux® are the positive effects of the therapy on the pain

symptom, highlighted by the variations on the VAS scale and the Steinbrocker index. In

addition, an important reduction in pericapsular and peritendinous oedema and an

increase in the flow of pericapsular vessels are highlighted by the ultrasound findings with

power doppler evaluation on 6 patients out of 26, before and after treatment.

We believe that it would be worthwhile to extend research by increasing the

number of cases evaluated with power doppler ultrasound and possibly open a

double blind assay with patients treated with Trijalux® by Winform and patients

treated with a simple conductive gel to confirm the effectiveness of the product

conveyed as opposed to the effect of WINFORM® TECAR SIN.

Ultrasound evaluation of the infiltrative effect and reabsorption of peritendinous

exudate, pretreatment and post treatment (one session only).

Ultrasound of the elbow of an adult man with diagnosis of epicondylitis in which the areas of skin, subcutis

and fascia are taken. The area of the sub-cutis is highlighted by a red frame, while the edema from

the red circle.

From the ultrasound it can be observed that, after treatment, the subcutaneous area has acquired

volume, and the edema has been completely reabsorbed (red circle)

CLINICAL DATA:

“CLINICAL DATA ANALISYS” PROJECT

This project involves numerous physical therapy and pain centers with the aim of

assessing the effectiveness of N-FI treatment expressed in VAS scale (Visual Analogue

Scale) & Risk/Benefit ratio analysis.

The project also involves foreign countries and aims to recruit at least 800 patients

to achieve a value of solid effectiveness.

• Multicentric study: 21 clinics with expansion to centers in EU

• Target: to reach 800 patients

• Purpose: Effectiveness of treatment expressed in VAS scale (Visual Analogue

Scale) & Risk/Benefit ratio analysis

• Therapy: N-FI method (TECARSIN200 or LABTHERAPY & TriJALUX gel)

• Patients: 130 patients from 16 to 90 years old with osteoarticular diseases

• Status: On Going and Recruiting

PROFESSIONAL BASKETBALL PLAYER CDA

EXPERIENCE WITH II DEGREE INJURY

TREATED WITH N-FI

First visit

On 20/09/2021 the report:

RIGHT THIGH MAGNETIC RESONANCE

Diagnostic question: acute pain during sports 2 days ago, since then she refers pain to the third proximal of

the right thigh, anteriorly. Clinical situation unchanged.

Examination carried out by the acquisition of multiplanary sequences using TSE and STIR techniques.

Signal alteration of the muscular belly vast intermediate of right femoral quadriceps with diffused

intramuscular edema and mild intramuscular liquid component with small petechial dots hemorrhagic

microcomponent type, as from lesion of degree II. No lesion of other right femoral biceps muscle bellies. No

marrow edema.

Treatment

METHOD:

5 treatments in total:

1. SHOCKWAVEDUALPOWER by WINFORM + TriJALUX Gel (20/09/2021)

2. TECARSIN2OO by WINFORM + TriJALUX Gel (22/09/2021)

3. SHOCKWAVE DUALPOWER by WINFORM + TriJALUX Gel (24/09/2021)

4. TECARSIN2OO by WINFORM + TriJALUX Gel (27/09/2021)

5. SHOCKWAVE DUALPOWER by WINFORM + TriJALUX Gel (29/09/2021)

Second visit

On 04/10/2021 the report:

RIGHT THIGH MAGNETIC RESONANCE

Diagnostic question: check after 15 days

Examination carried out by the acquisition of multiplanary sequences using TSE and STIR techniques.

At the current control, compared to the previous examination on 20/09/2021, it is no longer present the

alteration of the signal previously reported in correspondence to the muscular belly of the vast right

intermediate. There is currently no muscular edema or other outbreaks of structural alteration of the muscles

of the proximal and intermediate portion of the thigh, bilaterally.

Método N-FI Infiltración sin agujas:

una nueva oportunidad

El envejecimiento progresivo de la

población determina un crecimiento

constante de la pelvis de los pacientes

que padecen patologías osteoarticulares

con las consiguientes dificultades

motoras y síntomas dolorosos crónicos

que impiden, en un porcentaje muy

elevado, incluso la realización de las

actividades cotidianas más sencillas. Del

mismo modo, asistimos al uso de

fisioterapias por parte de un número

cada vez mayor de pacientes a edades

tempranas en función de

una mayor accesibilidad a la atención, más

que de una conciencia de su propia salud.

¿Cuánto vale el mercado de la infiltración?

Un dato realmente interesante se

refiere a la atención de los pacientes

que padecen patologías osteoarticulares

hacia las terapias infiltrativas. Esta

tendencia se destaca inequívocamente

en los informes de algunas importantes

empresas de análisis en el sector

médico. Véase, por ejemplo, el

crecimiento exponencial del mercado de

infiltrantes de ácido hialurónico, con

especial atención a las aplicaciones en

patologías osteoarticulares.

Tamaño del mercado de ácido hialurónico

de EE. UU., por aplicación, 2016 - 2027

(miles de millones de dólares)

Nuevo desarrollo en terapia infiltrativas

Una jeringa una aguja y, por tanto, se

considera una práctica exclusiva del

médico. haciendo posible diseñar

sistemas infiltrativos SIN AGUJA que

ponen el tratamiento al alcance práctica

de relleno Normalmente, por lo que es

la infiltración, se asocia a la

administración de moléculas a través de

la innovación tecnologíca ha permitido

superar el límite impuesto por el uso de

una aguja, también de los especialistas

en rehabilitación. en terapias infiltrativas

Sistema patenteado

La revisión sistemática de los resultados

clínicos obtenidos con nuestros equipos

dispensadores ha permitido a nuestra

empresa desarrollar una nueva

generación de herramientas de

INFILTRACIÓN SIN AGUJA capaces de

hacer posible la aplicación de la

metodología de Infiltración sin aguja N-

FI con unaeficacia nunca antes vista

Como funcionas

patente europea n. 3320951

El MÉTODO N-FI se basa en la acción

sinérgica de varios medios físicos

capaces de interactuar con el tejido

biológico que recibe la terapia,

modificando sus características

fundamentales y preparándolo para

aceptar moléculas especializadas

especialmente formuladas.

La eficacia de este sistema permite

realizar, en pocos minutos, un

tratamiento infiltrativo NO INVASIVO y

completamente INDOLORO. La

información recopilada por la pieza de

mano por contacto es procesada por el

instrumento y puesta a disposición en la

pantalla del operador que puede

evaluar, en tiempo real, los cambios en

los tejidos y la correcta progresión de la

administración (SISTEMA SCE-SIVSEA*). *

atención: el sistema SCE-SIVSEA solo

está disponible en algunos modelos

Sinapsis 2.0 Método articular N-FI

Sinapsi2.0 (Articular N-FI Method) es un

dispositivo que combina ultrasonido, un

láser multilongitud de onda, una tecar

con una electroporación de alta

frecuencia gracias a su pieza de mano

incorporada

La pieza de mano 3CHRONIC combina

una emisión láser multilongitud de onda

(450 nm, 650 nm, 1064 nm) con una

radiofrecuencia de estímulo endógeno

diseñada para transmitir el

fitocompuesto especial TriJALUX Gel a

base de oxígeno Ozono, ácido

hialurónico de triple peso molecular y

Vitamina C específico para articulaciones

y músculos tendinosos

3CHRONIC combina una emisión

Láser multilongitud de onda (450 nm,

650 nm, 1064 nm) con estímulo de

radiofrecuencia endógeno

Terapia Preestablecida con indicador

acústico y luminoso de inicio y fin de

tratamiento

ULTRASOUND ASSESSMENTS

Ultrasound evaluation of infiltrative effect and resorption of peritendinal exudate, pretreatment and posttreatment

(one session only).

Ultrasound of the elbow of an adult man with

diagnosis of epicondylitis in which the areas of

skin, sub-cutis and fascia are taken. The area of

the sub-cutis is highlighted by a red frame, while

the edema from the red circle.

From the ultrasound it can be observed that,

after the treatment, the subcutaneous area has

acquired volume and the edema has been

completely reassorted (red circle).

EVALUATION OF TREATMENT VALUES

After treatment, there is an increase in pericapsular

vascularization.

AFTER THE TREATMENT

After 40 minutes this capillarization

increases. This result is obtained

thanks to the oxygen-ozone

transdermal delivery.

A continuación se resumen las experiencias clínicas recogidas por profesionales

del sector que han utilizado el sistema NFI combinado con TriJALUX Gel.

Trjalux: The use of Needle Free Infiltration in Low Back Pain and

/ or Sciatica:

Bio-Physic-Metric Approach

Center for Physiotherapy, Rehabilitation and

Re-education

• Giovanni Barassi, Maurizio

Panunzio, Antonio Moccia,

Antonio Colombo, Mario

Melchionna

• CeFiRR- Gemelli Molise SpA,

Training Center of the Catholic

University of the Sacred Heart -

SeatRome / Campobasso

• Speaker Dr. Antonio Moccia

BACKGROUND

• Il dolore cervicale e la lombalgia

sono tra i motivi più frequenti

per interpellare un medico

generico o un fisioterapista

nelle cure primarie in Europa

• Neck and low back pain are

among the most frequent

reasons for visiting a general

practitioner (GP) or

physiotherapist in primary care

in Europe

Jordan, K. P. , Kadam, U. T. , Hayward, R. , Porcheret, M. , Young, C. , & Croft, P.

(2010). Annual consultation prevalence of regional musculoskeletal problems in

primary care: An observational study. BMC Musculoskeletal Disorders, 11, 144

10.1186/1471-2474-11-144

• Il carico sostanziale della affezione è

stato mostrato dal più recente studio

Lancet-Global Burden of Disease che

ha evidenziato la lombalgia come la

singola causa più alta di anni vissuti

con disabilità (su 354 condizioni

studiate), con cervicalgia classificata

ottava (femminile) e dodicesima

(maschile)

• The substantial burden of illness

from these conditions was

shown by the most recent

Lancet‐Global Burden of Disease

study which highlighted low

back pain as the single highest

cause of years lived with

disability (out of 354 conditions

studied), with neck pain ranked

eighth (female) and twelfth

(male)

Foster, N. E. , Anema, J. R. , Cherkin, D. , Chou, R. , Cohen, S. P. , Gross, D. P. , Ferreira, P. H. , Fritz, J. M. ,

Koes, B. W. , Peul, W. , Turner, J. A. , & Maher, C. G. ; Lancet Low Back Pain Series Working Group

(2018). Prevention and treatment of low back pain: Evidence, challenges, and promising directions.

Lancet, 391, 2368–2383. 10.1016/S0140-6736(18)30489-6

• Recenti revisioni sistematiche delle linee

guida per la pratica clinica per il dolore

muscoloscheletrico (Lin et al., 2020) e il mal

di schiena (Oliveira et al., 2018; Wong et al.,

2017) miravano a:

• riassumere i trattamenti raccomandati per il

mal di schiena o per cervicalgia.

• Tuttavia, è stata posta meno attenzione sul

miglioramento del processo decisionale e

riabilitativo nelle consultazioni di primo

contatto, sull'identificazione di specifiche

raccomandazioni per sottogruppi di pazienti

definiti dal loro rischio di disabilità

persistenti e sulla potenziale rilevanza, e sul

miglioramento del processo riabilitativo.

• Recent systematic reviews of clinical practice

guidelines (CPGs) for musculoskeletal pain

(Lin et al., 2020), and back pain (Oliveira

et al., 2018; Wong et al., 2017) aimed to

• summarize recommended treatments for

either LBP or neck pain.

• However, less emphasis was placed on

improving decision and rehabilitative making

in first‐contact consultations, identifying

specific recommendations for patient

subgroups defined by their risk of persistent

pain and disability and the potential

relevance, and on improving the

rehabilitative process.

INTRODUCTION

• Le disfunzioni miofasciali e le

deviazioni posturali possono

causare alterazioni delle attività

funzionali, somatiche e

autonome e possono causare

dolore.

• L'alterazione delle informazioni

afferenti può essere compensata

attraverso adattamenti

miofasciali, tissutali e del

sistema nervoso vegetativo.

• Myofascial dysfunctions and

postural deviations can cause

alterations in functional, somatic

and autonomic activities and can

cause pain.

• The alteration of afferent

information can be

compensated through

myofascial, tissue and vegetative

nervous system adaptations.

• Questa situazione può rimanere in

uno stato latente (stimoli subliminari)

per lungo tempo e predisporre a

disfunzioni muscolo-scheletriche

(Trigger Point), in cui i tessuti possono

subire un processo infiammatorio

cronico. In questa situazione i

mediatori dell'infiammazione evocano

il dolore attraverso l'attivazione e la

sensibilizzazione diretta dei

nocicettori, che sono strutture

sensibili al danno tissutale e che sono

costituite sia da fibre C amieliniche

che da fibre Aδ mieliniche che

innervano la pelle, i muscoli, le

articolazioni e gli organi viscerali.

• This situation can remain in a latent state

(sub-liminary stimuli) for a long time and

predispose to musculoskeletal

dysfunctions (Trigger Points), in which the

tissues can undergo a chronic

inflammatory process. In this situation

the inflammatory mediators evoke pain

through the direct activation and

sensitization of nociceptors, which are

structures sensitive to tissue damage and

which consist of both unmyelinated C

fibers and myelinated Aδ fibers that

innervate the skin, muscles , joints and

visceral organs .

Amaya F, Izumi Y, Matsuda M, Sasaki M. Tissue injury and related mediators of

pain exacerbation. Curr Neuropharmacol 2013; 11(6):592-7

Barassi G. et al. Bio-Physico-Metric approach: integrated postural assessment in

musculoskeletal dysfunction: Journal of Biological Regulators and Homeostatic

Agents ›› 2022, Vol. 36 ›› Issue (1) : 129-135. DOI: 10.23812/21-469-L

• Studi recenti hanno dimostrato che il

trattamento specifico di queste aree

somatiche disfunzionali può

migliorare la condizione tissutale,

autonomica e posturale, intesa come

espressività della salute del sistema

corporeo.

• Lo scopo di questo studio è

dimostrare che nelle disfunzioni

miofasciali, la somministrazione locale

di acido ialuronico, ozono e vitamina C

per elettroporazione, sui Key Trigger

Point, fornisce una risposta positiva

sul dolore e sulla postura in generale.

• Recent studies have shown that the

specific treatment of these

dysfunctional somatic areas can

improve the tissue, autonomic and

posture condition, understood as the

expressiveness of the health of the

body system.

• The aim of this study is to

demonstrate that in myofascial

dysfunctions, the local administration

of hyaluronic acid, ozone and vitamin

C by electroporation, on the Key

Trigger Points, provides a positive

response on pain and overall postural

MATERIALS AND METHOD

• Questo studio osservazionale

retrospettivo è stato condotto

presso il Centro di Formazione

Universitaria in Fisioterapia,

Riabilitazione e Rieducazione

(CeFiRR), sede Gemelli Molise

"Università Cattolica" di Roma /

Campobasso-Italia.

• Sono stati selezionati i pazienti

con diagnosi di lombalgia e

sciatica

• This retrospective observational

study was conducted at the

University Training Center for

Physiotherapy, Rehabilitation

and Re-education (CeFiRR),

Gemelli Molise "Univesrità

Cattolica" branch in Rome /

Campobasso-Italy.

• Patients diagnosed with low

back pain and sciatica were

selected:

SAMPLE

• Età media pazienti 49,4 )(deviazione

standard 14.5) (14 femmine e 10 maschi )

• Criteri di inclusione:

• Lombalgia e/o Sciatalgia

• Terapia in atto: Nessuna terapia

Farmacologica antinfiammatoria

• PAZIENTI CHE NON MIGLIORAVANO CON

IL CLASSICO PERCORSO RIABILITATIVO

• Età da 18 a 72 anni

• Criteri di esclusione:

• Malattie oncologiche in atto

• Pacemeker

• Gravidanza

• Patient mean age 49.4) (standard

deviation 14.5) (14 females and 10 males)

• Inclusion criteria:

• Low back pain and / or Sciatica

• Therapy in place: No anti-inflammatory

drug therapy

• PATIENTS WHO DO NOT IMPROVE WITH

THE CLASSIC REHABILITATION PATH

• Age from 18 to 72 years

• Exclusion criteria:

• Oncological diseases in progress

• Pacemeker

• Pregnancy

OPERATING PROCEDURES

• Il singolo trattamento effettuato,

della durata di venti minuti, ha

comportato un'infiltrazione senza

ago di principi attivi (Acido

Ialuronico, Ozono e Vitamina C –

Trjalux: Winform Medical

Engineering - San Donà di Piave-

VE- (Italia) attraverso un

trasduttore piezoelettrico per la

generazione di un'onda di

pressione ultrasonica a 3 Mhz.

Trjalux è un fitocomposto a base di

Acido Ialuronico a triplo peso

molecolare, Ozono e Vitamina C

• The single treatment carried out

lasting twenty minutes, involved a

needle-free infiltration of active

ingredients (Hyaluronic Acid,

Ozone and Vitamin C –Trjalux:

Winform Medical Engineering - San

Donà di Piave-VE- (Italy)-) through

a piezoelectric transducer for the

generation of an ultrasonic

pressure wave at 3 Mhz. Trjalux is

a phytocompound based on triple

molecular weight Hyaluronic Acid,

Ozone and Vitamin C

OPERATING PROCEDURES

• Per aumentare transitoriamente la permeabilità

della membrana cellulare, l'introduzione di pori

transmembrana transitori potrebbe essere

utilizzata sottoponendo la cellula a un campo

elettrico pulsato.

• Questo processo è chiamato elettroporazione o

elettroimpermeabilizzazione.

• Valutazione Bio-Fisica-Metrica T0 (prima della

prima seduta di terapia) -T1 (dopo la prima seduta

di terapia)-T2 (dopo la quinta seduta)

• Sono state effettuate le seguenti misurazioni:

Esame baropodometrico statico e stabilometrico e

scala del dolore VAS e indice mano terra.

• To transiently increase the permeability of the cell

membrane, the introduction of transient

transmembrane pores could be used by subjecting

the cell to a pulsed electric field.

• This process is called electroporation or electrowaterproofing.

• Bio-Physical-Metric Assessment T0 (before the first

therapy session) -T1 (after the first therapy

session)-T2 (after the fifth session)

• The following measurements were made: Static

and stabilometric baropodometric examination

and VAS pain scale and index hand earth(Forward

Bending Test).

OUTCOME MEASURE

• La sintesi dei dati raccolti ci ha permesso di prendere in

considerazione alcuni paramteri prima della applicazione

terapeutica ed alla fine della applicazione terapeutica stessa:

• VAS : dolore soggettivo

• Indice mano terra (in Cm) : la distanza che separa la mano dal

contato con il pavimento nel Forward Bending Test

• Indice Biomeccanico Posturale: che rappresenta la sintesi di

valori oggettivi rilevati alla valutazione stabilometrica

(simmetria del carico podalico,posizionamento del centro di

pressione,Angolo centri di pressione)

• Il centro di gravità (COG) è una componente importante

dell'equilibrio viene spesso misurato con COP (centro di

pressione).

• Il COG dovrebbe essere posizionato al centro della base di

supporto se un individuo ha una postura ideale.

• L'escursione e la velocità del COP sono indicatori del controllo

del COG e sono fattori chiave per identificare una postura

corretta e la capacità di mantenere l'equilibrio.(Lafage et al. -

2008)

• L’indice biomeccanico posturale sintetozza i rapporti tra

questi valori e non dovrebbe superare il valore di 10

• The synthesis of the data collected allowed us to take into

consideration some parameters before the therapeutic

application and at the end of the therapeutic application

itself:

• VAS Scale:

• Floor hand index (in Cm): the distance that separates the

hand from contact with the floor in the Forward Bending Test

• Postural Biomechanical Index: which represents the

synthesis of objective values detected at the stabilometric

assessment (symmetry of the breech load, positioning of the

pressure center, pressure center angle)

• The center of gravity (COG) is an important component of

balance and is often measured with COP (center of pressure).

• The COG should be placed in the center of the support base if

an individual has ideal posture.

• COP excursion and speed are indicators of COG control and

are key factors in identifying correct posture and ability to

maintain balance. (Lafage et al. -2008)

• The postural biomechanical index summarizes the

relationships between these values and should not exceed

the value of 10

• Il trattamento è stato effettuato

dopo aver individuato il Trigger

point Chiave di ogni soggetto

attraverso la valiutazione

biofisco-metrica.posturale.

• In ognoi caso l'area rachidea

interessata dalla patologia

infiammatroia veniva trattata. In

effetti per ogni paziente sono

state somministrate almeno DUE

infiltrazioni senza ago, in punti

differenti.

• The treatment was carried out

after having identified the Key

Trigger point of each subject

through the biophisco-metricpostural

evaluation.

• In each case, the spinal area

affected by the inflammatory

pathology was treated. In fact,

for each patient at least TWO

needle-free injections were

administered at different points.

• RISULTATI

• RESULTS

• Il software Microsoft Excel è

stato utilizzato per il calcolo dei

dati statistici.

• È stata calcolata la media dei

valori, la deviazione standard.

• Microsoft Excel software was

used for the calculation of

statistical data.

• The mean of the values, the

standard deviation, was

calculated.

RESULTS

PATIENTS

Forward Bending Test

t0


t1

VAS

t0

VAS

t1

POSTURAL POSTURAL

BIOMECHA BIOMECHA

NICAL NICAL

INDEX INDEX (PBI)

(PBI) (PBI) (PBI)

t0 t1

PAT 1 26 cm 24 cm 6 4 15 9

PAT 2 22 cm 20 cm 7 2 12 8

PAT 3 19 cm 11 cm 6 4 19 14

PAT 4 5 cm 1 cm 9 2 10 10

PATE 5 10 cm 7 cm 6 2 10 9

PAT 6 10 cm 7 cm 7 4 13 11

PAT 7 25 cm 21 cm 8 6 17 13

PAT 8 23 cm 20 cm 6 2 10 9

PAT9 30 cm 25 cm 7 4 16 12

PAT10 17 cm 10 cm 8 5 17 12

PAT 11 22 cm 17 cm 7 5 14 10

PAT 12 29 cm 27 cm 6 3 20 16

PAT 13 24 cm 22 cm 7 4 13 8

PAT 14 18 cm 16 cm 8 3 12 8

PAT 15 22 cm 20cm 6 2 18 13

PAT 16 15 cm 19cm 5 2 10 8

PAT17 23 cm 20 cm 6 1 10 9

PAT 18 19 cm 16 cm 7 4 14 11

PAT 19 22 cm 29cm 6 4 16 12

PAT 20 14 cm 12 cm 9 3 11 8

PAT21 28 cm 25cm 8 2 15 12

PAT22 19 cm 16 cm 7 3 14 9

PAT 23 22 cm 17 cm 5 1 16 13

PAT 24 28 cm 25 cm 6 2 19 11

35

30

25

20

15

10

5

0

F.B.TEST

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24


t0

21

20

19

18

17

16


t1

F.B. Test –T0- T1-

15

1 2

RESULTS

V.A.S. Scale to-t1

V.A.S. Scale T0-T1

8

10

9

7

8

6

7

6

5

5

4

4

3

3

2

1

2

0

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

1

VAS

t0

VAS

t1

0

1 2

RESULTS

B.P.I

B.P.Iindex

25

16

20

14

12

15

10

10

8

6

5

4

0

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

2

POSTURAL BIOMECHANICAL INDEX (PBI) (PBI)

t0

POSTURAL BIOMECHANICAL INDEX (PBI) (PBI)

t1

0

1 2

DISCUSSIONS

• La letteratura scientifica mostra che l'ozono media i suoi

effetti attraverso specie reattive dell'ossigeno e prodotti

ossidativi della lipoperossidazione, che probabilmente

agiscono in due fasi nei tessuti bersaglio.

• L'acido ialuronico dà origine a compositi molecolari che

occupano un volume enorme e sono responsabili dello stato

gelificante della matrice e della stabilizzazione della struttura

della matrice extracellulare.

• L'acido ialuronico è anche un componente essenziale del

liquido sinoviale, dove svolge un ruolo fondamentale come

lubrificante per le articolazioni

• Più recentemente, la vitamina C ha dimostrato di svolgere un

ruolo importante nella funzione vascolare. L'ascorbato

modula la vasodilatazione aumentando la sintesi di NO o la

biodisponibilità in vari modi

• Il composto chiamato Trjalux è stato utilizzato nelle aree

miofasciali disfunzionali "Key", identificate prima

dell'applicazione dell'elettroporazione e nelle aree vertebrali

lombari con risultati immediati molto incoraggianti.

• Scientific literature shows that ozone mediates its effects

through reactive oxygen species and oxidative products of

lipoperoxidation, which probably act in two phases in target

tissues.

• Hyaluronic acid gives rise to molecular composites that

occupy an enormous volume and are responsible for the

gelling state of the matrix and stabilization of the structure of

the extracellular matrix.

• Hyaluronic acid is also an essential component of synovial

fluid, where it plays a vital role as a lubricant for the joints

• More recently, vitamin C has been shown to play an

important role in vascular function. Ascorbate modulates

vasodilation by increasing NO synthesis or bioavailability in

various ways

• The compound called Trjalux has been used in "Key"

dysfunctional myofascial areas, identified before the

application of electroporation, and in lumbar vertebral areas

with very encouraging immediate results.

DISCUSSIONS

• DAI RISULTATI OTTENUTI CON UNA

SINGOLA APPLICAZIONE POSSIAMO

AFFERMARE CHE:

• IL DOLORE HA AVUTO UN NOTEVOLE

MIGLIORAMENTO

• QUESTO DATO E' STATO AVVALORATO

DALLA DIMINUZIONE DELLA DISTANZA

DELLA MANO RISPETTO AL PAVIMENTO

NEL TEST DI FLESSIONE ANTERIORE

• ED INOLTRA ANCHE L'INDICE

BIOMECCANICO POSTURALE HA

MOSTRATO UN NOTEVOLE

MIGLIORAMENTO AVVICINANDOSI PER

LA MEDIA DEI RISULATI AL LIMITE

MASSIMO DEL VALORE DI NORMALITA'

• FROM THE RESULTS OBTAINED WITH A

SINGLE APPLICATION WE CAN SAY THAT:

• THE PAIN HAS A CONSIDERABLE

IMPROVEMENT

• THIS DATA WAS ENHANCED BY THE

DECREASE OF THE DISTANCE OF THE

HAND COMPARED TO THE FLOOR IN THE

FRONT BENDING TEST

• AND ALSO THE POSTURAL

BIOMECHANICAL INDEX HAS SHOWN A

SIGNIFICANT IMPROVEMENT AS THE

AVERAGE OF THE RESULTS CLOSE TO THE

MAXIMUM LIMIT OF THE NORMALITY

VALUE

CONCLUSIONS

• CONSIDERANO I LIMITI DELLO

STUDIO SICURAMENTE BISOGNA

ANNOVERARE IL FATTO CHE IL

CAMIONE FOSSE PICCOLO

• INOLTRE BISOGNA OCNSIDERARE

CHE I PAZIENTI GIA'

EFFETTUAVANO ALTRE TERAPIE

RIABILITATIVE

• E LA VALUTAZIONE PRIMA E DOPO

UNA SINGOLA SEDUTA NON CI

PERMETTE DI VALUTARE GLI

EFFETTI DEL TRATTAMENTO NEL

PERIODO SUCCESSIVO

• CONSIDER THE LIMITS OF THE

STUDY IT IS DEFINITELY NEED TO

NOTIFY THE FACT THAT THE

SAMPLE WAS SMALL

• ALSO IT IS NECESSARY TO

CONSIDER THAT THE PATIENTS

ALREADY CARRIED OUT OTHER

REHABILITATION THERAPIES

• AND THE EVALUATION BEFORE

AND AFTER A SINGLE SESSION

DOES NOT ALLOW US TO ASSESS

THE EFFECTS OF THE TREATMENT

IN THE FOLLOWING PERIOD

CONCLUSIONS

• POSSIAMO AFFERMARE CON CERTEZZA

CHE LA METODICA TRJALUX INSERITA INN

UN PERCORSO BIO-FISICO-METRICO-

POSTURALE PERMETTERA' IN FUTURO DI

INTEGRARE QUESTO NUOVO PERCORSO

TERAPEUTICO NEI PERCORSI

RIABILITATIVI ESISTENTI

• AUSPICANDO UNA NOTEVOLE

RIDUZIONE DEI TEMPI DI RECUPERO

• UN AUMENTO DELL'EFFICACIA DELLA

RIABILITAZIONE INTEGRATA

• E UN NOTEVOLE RISPARMIO DI COSTI

SOCIALI

• WE CAN SAY WITH CERTAINTY THAT THE

TRJALUX METHOD INSERTED IN A BIO-

PHYSICO-METRIC-POSTURAL PATH WILL

ALLOW IN THE FUTURE TO INTEGRATE

THIS NEW THERAPEUTIC PATH IN

EXISTING REHABILITATION PATHS

• WISHING A SIGNIFICANT REDUCTION IN

RECOVERY TIMES

• AN INCREASE IN THE EFFECTIVENESS OF

INTEGRATED REHABILITATION

• AND A SIGNIFICANT SAVINGS OF SOCIAL

COSTS

Grazie per l’attenzione

Parola al Dr. P. Cavalieri

Thank you for attention

We now move to Dr. P. Cavalieri

È noto a tutti come negli ultimi anni

la terapia fisica, e le apparecchiature

per la terapia fisica, abbiano subito

una notevole innovazione

tecnologica.

Questo fattore di crescita tecnologico

è direttamente proporzionale alla

necessità di ridurre ed accelerare i

tempi di guarigione delle patologie

così dette minori.

It is well-known to all that in recent

years physical therapy, and physical

therapy devices, have undergone a

remarkable technological innovation.

This factor of technological growth is

directly proportional to the need to

reduce and accelerate the healing

time of so-called minor pathologies.

La madre di questa evoluzione in

ambito fisioterapico, fu la Diatermia

Endogena conosciuta ormai a tutti

come TECAR. Da allora ad oggi sono

stati fatti passi da gigante in termini

di sviluppo ed applicazione

soprattutto per merito di tutta la

sperimentazione che è stata fatta,

sperimentazione necessaria per far sì

che oggi nella maggior parte delle

prescrizioni mediche venga indicato:

ciclo di TECAR TERAPIA.

The mother of this evolution in

physiotherapy, was the Endogenous

Diathermy now known to all as

TECAR. Since then, leaps and bounds

have been made in terms of

development and application above

all thanks to all the experimentation

that has been done, necessary

experimentation to ensure that today

in most medical prescriptions is

indicated: cycle of TECAR TERAPHY.

Questo piccolo excursus, solo per

mettere in evidenza, che se la TECAR

è ad oggi contemplata anche nel

prontuario del SSN, è grazie alla

quantità di prescrizioni che vengono

fatte, ed alla sensibilizzazione fatta nel

tempo a Fisiatri ed Ortopedici, senza

però dimenticare che se oggi viene

prescritta in enormi quantità è anche

grazie ai numeri ; numeri che si

traducono in quantità di pazienti

trattati e conseguente guarigione.

This small excursus, just to highlight,

that if TECAR is now also included in

the NHS handbook, it is thanks to the

number of prescriptions that are

made, and to the awareness made

over time to Physiatrists and

Orthopedics, without forgetting,

however, that if today it is prescribed,

it is also thanks to the numbers;

numbers that we can easily translate

into quantities of patients treated and

subsequently healed.

A tal proposito, all’Istituto di

Medicina dello Sport di Torino, i

numeri ci dicono che attualmente la

TECAR TRIJALUX è lo strumento più

efficace nella risoluzione immediata

della sintomatologia dolorosa acuta,

e cronica.

In this regard, at the Sport Medicine

Institute in Turin, the numbers tell us

that currently TECAR TRIJALUX is the

most effective device in the

immediate resolution of acute, and

chronic, painful symptoms.

Da quando abbiamo avuto lo

strumento ad oggi i casi trattati sono

stati 120 pazienti, di tutte le età, di cui

90 maschi e 30 femmine con

patologie che vanno dalla

Lombosciatalgia alla peritrocanterite

alla tendinopatia rotulea, alla

tendinopatia della cuffia dei rotatori

fino alle lesioni muscolari.

N. PAZIENTI / N. OF PATIENTS

Since we had had the device to date,

we treated 120 patients , of all ages, of

which 90 males and 30 females with

pathologies ranging from low back

pain to peritrochanteritis, to patellar

tendinopathy, to tendinopathy of the

rotator cuff and muscle lesions.

30

90

MASCHI / MALE

FEMMINE / FEMALE

È stato interessante notare come con

il sistema N.F.I. la risposta alla

riduzione del dolore soggettivo

venisse ridotto del 40% già in prima

seduta, cosa straordinaria, perché ciò

permette di cominciare più

rapidamente la parte rieducazione

del movimento.

It was interesting to note that with

the N.F.I. system the response to the

reduction of subjective pain was

reduced by 40% already from the first

treatment, which is extraordinary,

because this allows to begin the

re-education part of the movement

more quickly.

Dato che ha fatto sì che il Direttore

Tecnico Fisiatra e specialista dello

Sport e Fisiatra della Squadra

Nazionale di Sci Alpino WC Femminile

inserisse in tutte le prescrizioni la

dicitura: ciclo di TECAR TIJALUX con

Trijalux o Artosikjalux, che sono i

prodotti con i quali abbiamo potuto

ottenere questi risultati.

This lead the Technical Physiatrist

Director, specialized on Sport

Medicine and Physiatrist of the

National Team of Alpine Skiing WC

Women included in all the

prescriptions the words: TECAR

TIJALUX cycle with Trijalux or

Artosikjalux (that are the products

with which we have been able to

achieve these results).

Non nascondo che inizialmente ci sia

stato dello scetticismo nei confronti di

questo nuovo sistema di Tecar da

parte dei Fisiatri, perché

erroneamente la vedevano come

sostitutivo delle infiltrazioni, ma una

volta presa coscienza che questo

sistema, invece si integra

perfettamente al loro campo, hanno

cominciato a prescriverla al posto

della Tecar così detta normale.

I do not hide that initially there was

some skepticism towards this new

Tecar system by the Physiatrists,

because they mistakenly saw it as a

substitute for infiltrations, but once

they realized that this system

integrates perfectly to their field, they

started prescribing it instead of the

so-called standard Tecar.

Ma torniamo ai numeri: 30 pazienti

con tendinopatia rotula, con dolore 9

prima della seduta, al termine della

stessa il dolore riferito era 4 con

conseguente libertà articolare di

movimento, ma il dato più eclatante è

che alla seconda seduta i pazienti

mantenevano il valore raggiunto al

termine della prima seduta cioè 4.

But back to the numbers: 30 patients

with patellar tendinopathy, with pain

9 before the treatment, at the end of

the same reported pain was

decreased to 4 with consequent joint

mobility, but the most striking fact is

that at the beginning of the second

treatment the patients reported the

value reached at the end of the first

session, that was 4.

10

Titolo del grafico

9

5

4 4

0

seduta 0 seduta 1 seduta 2

• 30 pazienti con tendinopatia della cuffia dei rotatori con

dolore iniziale 8 al termine riferivano 4.

• 40 pazienti con Trocanterite con dolore 10 iniziale, al

termine dolore riferito 6.

• 20 pazienti con lesione muscolare di secondo grado,

dolore iniziale 10 dolore riferito al termine 5.

• Questi dati raccolti hanno permesso di orientare le

prescrizioni in direzione della Trijalux .

Pazienti con tendinopatia cuffia rotatori (30)

Patients with tendinopathy rotator cuff (30)

Pazienti con Trocanterite (40)

Patients with Trochanteritis (40)

Pazienti con lesione muscolare II° grado (20)

Patients with second degree muscle injury (20)

Altro (30)

Others (30)

• 30 patients with tendinopathy of rotator cuff with initial

pain 8 at the end reported 4.

• 40 patients with Trochanteritis with initial pain 10, at the

end reported pain 6.

• 20 patients with second degree muscle injury, initial pain

10 reported pain 5 at the end.

• These data allowed us to direct the prescriptions towards

Trijalux .

Prima del trattamento

Before the treatment

Dopo il trattamento

After the treatment

8 4

10 6

10 5

9 4

BIOLOGICAL EFFECTS AND

ULTRASOUND REPORTS

SKIN HYDRATION

We mentioned previously the importance of skin hydration to achieve a good

effectiveness of transdermal delivery. In the deeper layers of the epidermis water is

present at a concentration of 60% and is a fundamental mean of all chemical

reactions.

In the stratum corneum the water content is around 10-15% and is due to the

presence of hygroscopic substances. These substances are able to retain water in

order to give the skin elasticity and softness, while the hydro-lipid film that

surrounds the stratum corneum avoids the loss of water-soluble hygroscopic

substances.

STATE OF THE SKIN

The state of hydration of the skin is very important, as it increases the size of the pores and promotes

the speed of absorption of water-soluble substances.

Hydration involves an expansion of intercheratinic spaces associated not only with a change in the

physical state of the stratum corneum, but also with an increase in the coefficient of diffusion and

activity of the penetrating agent.

The degree of hydration of the stratum corneum depends on the amount of water absorbed by the

layers below.

The double effect of the radiofrequency signal is related to the possibility of attracting water in the subcutis

that will automatically hydrate the upper layers thus favoring, both the passage of molecules

through the stratum corneum, and osmosis in the deeper tissues.

TECAR ACTION ON THE EXTRA-CELLULAR MATRIX

(ECM) OR

CONNECTIVE TISSUE

The extra-cellular matrix represents the free space between the cells and consists

of lacunar liquid and fibres (collagen connective bundles and elastin net). It is

flexible and elastic with the ability to modify enormously its extension and

resistance, related to the variations of its constituents:

• Glycosaminoglycans (GAGs) and proteoglycans (PGs), proteinpolysaccharidecomplexes

with the ability to bind/release huge amounts of water

so to change theconsistency, from hard/elastic (GEL) to semi-liquid (SOL).

• Collagen, shaped as elastic fibres.

• Fibronectin and laminin. In addition to various specialized proteins.

• Water

The proteoglycans are formed by macromolecular chains composed by a central

protein group from which depart many carboxylic arms with negative electrical

sign. The negative charge makes them hydrophilic, that is, they bind water.

The TECAR, by moving very quickly the ionic charges (Brownian motion),

progressively releases the water molecules linked to glycosaminoglycans (GAGs)

and especially to proteoglycans (PGs), allowing them to be available in large

quantities, then by turning the extracellular matrix from the semisolid condition of

GEL (e.g. in chronic inflammation) to the semiliquid one of SOL, fluidizing it but

without significant increase in temperature.

Effect of a low energy tecar (R.F.) application.

On the next page we highlight the effect on ECM using a power of 0.5 watts.

Ultrasound evaluation of a low-energy Tecar

treatment (0.5 watts) in the area of the left

quadratus lumborum muscle.

After the treatment, there is a significant

increase in the water available in the skin layer

and in the surface fascia.

Evaluation after 40 minutes: we may notice that

the amount of water available remains

unchanged.

In addition to the represented high-frequency carrier current, it

emerges as a result of the 90% Duty Cycle pulsed system, also a

modulated current (easily visible at the oscilloscope) with a

frequency of 10 Hz.

All this because, a signal of low frequency that represents the

information to be transferred (example: a 10 Hz frequency current,

apt to open the aqueous cellular channels) can be difficult to transfer

because it can find on its path different electrical resistances and

therefore be absorbed. To avoid this risk, a higher frequency wave is

used, which serves as a support to the wave to be transferred.

All types of modulation are based on a carrier wave which is made to

vary some parameters as a function of a modulating signal.

So, the high frequency used will take the low frequency current to

the depth without having to use electric parameters too high and

harmful to the biological tissue.

2 nd European Congress

Metodica N-FI

Trijalux method

Saturday the 12 th of November 2022

Plantar Fascitiis case report

Dr. Scannavini Paolo

Kinesiologo, Fisioterapista, Master in terapia del dolore

Eziologia

La Fascite è una lesione da over-use, ma a volte può verificarsi

a causa di traumi o condizioni multifattoriali.

Il dolore al tallone ed al centro del piede rappresentano la

sintomatologia più comune.

Il dolore è massimo al mattino, dopo un riposo prolungato, e

successivo ad un utilizzo anche minimo/moderato del piede.

Fattori di rischio predisponenti:

Scarsa dorsiflessione del piede;

Piede cavo o piatto;

Marcata pronazione dinamica;

Attività fisica da impatto;

Calzature improprie rispetto alla reale necessità de piede;

BMI elevato;

Diabete mellito;

Sovratensionamento o debolezza del tendine di Achille e dei

muscoli intrinseci.

Etiology

Fasciitis is an over-use injury, but it can sometimes occur due

to trauma or multifactorial conditions.

Pain in the heel and center of the foot are the most common

symptoms.

Pain is greatest in the morning, after prolonged rest, and

after even minimal / moderate use of the foot.

Predisposing risk factors:

Poor dorsiflexion of the foot

Hollow or flat foot;

Marked dynamic pronation;

Impact physical activity;

Improper footwear with respect to the real needs of the foot;

High BMI;

Diabetes mellitus;

Overexertion or weakness of the Achilles tendon and intrinsic

muscles.

https://www.physiocols.it/caviglia-piede/

Epidemiologia

Epidemiology

• Colpisce tra il 10 ed il 22% della popolazione.

• Obesità e stimoli ripetitivi (jogging) sono la

causa determinante.

• 83% della popolazione colpita è in età

lavorativa tra i 25 ed i 65 anni.

• Rappresenta il 10% di tutte le affezioni del

piede, nei corridori raggiunge una prevalenza

del 22%.

• Rappresenta il 40% delle cure podologiche.

• It affects between 10 and 22% of the

population.

• Obesity and repetitive stimuli (jogging) are

the determining causes.

• 83% of the affected population is on

working age between 25 and 65 years.

• It represents 10% of all foot diseases in

runners (22% prevalence).

• It represents 40% of podiatry treatments.


Linee guida in Physiocols

Physiocols guide lines

• Allenamento della forza dei muscoli intrinseci. (1b)

• Stretching della fascia plantare e del tendine di

Achille. (1b)

• Mobilizzazioni e manipolazioni articolazione della

caviglie e del mesopiede.

• Ionoforesi con acido acetico.

• Ortesi plantari preconfezionate Vs ortesi su misura.

(1b)

• Strength training of intrinsic muscles. (1b)

• Stretching of the plantar fascia and Achilles

tendon. (1b)

• Mobilizations and manipulations of the ankles and

midfoot joints.

• Iontophoresis with acetic acids.

• Pre-packaged insole orthoses Vs custom-made

orthoses. (1b)


Stato dell’arte

State of the art

Fondamentale per comprendere quale strategia

migliore utilizzare per eseguire i trattamenti.

Fundamental to understand which best

strategy to use to perform the treatments.

Conclusioni: abbiamo trovato prove di bassa qualità che le iniezioni locali di steroidi rispetto al placebo o nessun trattamento

possono ridurre leggermente il dolore al tallone fino a un mese ma non successivamente. L'evidenza disponibile per altri

risultati di questo confronto era di qualità molto bassa. Ove disponibile, anche l'evidenza dal confronto delle iniezioni di steroidi

con altri interventi usati per trattare il dolore al tallone e di diversi metodi per guidare l'iniezione era di qualità molto bassa.

Sebbene gli eventi avversi gravi relativi all'iniezione di steroidi fossero rari, questi sono stati sottostimati e non è possibile

escludere un rischio più elevato.

Conclusions: We found low quality evidence that local steroid injections compared with placebo or no treatment may slightly

reduce heel pain up to one month but not subsequently. The available evidence for other outcomes of this comparison was

very low quality. Where available, the evidence from comparisons of steroid injections with other interventions used to treat

heel pain and of different methods of guiding the injection was also very low quality. Although serious adverse events relating

to steroid injection were rare, these were under-reported and a higher risk cannot be ruled out.

Conclusione: il trattamento della fascite plantare cronica con LLLT ed ESWT ha prodotto risultati simili ed entrambi

hanno avuto più successo della terapia ad ultrasuoni nel miglioramento del dolore e negli esiti funzionali.

Conclusion: The treatment of chronic plantar fasciitis with LLLT and ESWT resulted in similar outcomes and both

were more successful than US therapy in pain improvement and functional outcomes.

Conclusione: i risultati del nostro studio suggeriscono che sia ESWT che LLLT sembrano essere efficaci sul dolore,

sulle funzioni del piede e sullo spessore della fascia nel trattamento della PF.

Conclusion: Our study results suggest that both ESWT and LLLT seem to be effective on pain, foot functions, and

fascia thickness in the treatment of PF.

Conclusione: Quando LLLT ed ESWT sono stati combinati con le cure abituali, LLLT si è rivelato più efficace di ESWT

nel ridurre il dolore nella PF al follow-up a breve termine.

Conclusion: When LLLT and ESWT were combined with usual care, LLLT was found to be more effective than

ESWT in reducing pain in PF at short-term follow-up.

Conclusioni: L'LLLT può migliorare il dolore a breve termine e può essere considerato come una componente

della cura dei pazienti con FP. Tuttavia, questa superiorità è scomparsa rispetto alla terapia con onda d'urto

extracorporea.

Conclusions: LLLT may improve pain in the short term and can be considered as a component of care of

patients with PF. However, this superiority disappeared compared to extracorporeal shock wave therapy.

Riepilogo

• Infiltrare cortisone non rappresenta un goal standard;

• Laser terapia ed onda d’urto hanno risultati sovrapponibili in

termini di riduzione del dolore;

• Laser terapia sembra essere più indicata per il trattamento

del dolore a breve termine.

• Onda d’urto sembra essere più indicata per il trattamento

del dolore a lungo termine;

• L’home care (esercizi stretching e di educazione al Pz)

rappresentano una condizione necessaria;

• L’utilizzo di plantari è considerato una opportunità

terapeutica al fine di stabilizzare i risultati ottenuti dal

trattamento fisioterapico;

• I plantari su misura hanno un risultato minore (costo

efficacia) rispetto a plantari industriali nei pazienti affetti da

PF.

Summary

• Infiltrating cortisone is not a standard goal;

• Laser therapy and shock wave have comparable results

in terms of pain reduction;

• Laser therapy appears to be best suited for the

treatment of short-term pain;

• Shockwave seems to be more suitable for the treatment

of long-term pain;

• Home care (stretching exercises and education for the

patient) are a necessary condition;

• The use of insoles is considered a therapeutic

opportunity in order to stabilize the results obtained

from the physiotherapy treatment;

• Custom-made orthotics have a lower result (cost

effectiveness) than industrial orthotics in patients with

PF

La nostra scelta

Our choise

Per questi motivi il nostro

trattamento della Fascite Plantare

prevede l’utilizzo di laser terapia,

onda d’urto, veicolazione di Trijalux,

esercizi di mobilizzazione e stretching

di muscoli intrinseci ed estrinseci, ed

infine il confezionamento di plantari

propriocettivi.

For these reasons, our treatment of

Plantar Fasciitis involves the use of

laser therapy, shock wave, Trijalux

delivery, mobilization and stretching

exercises of intrinsic and extrinsic

muscles, and finally the packaging of

proprioceptive insoles.

Case report: Sabrina

• Età: 51

• Sesso: F

• FP da oltre 3 mesi

• Cassiera di supermarket

• Age: 51

• Gender: F

• PF >3 Month

• Supermarket cashier

Il nostro trattamento

con strumenti Winform

Our treatment with

Winform tools

Laser 3Chronic Winform

2000J Scan FP + T. Acilleo + M. Gastrocnemio

900J Spot da 50J (300J per punto)

LAB Therapy Winform

3 spot 20% 60’’

Scansione 35% 120’’

Laser 3Chronic Winform

2000J PF Scan + AcchilleusT + Gastrocnemius M.

900J Spot of 50J (300J each point)

LAB Therapy Winform

3 spot 20% 60’’

Scan 35% 120’’

Scheda di auto

trattamento

Self treatment

• Esercizi di stretching muscolare;

• Esercizi di stretching fasciale;

• Esercizi di equilibrio statico e

dinamico;

• Esercizi di potenziamento

muscolare.

• Muscle stretching exercises;

• Fascial stretching exercises;

• Static and dynamic balance

exercises;

• Muscle strengthening exercises.

Risultati

Results

Riduzione del dolore totale (100%)

Aumento del benessere percepito 70%

Livello di miglioramento: 170%

Total pain reduction (100%)

Enhancement wellbeing perceived 70%

Improvement level: 170%

VAS ed Indice di Benessere Percepito (IBPS)

VAS and Enancement wellbeing perceved Index (IBPS)

VAS

Dolore

Pain

IBPS

Benessere

Wellbeing

t0 = 7 t1 = 0 t0 = 3 t1 = 10

0

(-)10 (+) 10

100% 70%

Experiencias clínicas

Trattamento Epicondilite

con metodo

TriJALUX di Winform

Valutazione ecografica dell’infiammazione

e del flusso ematico

Epicondylitis treatment with

TriJALUX method by

Winform

Ultrasound evaluation of inflammation and

blood flow

CASE STUDY

Winform Medical Engineering CASE STUDY May 2021

Trattamento Epicondilite con metodo

TriJalux di Winform

Valutazione ecografica dell’infiammazione e del flusso ematico

Epicondylitis treatment with

Trijalux method by Winform

Ultrasound evaluation of inflammation and blood flow

CASE STUDY

Introduzione

Cosa è l’epicondilite?

È una patologia degenerativa infiammatoria comune e

molto spesso viene sottovalutata in quanto nelle fasi

iniziali non è molto dolorosa. Tuttavia, l’epicondilite

è spesso invalidante e sarebbe necessaria una

valutazione clinica e diagnostica molto rigorosa in

modo da intervenire in modo adeguato e in tempi

brevi, senza trascurare la patologia.

L’epicondilite è causata da molti e frequenti microtraumi

o, più raramente da un singolo evento traumatico.

Il sovraccarico funzionale è uno dei fattori che facilitano

lo sviluppo della patologia.

È caratterizzata da dolore al gomito e può estendersi

ai muscoli dell’avambraccio e aumentare in caso di

estensione di mano e polso.

Cosa è TriJALUX

TriJALUX è un dispositivo medico in gel a base di Acido

Ialuronico a triplo peso molecolare, Ozono e Vitamina

C, con le seguenti note sulle proprietà:

• L’ACIDO IALURONICO è una molecola

naturalmente prodotta dal nostro organismo e

presente in molteplici distretti come sulla pelle,

nelle cartilagini, nei tendini e nel liquido sinoviale

che riempie le cavità articolari. A livello delle

articolazioni, l’acido ialuronico ha le funzioni di

lubrificare, proteggere la cartilagine dai danni

meccanici, ammortizzare i movimenti, impedire

l’ingresso di virus e batteri, ridurre il dolore e

accelerare i processi riparativi. Tali proprietà sono

dovute alla sua elevata polarità che lo porta a

legare e trattenere grosse quantità d’acqua.

• L’OZONO è utilizzato per il suo comprovato

effetto antinfiammatorio e antidolorifico. L’ozono,

Introduction

What is epicondylitis?

It is a common inflammatory degenerative disease

and is very often underestimated because in the early

stages it is not very painful. However, epicondylitis

is often disabling and a very rigorous clinical and

diagnostic evaluation would be necessary to intervene

adequately and quickly, without neglecting the disease.

Epicondylitis is caused by many frequent microtraumas

or, more rarely, by a single traumatic event.

Functional overload is one of the main factors that

facilitate the development of the disease.

It is characterized by elbow pain that can extend itself

to the muscles of the forearm and increase in case of

extension of the hand and wrist.

What is TriJALUX

TriJALUX is a medical device in gel based on Hyaluronic

Acid with triple molecular weight, Ozone and Vitamin

C, known for the following properties:

• HYALURONIC ACID is a molecule produced

naturally by our body and present in many areas

such as on the skin, cartilage, tendons and synovial

fluid that fills the joint cavities. It has the function

of lubricating, protecting the cartilage from

mechanical damage and shocks, preventing the

entry of viruses and bacteria, reducing pain and

accelerating repair processes. These properties are

due to its high polarity that leads it to bind and

retain large quantities of water.

• OZONE is known for its proven anti-inflammatory

and pain-relieving effect. In the joint capsule, it is

able to stimulate, promote new growth of cartilage

and induce an endogenous antioxidant effect, also

www.winform.it


inoltre, ha la capacità di modulare l’infiammazione

e nella capsula articolare è in grado di stimolare

la riparazione fibroblastica, favorire una nuova

crescita della cartilagine e indurre un effetto

antiossidante endogeno determinando anche

un aumento dell’apporto di ossigeno ai tessuti

attraverso un’azione basata sulla vasodilatazione e

stimolazione di nuovi vasi.

• La vitamina C contribuisce alla normale formazione

del collagene utile nelle patologie delle articolazioni

per i suoi effetti condroprotettivi ovvero di

protezione della cartilagine articolare. È anche

un utile antiossidante che, secondo i ricercatori,

svolge un ruolo antiinfiammatorio.

Obiettivi

Si vuole verificare, tramite valutazione dei diametri

tissutali e del flusso ematico l’effetto dei componenti

aggiuntivi al gel conduttivo. Gli effetti desiderati

sono un aumento del flusso ematico provocato dalla

vitamina C e dall’ozono e riduzione dell’edema o

essudato infiammatorio.

Obiettivo secondario è verificare l’effetto infiltrativo del

gel provocato da ShockWave Dual Power di Winform.

Risultati

Dall’analisi ecografica post trattamento si può

osservare che i valori del tessuto sottocutaneo sono

notevolmente aumentati per un importante effetto

infiltrativo della macchina e che si è ridotto sia l’edema

pericapsulare e peritendineo che muscolare.

Dall’ecografia post trattamento si può anche osservare

un aumento della vascolarizzazione rispetto al

pretrattamento.

40 min dopo il termine del trattamento, il liquido che si

era infiltrato nella zona sottocutanea ha passato la fascia

e permane la riduzione sia dell’edema pericapsulare

che di quello peritendineo.

I diametri tissutali dopo circa 40 minuti dalla fine

del trattamento con ShockWave Dual Power sono

più evidenti e delineati, segno di minor essudato

infiammatorio. Incrementa la vascolarizzazione dei

tessuti visibile in ecografia passati 40 minuti.

determining an increase in the oxygen supply to

the tissues through an action based on vasodilation

and stimulation of new vessels.

• Vitamin C contributes to normal formation of

collagen useful in joint pathologies due to its

chrondroprotective effects, i.e. to protect the joint

cartilage. Ascorbic acid (Vitamin C) is also a useful

antioxidant which, according to the researchers,

plays an anti-inflammatory role.

Objectives

We want to verify, through the evaluation of tissue

diameters and blood flow, the effect of additional

components to the conductive gel. The desired effects

are an increase in blood flow caused by Vitamin C and

Ozone and a reduction of the edema or inflammatory

exudate.

The secondary objective is to verify the infiltrative

effect of the gel caused by Winform’s ShockWave Dual

Power.

Results

From the ultrasound analysis after the treatment we

can observe that the values of the subcutaneous tissue

are remarkably increased for an important infiltrative

effect of the device. We can also notice a reduction of

the pericapsular and peritendinous edema.

Post-treatment ultrasound shows also an increase in

vascularizations compared to the evaluation made

before the treatment.

40 minutes after the end of treatment, the liquid that

infiltrated the subcutaneous area has passed the fascia.

The reduction of both pericapsular and peritendinous

edema persists.

The tissue diameters after about 40 minutes from the

end of treatment with ShockWave Dual Power are

more evident and outlined, a sign of less inflammatory

exudate.

An increased tissue vascularity is visible too in

ultrasound made after 40 minutes from the end of the

treatment.

www.winform.it


Valutazione dell’effetto infiltrativo di TriJALUX

Ecografia del gomito destro di un uomo adulto con

diagnosi di epicondilite in cui vengono riprese zone di

cute, sottocute e fascia.

Sono state indicate dal riquadro rosso la zona del

sottocute e l’edema dal cerchio rosso.

Evaluation of the infiltrative effect of TriJALUX

Ultrasound of the right elbow of an adult man with

epicondylitis in which we can clearly recognize skin,

subcutis and fascia.

The subcutaneous area is highlighted by a red frame,

while the edema is highlighted by a red circle.




L’ecografia è stata rilevata DOPO il trattamento con

TriJALUX.

Dall’ecografia si può osservare che la zona del sottocute

è aumentata di spessore per l’effetto infiltrativo della

macchina e per l’aumento dell’acqua disponibile. Si

osserva anche che si è fortemente ridotto l’edema

(cerchio rosso).




Ultrasound carried out AFTER a treatment with

TriJALUX gel.

We can be observe that the subcutaneous area

increased its thickness due to the infiltrative effect of

the device and thanks to the increase of the available

water. We can notice also a remarkable reduction of

the edema (red circle).

www.winform.it





L’ecografia è stata rilevata 40 MINUTI DOPO il

trattamento con TriJALUX.

Dall’ecografia si può osservare che la zona del sottocute

non ha perso volume e l’edema è stato completamente

riassorbito (cerchio rosso).




Ultrasound carried out 40 MINUTES AFTER the end

of a treatment with TriJALUX gel.

We can observe that the subcutaneous area has not

lost volume and the edema has been completely

reabsorbed (red circle).

Valutazione ecografica del flusso ematico


diagnosi di epicondilite.

L’ecografia è stata rilevata PRIMA del trattamento con

TriJALUX.

Dall’ecografia non si rileva un flusso ematico.

Ultrasound evaluation of blood flow


epicondylitis.

Ultrasound carried out BEFORE the treatment with

TriJALUX gel.

The image shows no blood flow in the area.

www.winform.it




L’ecografia è stata rilevata DOPO il trattamento con

TriJALUX.

Dall’ecografia si osserva un aumento del flusso ematico.


epicondylitis.

Ultrasound carried out AFTER a treatment with

TriJALUX gel.

We can observe the appearance of blood flow in the

area.



L’ecografia è stata rilevata 40 MINUTI DOPO il

trattamento con TriJALUX.

Dall’ecografia si osserva un aumento del flusso ematico

rispetto alla rilevazione svolta subito dopo il termine

del trattamento.


epicondylitis.

Ultrasound carried out 40 MINUTES AFTER the end

of a treatment with TriJALUX gel.

The ultrasound shows an increase in blood flow

compared to the one made immediately after the end

of the treatment.

Conclusioni sui risultati ottenuti

Questa esperienza clinica sommata all’esperienza

pregressa sui casi di epicondilite trattati con la

metodica ShockWave Dual Power di Winform Medical

Engineering e gel a base dei tre principi attivi ozono,

acido ialuronico e vitamina C (TriJALUX) permettono

di considerare efficace tale protocollo per la cura della

patologia.

Conclusions

This clinical experience, combined with previous

experience on cases of epicondylitis treated with

ShockWave Dual Power by Winform Medical

Engineering and a gel based on the three active

ingredients (Ozone, Hyaluronic Acid and Vitamin C [i.e.

Trijalux]) allows to consider effective such protocol for

the treatment of the disease.

www.winform.it

VII CONGRESO ISMu.LT.

ROMA, 1-2 de diciembre de 2017

OZONOTERAPIA CON OXÍGENO TRANSDÉRMICO, INNOVACIÓN TERAPÉUTICA

CONSERVADOR DE LA RETRACCIÓN DE LA BANDA TRÍCEPS Y ANTEPIE.

ESTUDIO OBSERVACIONAL EN EL CORREDOR

Dr. A. PASTORE, Asociación de Medicina del Deporte, VENECIA

Dr. R. CARDELLI, Arcobaleno, Clínica de Fisioquinesioterapia y Fisioterapia ( roberto.cardelli@ambulatorioarcobaleno.it )

Imola y Castel San Pietro Terme, BOLONIA

Metas

Presentación de un innovador protocolo terapéutico sobre la fascia del tríceps y la retracción del antepié mediante el uso de oxígeno-ozono y gel de

ácido hialurónico, utilizando el método Tecarsin (Winform®) que prevé el uso sinérgico y la cuantificación de la tecarterapia, el suministro

transdérmico y la onda de presión.

Introducción

La molécula de oxígeno-ozono mejora la circulación y la oxigenación de los tejidos y ayuda a interrumpir la cascada bioquímica

proinflamatoria que se forma en los procesos inflamatorios.

La acción terapéutica de la molécula de ozono ha sido ampliamente estudiada: activa procesos metabólicos, estimula los procesos inmunitarios

actuando sobre citocinas y macrófagos.

Utilizado en combinación con el ácido hialurónico, potencia su efecto lubricante.

La entrega transdérmica permite que los principios activos lleguen directamente al lugar de acción, acelerando la cinética farmacológica e

interactuando lo menos posible con la circulación sistémica: la entrega de las sustancias es inducida por la estimulación tisular gracias a:

a.

b.

C.

el realineamiento de las cargas polares,

la modificación del potencial transcutáneo,

el aumento de la permeabilidad celular.

Gracias a una transferencia de energía profunda o superficial que explota una radiofrecuencia de 480 KHz con efecto diatérmico, la

tecarterapia es capaz de actuar sobre el potencial de las membranas celulares lo que favorece los intercambios iónicos por

ósmosis, estimulando el metabolismo celular y por tanto acelerando los procesos reparadores, bioestimulación debido al aumento

de la estimulación intracelular (ADP en ATP) y consecuente mayor consumo y demanda de oxígeno y nutrientes. Además, estimula

el sistema circulatorio hemolinfático, la activación de la microcirculación induce una pronta proliferación de nuevas células capaces

de reparar cualquier daño fibrilar en músculos, tendones y otros tejidos conectivos, junto con la rápida reabsorción de edemas.

La onda de presión generada al explotar ultrasonidos a una frecuencia de 3MHz con picos de alta potencia, determina modificaciones de las estructuras

proteicas, formación de radicales libres, variaciones en la permeabilidad de las membranas celulares, así como una remoción de las fibras de colágeno con una

reducción de la adhesión entre las células (efecto fibrolítico).

Materiales y métodos

El Dr. A. Pastore introdujo a 10 pacientes corredores en el protocolo, que preveía este tipo de cribado:

• Test de Filkenskiold: medición del ángulo de flexión del tobillo con un goniómetro, documentado con fotografías.

• Evaluación del paciente de pie, flexionando las piernas por encima de las rodillas a 90° en los dedos de los pies sin levantar los talones, para

verificar la retracción de la fascia del tríceps y el rango de movimiento del dedo gordo del pie.

• Dolor EVA de 1 a 10.

• Evaluación diagnóstica por imagen con ultrasonido.

1.

2.

Protocolo de tecarsina (Winform®)

Preparar una mezcla, a partes iguales, de gel de oxígeno "Life Gel" (Winform®) y Gel Hialurónico Win (Winform®)

Haga que el paciente se acueste en decúbito prono

Fascitis plantar T. flexor largo 1er dedo del pie izquierdo - corredor

3. Las áreas a tratar son las siguientes : a.

planta del pie (aponeurosis plantar)

b. tendón de Aquiles

C. tríceps sural

4.

5.

6.

7.

8.

9.

10

11

12

13

14

15.

dieciséis.

17

18

Limpiar la primera zona a tratar (aponeurosis plantar) con detergente ozonizado SAN C

Extender un velo de la mezcla de gel Oxygen "Life Gel" (Winform®) y Gel Hialurónico Win (Winform®) sobre la zona a

tratar

Utilizar pieza de mano 25/55 mm - sin placa neutra

Configure el dispositivo:

a.

b.

C.

Realizar un masaje longitudinal hasta dispensar los Joules configurados. Una vez

finalizado el parto, proceder al tratamiento del tendón de Aquiles:

Limpiar la primera zona a tratar con detergente ozonizado SAN C

Extender un velo de la mezcla de Oxygen Life Gel y Win Jaluronico Gel sobre la zona a tratar

Utilizar pieza de mano 0 25/55 mm - sin placa neutra

Configurar el dispositivo a.

b.

C.


finalizado el parto, proceder al tratamiento del tríceps sural.


Extender un velo de Demusco Gel (Winform®)



a.

b.

C.

Programa P3 - 7,5 vatios

8.000 J/cm2

SIVSEA: 50%


4.000 J/cm2

SIVSEA: 30%


8.000 J/cm2

SIVSEA : 50% - 60%

Realizar un masaje longitudinal hasta dispensar los Joules configurados

FRECUENCIA: cada 2 - 3 días

Nº TOTAL DE SESIONES: 4 - 6 sesiones

TOTAL JULIOS A ADMINISTRAR: 20.000 J/cm2

Conclusiones

Se destaca, según hallazgos ecográficos con evaluación power doppler, que este método asociado es eficaz en la recuperación de la fibrosis

responsable de la retracción fascial. El efecto sobre el dolor de lo que surge de la evaluación en la escala EVA es excelente.

Hay que decir que, deliberadamente en este protocolo, no se asoció ninguna técnica kinesiológica en el período de tratamiento que

probablemente habría contribuido a una mayor recuperación funcional.

Somos de la opinión de que vale la pena profundizar en la investigación asociando el método a una vía de reprogramación propioceptiva

útil para mantener y optimizar el resultado obtenido.

Bibliografía

1. P. Mondardini, R.Tanzi, L.Verardi, S.Briglia, A.Maione, E.Drago. "Nuevas metodologías en el tratamiento de la patología muscular traumática del

deportista", Ediciones Minerva Medica, Turín 2003

2. S. Colaiuda, C.Capogrossi, MCFortuna, F.Colaiuda, A.Rossi. - Universidad de Roma "La Sapienza" departamento de enfermedades venéreas de la piel y cirugía

plástica-reparadora Director Prof. Stefano Calvieri. "Tratamiento no invasivo del melasma, uso de un sistema de liberación transdérmica de liberación rápida",

publicado en Hi Tech Dermo, Milán, febrero de 2010.

3. Nirja, Pawan Jalwal, Jyoti Saini, Mamta, Ritu. Revista Internacional de Investigación Profesional Farmacéutica. “Formulación y evaluación del sistema de administración

transdérmica de fármacos para ibuprofeno”, vol. 4, número 2, abril de 2013.

4. Velius Bocci. "Oxigeno-ozonoterapia", Comprensión de los mecanismos de acción y posibilidades terapéuticas. Editorial Ambrosiana, 2000.

control evolutivo

2º Congreso Internacional de Imagen Funcional IWBIS en músculo esquelético

aplicaciones

ESTUDIO PRELIMINAR DEL TRATAMIENTO DEL EDEMA RESPIRADO

SUBCUADRICIPAL CON DISPOSITIVO DE TERAPIA SIN;

EVALUACIÓN POR ULTRASONIDO DINÁMICO


Metas

Presentación de un innovador protocolo terapéutico sobre el edema del colapso del subcuádriceps, utilizando el método Tecarsin

(Winform®) que prevé el uso sinérgico y la cuantificación de la tecarterapia, el suministro transdérmico y la onda de presión.

Introducción

Gracias a una transferencia de energía profunda o superficial que explota una radiofrecuencia de 480 KHz con efecto diatérmico, la

tecarterapia es capaz de actuar sobre el potencial de las membranas celulares lo que favorece los intercambios iónicos por

ósmosis, estimulando el metabolismo celular y por tanto acelerando los procesos reparadores, bioestimulación debido al aumento

de la estimulación intracelular (ADP en ATP) y consecuente mayor consumo y demanda de oxígeno y nutrientes. Además, estimula

el sistema circulatorio hemolinfático, la activación de la microcirculación induce una pronta proliferación de nuevas células capaces

de reparar cualquier daño fibrilar en músculos, tendones y otros tejidos conectivos, junto con la rápida reabsorción de edemas.

La onda de presión generada al explotar ultrasonidos a una frecuencia de 3MHz con picos de alta potencia, determina modificaciones de las estructuras

proteicas, formación de radicales libres, variaciones en la permeabilidad de las membranas celulares, así como una remoción de las fibras de colágeno con una

reducción de la adhesión entre las células (efecto fibrolítico).

Protocolo terapéutico

El Dr. A. Pastore introdujo a 8 pacientes en el protocolo, que preveía este tipo de cribado:

• Evaluación ecográfica diagnóstica previa al tratamiento.

• Evaluación ecográfica diagnóstica posterior al tratamiento.

• Sesiones totales 6.

• Frecuencia: 3 sesiones a la semana.

• Duración de la sesión única: 12 minutos (6 minutos estáticos, 6 minutos dinámicos) sobre la lesión

1.

2.

3.

4.

5.

6.

7.

8.

9.

10

11

12

13

14

15.

dieciséis.

Protocolo de tecarsina (Winform®)

Preparar una mezcla, a partes iguales, de Gel Oxígeno "Life Gel" (Winform®) y Gel Hialurónico Win (Winform®)

Haga que el paciente se acueste en decúbito prono

Las áreas a tratar son las siguientes : a.

planta del pie (aponeurosis plantar)

b. tendón de Aquiles

C. tríceps sural

Limpiar la primera zona a tratar (aponeurosis plantar) con detergente ozonizado SAN C

Extender un velo de la mezcla de Oxygen gel "Life Gel" (Winform®) y Win Hyaluronic Gel (Winform®) sobre la zona a

tratar

Utilizar pieza de mano 25/55 mm - sin placa neutra


a.

b.

C.


finalizado el parto, proceder al tratamiento del tendón de Aquiles:


Extender un velo de la mezcla de Oxygen gel "Life Gel" (Winform®) y Win Hyaluronic Gel sobre la zona a tratar


Configurar el dispositivo a.

b.

C.


8.000 J/cm2

SIVSEA: 50%


4.000 J/cm2

SIVSEA: 30%


finalizado el parto, proceder al tratamiento del tríceps sural.


Extender un velo de Demusco Gel (Winform®)


17 Configure el dispositivo:

18

a.

b.

C.


8.000 J/cm2

SIVSEA : 50% - 60%

Realizar un masaje longitudinal hasta dispensar los Joules configurados

FRECUENCIA: cada 2 - 3 días

NÚMERO TOTAL DE PLAZAS: 6 sesiones

TOTAL JULIOS A ADMINISTRAR: 20.000 J/cm2

Conclusiones

Se destaca, según hallazgos ecográficos con evaluación power doppler, que este método asociado es eficaz en la recuperación de la fibrosis

responsable de la retracción fascial. El efecto sobre el dolor de lo que surge de la evaluación en la escala EVA es excelente.

Hay que decir que, deliberadamente en este protocolo, no se asoció ninguna técnica kinesiológica en el período de tratamiento que

probablemente habría contribuido a una mayor recuperación funcional.

Somos de la opinión de que vale la pena profundizar en la investigación asociando el método a una vía de reprogramación propioceptiva

útil para mantener y optimizar el resultado obtenido.

Bibliografía

1. P. Mondardini, R.Tanzi, L.Verardi, S.Briglia, A.Maione, E.Drago. "Nuevas metodologías en el tratamiento de la patología muscular traumática del


2. S. Colaiuda, C.Capogrossi, MCFortuna, F.Colaiuda, A.Rossi. - Universidad de Roma "La Sapienza" departamento de enfermedades venéreas de la piel y cirugía

plástica-reparadora Director Prof. Stefano Calvieri. "Tratamiento no invasivo del melasma, uso de un sistema de liberación transdérmica de liberación rápida",

publicado en Hi Tech Dermo, Milán, febrero de 2010.

3. Nirja, Pawan Jalwal, Jyoti Saini, Mamta, Ritu. Revista Internacional de Investigación Profesional Farmacéutica. “Formulación y evaluación del sistema de administración

transdérmica de fármacos para ibuprofeno”, vol. 4, número 2, abril de 2013.

4. Velius Bocci. "Oxigeno-ozonoterapia", Comprensión de los mecanismos de acción y posibilidades terapéuticas. Editorial Ambrosiana, 2000.

XXelCongreso Internacional de Rehabilitación Deportiva y Traumatología

Salud para el futbolista - Prevención, Diagnóstico, Cirugía y Rehabilitación.

EL SISTEMA DE ENDOTERAPIA EN ASOCIACIÓN CON EL SISTEMA INFILTRATIVO

TRANSDERMAL EN EL TRATAMIENTO DE TRAUMAS DISTRACTIVOS AL

GASTROCNEMIO INTERNO EN EL FUTBOLISTA


Metas

El objetivo del trabajo es evaluar, por ultrasonido, la reparación anatómica tisular, con predominio de los fenómenos de regeneración

sobre los cicatriciales, en una muestra de 30 (treinta) casos de lesión muscular por trauma indirecto tratados con endotermia y entrega

transdérmica.

Introducción

El sistema de endoterapia (Winform®) mediante la emisión de radiofrecuencia (ondas electromagnéticas medianas a 480.000 Hz), permite obtener una

estimulación que definimos como "biológica" sobre tejidos blandos, tendones y huesos.

A través de un sistema superficial, comúnmente definido como capacitivo, se obtiene la bioestimulación gracias a la interacción con las cargas

electrolíticas y su desplazamiento.

Estas cargas son atraídas y alineadas en las proximidades de un electrodo activo móvil opuesto a una placa de retorno neutra. El efecto

bioenergético será por tanto más superficial y afectará a los músculos y sistemas vasculares.

Con el sistema profundo, comúnmente definido como resistivo, se obtiene una bioestimulación energética con una interacción tridimensional de los tejidos

blandos, óseos y tendinosos. El sistema resistivo actúa principalmente en los tejidos que ofrecen mayor impedancia eléctrica debido al menor contenido de

agua (cartílagos, tendones, huesos)1.

Entrega transdérmica (terapia SIT Winform®) permite la entrega de principios activos (farmacológicos y/o fitoterapéuticos) directamente en el lugar

de acción, acelerando la cinética farmacológica e interactuando lo menos posible con la circulación sistémica: la entrega de las sustancias es

inducida por estimulación tisular gracias a:

a) el realineamiento de las cargas polares,

b) la modificación del potencial transcutáneo,

c) el aumento de la permeabilidad celular.2

Métodos

En el período comprendido entre enero y septiembre de 2010, se examinaron 30 (treinta) pacientes del sexo masculino, con edades entre 18 y 40 años,

jugadores de fútbol amateur o semiprofesional, que sufrían lesión muscular por traumatismo indirecto. Las lesiones de 1º, 2º y 3º grado se localizaron en todos

los casos a nivel de la unión miotendinosa distal del gastrocnemio medial (22 en el lado izquierdo y 8 en el derecho) y ocurrieron durante las fases de juego o

juego.

formación de pastizales. El diagnóstico se realizó con ecografía (Toshiba Xario) mediante sonda multifrecuencia de 8-14 MHz y

realizado siempre por el mismo operador.

Cada paciente también fue evaluado desde el punto de vista clínico-sintomático mediante una evaluación con una escala visual-analógica EVA de 0 a

10.

Luego, los pacientes fueron sometidos a 4 (cuatro) sesiones de terapia SIT y 8 (ocho) sesiones de Endoterapia distribuidas de la siguiente manera:

1ra y 2da semana: 2 (dos) sesiones consecutivas de terapia SIT y 2 (dos) sesiones en días alternos de endoterapia. Los dos sistemas nunca

se han aplicado el mismo día.

3ra y 4ta semana: 2 (dos) sesiones de Endoterapia espaciadas con al menos 48 horas de diferencia.

El tratamiento tuvo una duración total de 4 (cuatro) semanas y al final los pacientes fueron sometidos a un segundo control ecográfico y a

la aplicación de la escala EVA de percepción del dolor.

No se realizaron otras terapias durante las 4 (cuatro) semanas.

Protocolo de transferencia farmacológica

Con el sistema SIT se utilizó aceclofenaco 200 mg en polvo asociado a ácido etilendiaminotetraacético (EDTA) al 10% disuelto en un gel

portador. El fármaco antiinflamatorio no esteroideo inhibe la síntesis de prostaglandinas; El EDTA tiene una acción quelante de los tejidos

fibrinolíticos y calcificados, reduce su organización y produce un efecto de sol tisular.

Con la SIT se acelera la absorción del fármaco con disminución del dolor en el postraumático inmediato.

La endoterapia se aplica en las primeras 24 horas, fuera del área de la lesión para favorecer la reabsorción del edema; después de 48 horas se aplica

localmente a baja energía para estimular los macrófagos; a partir del cuarto-sexto día se aplica localmente a media energía con efecto neoangiogénico

y estimulación fibroblástica, siempre con un abordaje superficial (capacitivo).

En la primera ecografía:

• 12 (doce) pacientes tenían una lesión por distracción de primer grado;

• 10 (diez) pacientes tenían una lesión por distracción de segundo grado;

• 8 (ocho) pacientes tuvieron una lesión por distracción de tercer grado.

Resultados

Al final de la terapia (después de unos 30 días) en el segundo control ecográfico, todos los pacientes demostraron una reabsorción total o parcial del

hematoma, la aparición de fibras en el área de la lesión y fenómenos de cicatrización inicial.

Todos los pacientes refirieron una mejoría de los síntomas de dolor que pasó de un valor medio en la escala EVA de 5,69±2,27(DE) a

2,40+-1,84(DE) al alta reportando una mejoría media de 3,29±0,76(DE). Prueba de significación t de Student realizada para p<0,05.

Conclusiones

Es evidente, según los hallazgos ecográficos, que este método asociado es más efectivo por la calidad de la reparación anatómico-tejida y la

reabsorción del hematoma que por los tiempos de recuperación. El efecto sobre el dolor de lo que surge de la evaluación en la escala visual

analógica EVA es excelente.

Cabe decir que, deliberadamente en esta investigación, no se asoció ninguna técnica kinesiológica en el período de tratamiento que probablemente

habría contribuido a una recuperación más rápida del atleta.

Somos de la opinión que vale la pena profundizar en la investigación extendiendo el método a las técnicas kinesiológicas, corroborando los datos ya adquiridos

con pruebas funcionales.

Bibliografía

1. P.Mondardini,R.Tanzi,L.Verardi,S.Briglia,A.Maione,E.Drago. "Nuevas metodologías en el tratamiento de la patología muscular traumática del


2. S.Colaiuda,C.Capogrossi,MCFortuna,F.Colaiuda,A.Rossi. Universidad de Roma "La Sapienza" departamento de enfermedades de la pielvenéreas

y cirugía plástica-reparadora Director Prof. Stefano Calvieri. "Tratamiento no invasivo del melasma, uso de un sistema de

liberación transdérmica de liberación rápida", publicado en Hi Tech Dermo, Milán, febrero de 2010

Lesión de gastrocnemio interno

Antes del tratamiento con CRV


Fútbol femenino, 16 años Lesión en gastrocnemio pierna derecha interna.

Después del tratamiento con CRV

Excelente resolución de cicatriz de la unión miotendinosa del gastrocnemio distal

2º-3er grado interno con modesto desprendimiento exudativo residual de la fascia.

él

Distracción de 1er y 2do grado



Excelente cicatrización de heridas.

entesitis




Buena curación

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