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Synergistic Mechanisms and Clinical Efficacy of Combined Shockwave and Ultrasound Therapy for Localized Adiposity: A Systematic Review and Meta-Analysis of 31 Studies.

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Τίτλος: Synergistic Mechanisms and Clinical Efficacy of Combined Shockwave and Ultrasound Therapy for Localized Adiposity: A Systematic Review and Meta-Analysis of 31 Studies.
Συγγραφείς: Wu Q; Department of Rehabilitation Medicine, Suzhou Ninth People's Hospital, No. 2666 Ludang Road, Songling Street, Wujiang District, Suzhou City, 215200, Jiangsu Province, China., Zhao W; Department of Rehabilitation Medicine, Suzhou Ninth People's Hospital, No. 2666 Ludang Road, Songling Street, Wujiang District, Suzhou City, 215200, Jiangsu Province, China., Liu Q; Department of Rehabilitation Medicine, Suzhou Ninth People's Hospital, No. 2666 Ludang Road, Songling Street, Wujiang District, Suzhou City, 215200, Jiangsu Province, China., Huang B; Department of Rehabilitation Medicine, Suzhou Ninth People's Hospital, No. 2666 Ludang Road, Songling Street, Wujiang District, Suzhou City, 215200, Jiangsu Province, China., Xiao Y; Department of Rehabilitation Medicine, Suzhou Ninth People's Hospital, No. 2666 Ludang Road, Songling Street, Wujiang District, Suzhou City, 215200, Jiangsu Province, China., Yang M; Department of Rehabilitation Medicine, Suzhou Ninth People's Hospital, No. 2666 Ludang Road, Songling Street, Wujiang District, Suzhou City, 215200, Jiangsu Province, China., Li F; Department of Rehabilitation Medicine, Suzhou Ninth People's Hospital, No. 2666 Ludang Road, Songling Street, Wujiang District, Suzhou City, 215200, Jiangsu Province, China., Du H; Department of Rehabilitation Medicine, Suzhou Ninth People's Hospital, No. 2666 Ludang Road, Songling Street, Wujiang District, Suzhou City, 215200, Jiangsu Province, China. xykk@qq.com.
Πηγή: Aesthetic plastic surgery [Aesthetic Plast Surg] 2026 Jul; Vol. 50 (13), pp. 5503-5521. Date of Electronic Publication: 2026 May 08.
Τύπος έκδοσης: Systematic Review; Journal Article; Meta-Analysis
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer-Verlag Country of Publication: United States NLM ID: 7701756 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-5241 (Electronic) Linking ISSN: 0364216X NLM ISO Abbreviation: Aesthetic Plast Surg Subsets: MEDLINE
Imprint Name(s): Original Publication: New York, Springer-Verlag.
Ιατρικοί όροι (MeSH): Ultrasonic Therapy*/methods , Adiposity*/physiology , Extracorporeal Shockwave Therapy*/methods , High-Energy Shock Waves*/therapeutic use , Body Contouring*/methods, Humans ; Combined Modality Therapy ; Treatment Outcome
Περίληψη: Background: Localized adiposity remains a significant clinical challenge. Combined shockwave and ultrasound therapy has emerged as a promising non-invasive approach, but its synergistic mechanisms and clinical efficacy require comprehensive evaluation. This systematic review aims to synthesize evidence for this combined therapy, with focus on the novel dual-action axis model.
Methods: A comprehensive search (2015-2025) was conducted following PRISMA guidelines. Thirty-one studies (n = 2,758 participants) were included. Methodological quality was assessed using ROBIS, AMSTAR 2, and RoB 2 tools. Data were synthesized narratively and with meta-analysis where appropriate.
Results: The dual-action axis model identified mechanical effects (cavitation, Piezo1 activation) and thermal effects (hyperthermia, TRPV4-mediated thermogenesis). Key mechanisms included Piezo1 activation (32 ± 5% increase in adipocyte apoptosis) and TRPV4 stimulation (1.8-fold mitochondrial activity). Meta-analysis showed significant fat reduction across areas: abdomen (2.1 cm, 95% CI 1.7-2.5), thighs (1.8 cm, 1.5-2.1). Combined therapy was superior to cryolipolysis at 6 months (2.3 cm vs 1.5 ± 0.8 cm, p = 0.008) but had higher 12-month recurrence (23% vs 8.7%, p < 0.001). Safety profile was favorable (severe adverse events < 1%).
Conclusion: Combined therapy achieves synergistic fat reduction through Piezo1/TRPV4 mechanisms. While superior to cryolipolysis short-term, maintenance strategies are needed. This approach represents a paradigm shift in non-invasive body contouring.
No Level Assigned: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
(© 2026. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)
Competing Interests: Declarations. Conflict of Interest: The authors declare that they have no conflicts of interest to disclose. Ethical Approval: This article is a systematic review of previously published peer-reviewed studies; no original human or animal experiments were conducted by the authors. All included primary studies have received ethical approval from their respective institutional review boards, with detailed information available in the original publications. For this type of study, formal ethical approval and informed consent are not required. AI Assistance Disclosure: During the preparation of this manuscript, the authors used Grammarly to review grammar and syntax, and the AI-assisted function of EndNote 21 to standardize the format of references. After using these tools, the authors reviewed and edited all content manually, and take full responsibility for the content of the manuscript. No AI tool was used to generate the core research content, data analysis, or interpretation of results. Human and Animal Rights: This article does not contain any studies with human participants or animals performed by any of the authors. Informed Consent: For this type of study informed consent is not required.
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Contributed Indexing: Keywords: Localized adiposity; Non-invasive body contouring; Piezo1; Shockwave therapy; TRPV4; Ultrasound
Entry Date(s): Date Created: 20260508 Date Completed: 20260805 Latest Revision: 20260902
Update Code: 20260903
DOI: 10.1007/s00266-026-05881-5
PMID: 42103962
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1432-5241
DOI:10.1007/s00266-026-05881-5