Clinical Benefits of Non-Invasive EPAT® Procedures

Disclaimer Please note: Some information contained herein specific to the applications and uses of Regenerative Medicine Technologies, may not be approved or cleared by governing bodies and/or regulatory restrictions to include the U.S. Food and Drug Administration. CuraMedix is providing this information in an educational format and and recommends that you consult your local representative for updates on approved applications and uses in your area.

Physical Effects of Acoustic Pressure Waves- EPAT® Acoustic pressure waves offer a non-invasive treatment solution to long term insertion and soft tissue pathologies. Local treatment in the affected area will support and reset the healing pattern.   Today there are several working hypothesis for the physical effects of acoustic pressure waves: • Pain reduction: The patient experiences a reduction of pain, explained by the Gate Control Theory. Intensive pulses from the transmitter into the tissues create a strong nociceptor activation of the A-β fibers, which affect interneurons that inhibit the transmission of the pain signals. • Increased metabolism: Acoustic pressure waves influence the tissues on a cellular level. The chemical environment of the cells is affected by free radicals promoting the release of pain and inflammatory inhibiting substances. • Revascularization: Repeated acoustic pressure waves to the affected area create a revascularization effect, with the new blood flow in the area promoting tissue healing and regeneration. • Reduced muscle tone: The “vicious circle”, as well as the strong pathological association between pain and muscle tone, will be broken and lead to restoring a normalized muscular tone.

How Non-Invasive EPAT® Procedures Work  Extracorporeal Pulse Activation Technology (EPAT®) is proprietary technology based on several unique sets of acoustic pressure waves that activate biologic and angiogenic responses including new vascularization and microcirculatory improvement, helping to restore the body’s normal healing processes and tissue regeneration.

Characteristics Continuous Ultrasound Wave Pulses propagate into the tissue No thermal effect No micro lesions

Fields Of Application & Relative Energy Levels Rompe: “Extrakorporale Stosswellentherapie“

All About The Right Energy Levels Stimulation of microcirculation (blood, lymph) and metabolism (nitrous oxide, vasodilation, reduction of oxidative stress) Mechanotransduction – cell matrix stimulation Increase of cell wall permeability (Cell metabolism) Release of substance P Antibacterial and anti-inflammatory effect Stimulation of growth factors (neogenesis of vessels, bone, collagen) Stimulation of stem cells (cell proliferation, transport and differentiation, skin rejuvenation) Analgesia effect (inhibition of nociceptive fibres – gate mechanism, endorfines and serotonine release, acceleration of substance P washout)

Effects of EPAT® Reduces/ Eliminates Pain Effect on nociceptors: → C-fibres (slow) inhibited by A-Delta-fibres (fast) Analgesic Effect Increases Circulation and Metabolism Stimulates Neovascularization Stimulates Tissue & Bone Growth Tissue engineering (Mense) Biological mechano-transduction Cell Proliferation (Neuland) Dissolves Calcium Deposits Reduces muscle tension Treats a Variety of Diseases Antibacterial effects

Biological Effects Disruption of cell membranes Neovascularization Stimulate osteoblasts, chondroblasts, macrophages

Biological Effects of Acoustic Waves in Musculoskeletal Tissue Bio-chemistry CJ Wang, MD

Clinical Benefits   Extracorporeal Pulse Activation Technology (EPAT®) accelerates healing while improving clinical outcomes non-invasively with all the benefits of traditional treatment methods including invasive procedures and without the risks. EPAT® Treatment Systems are scientifically proven, versatile and can be used for a broad range of musculoskeletal conditions for faster recovery times and easier more complete healing.  

Clinical Benefits Cont.   EPAT® benefits include: •    Quicker Recovery – Since a non-invasive procedure requires no incisions, no scaring, your body typically heals much faster. •    No Downtime – No restrictions on normal use. Non-invasive procedures help get you back to your active life immediately. •    No scarring – No incisions means no scaring or fibrotic tissue build-up •    Less pain – Because these procedures are non-invasive, there is typically less pain involved.

Indications Example of Applications: Orthopedic   General Acute and Chronic Musculoskeletal Pain to include Pain Associated with the Following Conditions: Foot & Ankle Pain Ankle Sprain Plantar Fasciitis Achillodynia Avascular Necrosis of the ankle Osteoarthritis

Indications Example of Applications: Orthopedic   General Acute and Chronic Musculoskeletal Pain to include Pain Associated with the Following Conditions:    Lower Leg Pain Shin Splint General Muscle Sprain, Calf Muscles Muscular Cramps/Spasm, Calf Muscles Stress Fracture Non-Union/ Delayed Union Frcture Myofacial Trigger Points

Indications Example of Applications: Orthopedic   General Acute and Chronic Musculoskeletal Pain to include Pain Associated with the Following Conditions: Thigh & Knee Pain Jumpers Knee Runners Knee General Muscle Sprain, Thigh Muscles Iliotibial Band Syndrome Myofacial Trigger Points Avascular Necrosis of the knee Meniscus tear or tear of the ACL or MCL Osteoarthritis

Indications Example of Applications: Orthopedic   General Acute and Chronic Musculoskeletal Pain to include Pain Associated with the Following Conditions: Pelvis & Hip Pain Trochanteric Insertional Tendonitis Bursitis Piriformis Syndrome Myofacial Trigger Points Avascular Necrosis of the hip Osteoarthritis

Indications Example of Applications: Orthopedic   General Acute and Chronic Musculoskeletal Pain to include Pain Associated with the Following Conditions: Lower Back Pain Lower Back Lumbalgia - Activation of Muscles and Connective Tissue Bulging (non herniated) lumbar (lower back) disc Myofacial Trigger Points Upper Back Pain Thoracic Back Pain Dorsalgia - Activation of Muscles and Connective Tissue

Indications Example of Applications: Orthopedic   General Acute and Chronic Musculoskeletal Pain to include Pain Associated with the Following Conditions: Neck Pain Cervicobrachial Neuralgia Trapezius Tension - Muscular Treatment Tension Headache - Muscular Treatment Myofacial Trigger Points

Indications Example of Applications: Orthopedic   General Acute and Chronic Musculoskeletal Pain to include Pain Associated with the Following Conditions: Shoulder Pain Calcified Tendonitis Shoulder Frozen Shoulder Bursitis - Muscular Treatment Myofacial Trigger Points Avascular Necrosis of the shoulder Partial tear of the rotator cuff

Indications Example of Applications: Orthopedic   General Acute and Chronic Musculoskeletal Pain to include Pain Associated with the Following Conditions: Upper Arm & Elbow Pain Ulnar / Medial Epicondylitis (Golfer's Elbow) Radial / Lateral Epicondylitis (Tennis Elbow) Myofacial Trigger Points Forearm, Wrist & Hand Pain Finger Tendonitis Dupuytren’s Contracture De Quervain Syndrome

Contraindications & Side Effects EPAT® – Contraindications EPAT® – Side effects Coagulation disorders (haemophilia) Use of anticoagulants, especially Marcumar Thrombosis Tumour diseases, carcinoma patients Pregnancy Cortisone therapy up to 6 weeks before first EPAT® treatment Swelling Reddening Haematomas Petechiae Pain Skin lesions in case of previous cortisone therapy

Clinical Data 25+Years of Clinical History ___Peer-reviewed publications ___Human procedures

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