Addressing the silent killer:
Revolutionising diabetic foot ulcer healing with shockwave therapy

Exploring shockwave therapy's feasibility, optimal dosage, and patient impact

The research team conducted a small-scale cohort study, examining the feasibility of shockwave therapy in the NHS. The review, published in the Journal of Wound Care, yielded promising results, demonstrating the tolerability and acceptability of shockwave therapy for patients. Furthermore, a systematic review, published in the International Wound Journal, showcased the potential effectiveness of shockwave therapy.

However, one of the main challenges lies in determining the optimal dosage for shockwave therapy for diabetic foot ulcers. To address this, the team collaborated with Professor Mat Hardman, Director of Research (Hull) and Chair in Wound Healing in the Biomedical Institute for Multimorbidity at Hull York Medical School, to conduct laboratory experiments sponsored by the NIHR MedTech program.

Through their experiments, they discovered that increasing the number of shocks delivered led to faster wound size reduction and an upsurge in the expression of vascular endothelial growth factor (VEGF), crucial for new blood vessel growth.

To investigate the impact of shockwave therapy on real patients, the Ms Hitchman is now conducting a pilot randomised control trial. The trial compares low-dose shockwave therapy (100 shocks per centimetre squared), high-dose shockwave therapy (500 shocks per centimetre squared), and a placebo shockwave therapy group acting as the control. The pilot trial aims to assess the scalability of conducting the research in a larger trial.

Alongside the trial, the Ms Hitchman is conducting qualitative interviews to gain insights into the experiences of trial participants and clinicians. They seek to understand patient experiences, clinician perspectives on shockwave therapy, reasons for dropouts, and factors contributing to potential trial non-participation.

Ms Hitchman explained, "Many people have to take long periods of time off work or give up their jobs entirely. It can have a huge impact on their finances and relationships. This is another reason why our research is so important – so we can improve people’s quality of life."

Ms Hitchman said of the qualitative interviews with patients, "Many patients have told us they appreciate the holistic approach and personalised care provided throughout the study.

"The support, including regular check-ins and personalised questionnaires, has fostered a sense of benefit and reassurance among participants."