title: Predictability of the individual clinical outcome of extracorporeal shock wave therapy for cellulite.
abstract: BACKGROUND
  Extracorporeal shock wave therapy has been successfully introduced for the treatment of cellulite in recent years. However, it is still unknown whether the individual clinical outcome of cellulite treatment with extracorporeal shock wave therapy can be predicted by the patient's individual cellulite grade at baseline, individual patient age, body mass index (BMI), weight, and/or height.
  
  
  METHODS
  Fourteen Caucasian females with cellulite were enrolled in a prospective, single-center, randomized, open-label Phase II study. The mean (± standard error of the mean) cellulite grade at baseline was 2.5±0.09 and mean BMI was 22.8±1.17. All patients were treated with radial extracorporeal shock waves using the Swiss DolorClast(®) device (Electro Medical Systems, S.A., Nyon, Switzerland). Patients were treated unilaterally with 2 weekly treatments for 4 weeks on a randomly selected side (left or right), totaling eight treatments on the selected side. Treatment was performed at 3.5-4.0 bar, with 15,000 impulses per session applied at 15 Hz. Impulses were homogeneously distributed over the posterior thigh and buttock area (resulting in 7,500 impulses per area). Treatment success was evaluated after the last treatment and 4 weeks later by clinical examination, photographic documentation, contact thermography, and patient satisfaction questionnaires.
  
  
  RESULTS
  The mean cellulite grade improved from 2.5±0.09 at baseline to 1.57±0.18 after the last treatment (ie, mean δ-1 was 0.93 cellulite grades) and 1.68±0.16 at follow-up (ie, mean δ-2 was 0.82 cellulite grades). Compared with baseline, no patient's condition worsened, the treatment was well tolerated, and no unwanted side effects were observed. No statistically significant (ie, P<0.05) correlation was found between individual values for δ-1 and δ-2 and cellulite grade at baseline, BMI, weight, height, or age.
  
  
  CONCLUSIONS
  Radial shock wave therapy is a safe and effective treatment option for cellulite. The individual clinical outcome cannot be predicted by the patient's individual cellulite grade at baseline, BMI, weight, height, or age.
authors.affiliation: Concept Clinic, Geneva, Switzerland.
authors.forename: Kai-Uwe
authors.initials: KU
authors.lastname: Schlaudraff
authors.affiliation: Department of Anatomy II, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Maren C
authors.initials: MC
authors.lastname: Kiessling
authors.affiliation: Department of Anatomy II, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Nikolaus Bm
authors.initials: NB
authors.lastname: Császár
authors.affiliation: Department of Anatomy II, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmitz
keywords: AWT; EPAT; RSWT; acoustic wave therapy; extracorporeal pulse activation therapy; radial shock wave therapy