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Evidence Based Care Backed by Clinical Research

"You won't find this level of medical transparency anywhere else"

At AVION, our treatments are firmly rooted in peer-reviewed clinical research. Each modality we employ, including shockwave therapy, photobiomodulation, and regenerative, is supported by an expanding body of evidence. This page serves as a reference to the literature that informs our clinical decision-making, ensuring our practices remain aligned with the latest scientific advancements.

Shockwave Therapy (EWST)

The following peer-reviewed studies form the clinical foundation for AVION's shockwave therapy protocols across tendon, bone, nerve, and pain conditions.

  • Tenforde AS, Borgstrom HE, DeLuca S, et al. Best practices for extracorporeal shockwave therapy in musculoskeletal medicine: Clinical application and training consideration. PM R. 2022;14(5):611–619.

  • Schroeder AN, Tenforde AS, Jelsing EJ. Extracorporeal Shockwave Therapy in the Management of Sports Medicine Injuries. Curr Sports Med Rep. 2021;20(6):298–305.

  • Guo et al. The effect of extracorporeal shockwave therapy in tendinopathy: A systematic review and network meta-analysis of randomized controlled trials (3,921 patients). 2025.

  • Li C, Li Z, Shi L, et al. Effectiveness of Focused Shockwave Therapy versus Radial Shockwave Therapy for Noncalcific Rotator Cuff Tendinopathies. Biomed Res Int. 2021.

  • Cortés-Pérez I, Moreno-Montilla L, Ibáñez-Vera AJ, et al. Efficacy of extracorporeal shockwave therapy, compared to corticosteroid injections, on pain, plantar fascia thickness and foot function in patients with plantar fasciitis. Clin Rehabil. 2024;38(8):1023–1043.

  • Weihs AM, Fuchs C, Teuschl AH, et al. Shock wave treatment enhances cell proliferation and improves wound healing by ATP release-coupled ERK activation. J Biol Chem. 2014;289(39):27090–27104.

  • Vetrano M, d'Alessandro F, Torrisi MR, et al. Extracorporeal shock wave therapy promotes cell proliferation and collagen synthesis of primary cultured human tenocytes. Knee Surg Sports Traumatol Arthrosc. 2011;19(12):2159–2168.

  • Chen Y, Lyu K, Lu J, et al. Biological response of extracorporeal shock wave therapy to tendinopathy in vivo (review). Front Vet Sci. 2022;9:851894.

  • Cheng JH, Jhan SW, Hsu CC, et al. Extracorporeal Shockwave Therapy Modulates the Expressions of Proinflammatory Cytokines IL33 and IL17A. Mediators Inflamm. 2021.

  • Gollmann-Tepeköylü C, Nägele F, Graber M, et al. Shock waves promote spinal cord repair via TLR3. JCI Insight. 2020;5(15):e134552.

  • Wess O, Mayer J. The interaction of shock waves with biological tissue — momentum transfer, the key for tissue stimulation and fragmentation. Int J Surg. 2025;111(4):2810–2818.

  • Lizis P, Kobza W, Manko G. Extracorporeal shockwave therapy vs. kinesiotherapy for osteoarthritis of the knee. J Back Musculoskelet Rehabil. 2017;30(5):1121–1128.

  • Mazin Y, Lemos C, Paiva C, et al. The Role of Extracorporeal Shock Wave Therapy in the Treatment of Muscle Injuries. Cureus. 2023;15(8):e44196.

  • Fleckenstein J, Friton M, Himmelreich H, Banzer W. Effect of a Single Administration of Focused Extracorporeal Shock Wave in the Relief of Delayed-Onset Muscle Soreness. Arch Phys Med Rehabil. 2017;98(5):923–930.

  • Mattyasovszky SG, Langendorf EK, Ritz U, et al. Exposure to radial extracorporeal shock waves modulates viability and gene expression of human skeletal muscle cells. J Orthop Surg Res. 2018;13(1):75.

  • Vahdatpour B, Kiyani A, Dehghan F. Effect of extracorporeal shock wave therapy on the treatment of patients with carpal tunnel syndrome. Adv Biomed Res. 2016;5:120.

  • Zhang L, Yang T, Pang L, et al. Effects of Extracorporeal Shock Wave Therapy in Patients with Mild-to-Moderate Carpal Tunnel Syndrome: An Updated Systematic Review with Meta-Analysis. J Clin Med. 2023;12(23):7363.

  • Hausdorf J, Lemmens MA, Heck KD, et al. Selective loss of unmyelinated nerve fibers after extracorporeal shockwave application. Neuroscience. 2008;155(1):138–144.

  • Ochiai N, Ohtori S, Sasho T, et al. Extracorporeal shock wave therapy improves motor dysfunction and pain originating from knee osteoarthritis in rats. Osteoarthritis Cartilage. 2007;15(9):1093–1096.

  • Monclús P, Bosque M, Margalef R, et al. Shock waves as treatment of mouse myofascial trigger points. Pain Pract. 2023;23(7):724–733.

  • Kou D, Chen Q, Wang Y, et al. The application of extracorporeal shock wave therapy on stem cells therapy to treat various diseases. Stem Cell Res Ther. 2024;15:271.

  • Modena DAO, Nogueira da Silva C, Delinocente TCP, et al. Effectiveness of the Electromagnetic Shock Wave Therapy in the Treatment of Cellulite. Dermatol Res Pract. 2019.

  • Rompe JD, Kirkpatrick CJ, Küllmer K, et al. Dose-related effects of shock waves on rabbit tendo Achillis. J Bone Joint Surg Br. 1998;80(3):546–552.

  • Ahmed H, Mazhar M, Rehan J. Bilateral Bell's Palsy and extracorporeal shockwave outcomes. Cureus. 2025;17(4):e82704.

Photobiomodulation (PBM) / Laser Therapy

The following studies support AVION's use FDA-cleared light emitting diode photobiomodulation therapy also known as Low level Laser for tissue repair, pain reduction, athletic performance, and regenerative medicine applications.

  • Hamblin MR. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophys. 2017;4(3):337–361.

  • Kitchen LC, Berman M, Halper J, Chazot P. Rationale for 1068 nm Photobiomodulation Therapy (PBMT) as a Novel, Non-Invasive Treatment for COVID-19. Int J Mol Sci. 2022;23:5221.

  • Pastore D, Greco M, Passarella S. Specific helium-neon laser sensitivity of the purified cytochrome c oxidase. Int J Radiat Biol. 2000;76(6):863–870.

  • Shen Q, Guo H, Yan Y. Photobiomodulation for Neurodegenerative Diseases: A Scoping Review. Int J Mol Sci. 2024;25(3):1625.

  • Berni M, Brancato AM, Torriani C, et al. The Role of Low-Level Laser Therapy in Bone Healing: Systematic Review. Int J Mol Sci. 2023;24(8):7094.

  • Lanferdini FJ, Bini RR, Baroni BM, et al. Improvement of Performance and Reduction of Fatigue With Low-Level Laser Therapy in Competitive Cyclists. Int J Sports Physiol Perform. 2018;13(1):14–22.

  • Ferraresi C, Hamblin MR, Parizotto NA. Low-level laser (light) therapy (LLLT) on muscle tissue: performance, fatigue and repair benefited by the power of light. Photonics Lasers Med. 2012;1(4):267–286.

  • Vanin AA, Verhagen E, Barboza SD, et al. Photobiomodulation therapy for the improvement of muscular performance and reduction of muscular fatigue. Lasers Med Sci. 2018;33(1):181–214.

  • Liu H, Cheema U, Player DJ. Photobiomodulation therapy (PBMT) in skeletal muscle regeneration: A comprehensive review. Photodiagnosis Photodyn Ther. 2025.

  • Infrared Low-Level Laser Therapy before Intense Progressive Running Test of High-Level Soccer Players. Oxidative Medicine and Cellular Longevity. 2019. doi:10.1155/2019/6239058

  • Effect of photobiomodulation therapy on performance and running economy in runners: A randomized double-blinded placebo-controlled trial. Journal of Sports Sciences. doi:10.1080/02640414.2021.1872930

  • Chen H, Gao F, Luo Y, et al. From concept to practice: intra-articular photobiomodulation for knee osteoarthritis. Front Immunol. 2026;17:1793440.

  • Zhang Y, Ji Q. Current advances of photobiomodulation therapy in treating knee osteoarthritis. Front Cell Dev Biol. 2023;11:1286025.

  • Wang Y, Huang Y-Y, Wang Y, et al. Red (660 nm) or near-infrared (810 nm) photobiomodulation stimulates proliferation in human adipose-derived stem cells. Sci Rep. 2017;7:7781.

Regenerative Medicine & Orthobiologics
(PRP + Stem Cells)

The following research supports AVION's regenerative rehab protocols combining PRP, stem cell therapies, and adjunct modalities including shockwave and PBM.

  • Ozaki GAT, Camargo RCT, Koike TE, et al. Analysis of photobiomodulation associated or not with platelet-rich plasma on repair of muscle tissue by Raman spectroscopy. Lasers Med Sci. 2016;31:1891–1898.

  • Irmak G, Gümüşderelioglu M, et al. Photobiomodulation combined with adipose-derived stem cells in methacrylated gelatin hydrogels enhances in vivo bone regeneration. Lasers Med Sci. 2022.

  • Gonçalves AB, Bovo JL, Gomes BS, et al. Photobiomodulation (λ=808nm) and Platelet-Rich Plasma (PRP) for the Treatment of Acute Rheumatoid Arthritis in Wistar Rats. J Lasers Med Sci. 2021;12:e60.

  • Alzyoud JAM, Al-Shudiefat AAS, Ali HA, et al. Effects of Collagenase Preconditioning on Partially Incised Rat Tendon Treated with Light-Emitting Diodes and Platelet-Rich Plasma. Biomedicines. 2025;13(5):1214.

  • Hanney WJ, et al. The Effect of Combined Bone Marrow Aspirate, Lipoaspirate, and Platelet-Rich Plasma Injections on Pain, Function, and Perceived Change in Individuals with Severe Knee Osteoarthritis. 2023.

  • Kim K, Lee J, Jang H, et al. Photobiomodulation Enhances the Angiogenic Effect of Mesenchymal Stem Cells to Mitigate Radiation-Induced Enteropathy. Int J Mol Sci. 2019;20(5):1131.

  • Chang S-Y, Carpena NT, Kang BJ, Lee MY. Effects of Photobiomodulation on Stem Cells Important for Regenerative Medicine. 2020.

  • Pinto H, Goñi Oliver P, Sánchez-Vizcaíno Mengual E. The Effect of Photobiomodulation on Human Mesenchymal Cells: A Literature Review. Aesth Plast Surg. 2021;45:1826–1842.

Stem Cell & Cellular Biology

These foundational studies inform AVION's understanding of stem cell biology, satellite cell activation, and the cellular mechanisms underlying regenerative rehabilitation.

  • Yin H, Price F, Rudnicki MA. Satellite cells and the muscle stem cell niche. Physiol Rev. 2013;93(1):23–67.

  • Cutler AA, Pawlikowski B, Wheeler JR, et al. The regenerating skeletal muscle niche drives satellite cell return to quiescence. iScience. 2022;25(6):104444.

  • Catlin SN, Busque L, Gale RE, et al. The replication rate of human hematopoietic stem cells in vivo. Blood. 2011;117(17):4460–4466.

  • Arner P, Andersson DP, Bäckdahl J, et al. Weight Gain and Impaired Glucose Metabolism in Women Are Predicted by Inefficient Subcutaneous Fat Cell Lipolysis. Cell Metab. 2018;28(1):45–54.

  • Alberts B, Johnson A, Lewis J, et al. Molecular Biology of the Cell. 4th ed. Garland Science; 2002.

  • Kim J, Sung DJ, Lee J. Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. J Exerc Rehabil. 2017;13(1):12–22.

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