Medical Background

evocell is a low energy device for stimulation of the cells by initiating mechanical transduction. It activates cells and loosens musculature of the whole body. Therefore, it is different to the classic extracorporal shock wave therapy (eswt, s.b., more information on shock wave treatment: www.shockwavetherapy.eu). evocell is used as a supportive treatment and can be easily combined with different therapies like indeed eswt, heat, compression or even as a tool for training.

Extracorporeal shockwave
  • established procedure
  • high energy
  • focused or radial
  • singular treatment
  • reduced location
  • can be painful
evocell
  • low energy
  • stimulating
  • 8 to 37 Hz
  • combinable with other treatments
  • whole body
  • low spectrum of side effects
  • painfree
Vibration platform
  • training device
  • 5 to 36 Hz
  • horizontal vibration
  • used for neuronal training
  • no tool for direct treatment
  • painfree

evocell can support your work as a physician, physiotherapist, alternative practicioner, trainer or athlete. Everybody reacts to mechanical transduction in a different way. That’s why it is crucial to use evocell with instructed personnel only. This will make sure to take care of patients with evocell the best way possible.

Extracorporeal shock wave therapy has been established in the clinical field for decades and count as scientifically evidence-based. Their numerous positive effects are mainly attributed to mechanical transduction and reach far beyond the well documented destructive effect (lithropsy).

Mechanical transduction has also been scientifically investigated from many perspectives, especially within the fields of biology and physiology. The structures involved in the transmission of mechanical stimuli into the cell interior are largely known (over 80% of all cell components). However, the exact procedures aren’t completely understood, although we know that cell-specific structures, such as ion channels or focal adhesions, can be activated by means of mechanical stimuli and thus produce a cell response.

 
Effects of extracorporeal shock wave therapy
  • Reduction in leukocyte migration and fewer cytokines, interleukins and chemokines
  • Reduction of the body's inflammatory response
  • Hyperstimulation of analgesics (pain reduction)
  • Edema, swelling and inflammation reduction
  • Gene expression TGF-beta 1 and IGF-1
  • Stimulation of osteoblast activity (promoting spread and multiplication)
  • Neovascularization (wound healing)
  • Formation of neurotransmitters (nitric oxide)
  • Tenocyte excitation

Thus, stimulation of mechanical transduction is able to initiate migration, proliferation, differentiation, growth and apoptosis of cells and the restructuring of the extracellular matrix (integrin forces or focal adhesions).

evocell bypasses the intense effect of high-energy shock waves due application of low-energy but – compared to other treatments (radial and focused shock waves) – high-frequency waves. The stimulative effects of shock waves have been scientifically investigated for years and are widely accepted.

  • Low energy level with low impulses showed positive stimulatory effects, whereas the high energy level with high impulses had significant inhibitory effects. At lower energy, up-regulation of proliferating cell nuclear antigen (PCNA), collagen type 1 & 3 and TGF1b gene expression were observed, followed by an increase in NO production, TGFb1 and collagen synthesis (Orhan et al. 2004)
  • Medial Tibial Stress Syndrome: 85% of patients return to active Sports faster (Rompe et al., 2009)
  • evocell treatment showed sig. pain reduction after 3 sessions (compared to the starting VAS, p<0.05) and highly significant decrease in pain intensity (p<0.001) over the whole period (Haag et al. 2016)

"Therefore it seemed likely that physical shockwaves raise the mechanotransduction and convert into biological signals that lead to a cascade of biological responses in tendons.“

Notarnicola, A. & Moretti, B. (2012). The biological effects of extracorporal shock wave therapy (eswt) on tendon tissue. Muscles, ligaments and Tendons Journal,2(1):33-7.

„These findings seem to indicate that tendon tissue can convert SW stimulation into biochemical signals via release of TGF-b1 and IGF-1 for tendinitis repair.“

Banes, A. J., Horesovsky, G., Larson, C., Tsuzaki, M. (1999). Mechanical load stimulates expression of novel genes in vivo and in vitro in avian flexor tendon cells. Osteoarthr Cartilage, 7,141-53.

„ESWT-treated tissue had more small, newly formed collagen fibrils and a greater expression of TGFb1 (4 weeks later, horses).“

Caminoto, E. H., Alves, A. L., Amorim, R. L., Thomassian, A., Hussni, C.A., Nicoletti, J. L. (2005). Ultrastructural and immunocytochemical evaluation of the effects of extracorporal shock wave treatment in the hind limbs of horses with experimentally induced suspensory ligament desmitis. American Journal of Veterinary Research, 66(5),892-6.

„TGF1 has been reported to act as a potent inhibitor of extracellular matrix degradation and inflammation during the healing of a wound.“

Feinberg, M. W., Jain, M. K., Werner, F., Sibinga, N. E. S., Wiesel, P., Wang, H. (2000)

„Higher fibroblast proliferation, mRNA exrpression high for TGF1b, collagenous type 1 & 3. Tissue repait seems to be stimulated by ESWT.“

Berta, L., Fazzari, A., Ficco, A. M., Enrica, P. M., Catalano, M. G., Frairia, R. (2009). Extracorporeal shock waves enhance normal fibroblast proliferation in vitro and activate mRNA expression for TGF-beta1 and for collagen types I and III. Acta Orthopedica, 80(5):612-617.