Comments on: “Positive Effects of Extracorporeal Shock Wave Therapy on Spasticity in Post-Stroke Patients: A Meta-Analysis”

2018 ◽  
Vol 27 (7) ◽  
pp. 2046 ◽  
Author(s):  
Mohammad Alwardat
Keyword(s):  
Shock Wave ◽  
Meta Analysis ◽  
Extracorporeal Shock Wave Therapy ◽  
Shock Wave Therapy ◽  
Stroke Patients ◽  
Post Stroke ◽  
Positive Effects ◽  
Extracorporeal Shock Wave

scholarly journals Effects of Radial Extracorporeal Shock Wave Therapy on Flexor Spasticity of the Upper Limb in Post-stroke Patients: Study Protocol for A Randomized Controlled Trial

2020 ◽  
Author(s):  
Tao Fan ◽  
Xiangying Zhou ◽  
Peichen He ◽  
Xiaojia Zhan ◽  
Peng Zheng ◽  
...  
Keyword(s):  
Shock Wave ◽  
Upper Limb ◽  
Controlled Trial ◽  
Extracorporeal Shock Wave Therapy ◽  
Function Evaluation ◽  
Attractive Alternative ◽  
Shock Wave Therapy ◽  
Stroke Patients ◽  
Post Stroke ◽  
Extracorporeal Shock Wave

Abstract Background: Flexor Spasticity of the Upper Limb is common in post-stroke patients and seriously affects the recovery of upper limb function. However, there are no standard management protocols for this condition. Radial extracorporeal shock wave therapy (rESWT) is widely used as a non-invasive treatment method for various diseases, but its efficacy in reducing spasticity remains undefined. Methods/design: A prospective, randomized, double-blind controlled trial is to be performed to study the efficacy of rESWT on the treatment of upper limb spasticity after strokes. One hundred participants will be recruited from the Inpatient department of Zhujiang hospital for this study. Patients who meet the inclusion criteria will be randomly allocated to either receive 3 sessions of active rESWT (Group A) or sham-placebo rESWT (Group B) with three day intervals between each session. Assessment will be performed at baseline and at each of the post-rESWT time points (t1, t2 and t3). The primary assessment outcome will be the Modified Ashworth Scale, while the secondary assessment outcomes will include surface electromyography, MyotonPRO digital muscle function evaluation and infrared thermal imaging. Discussion: This trial is aimed at analyzing the application of rESWT for the management of spasticity after stroke via comprehensive and quantitative assessments. We hypothesized that after receiving active rESWT, patients will show greater improvement of upper limb muscles, compared with patients of the sham-placeborESWT group. The rESWT would be an attractive alternative to traditional methods and the results of this study may provide guidance and support for the further study of potential mechanisms.

scholarly journals Recent Advances in the Treatment of Spasticity: Extracorporeal Shock Wave Therapy

2021 ◽  
Vol 10 (20) ◽  
pp. 4723
Author(s):  
En Yang ◽  
Henry L. Lew ◽  
Levent Özçakar ◽  
Chueh-Hung Wu
Keyword(s):  
Shock Wave ◽  
Botulinum Toxin ◽  
Motor Neuron ◽  
Extracorporeal Shock Wave Therapy ◽  
Current Evidence ◽  
Shock Wave Therapy ◽  
Muscle Spasticity ◽  
Post Stroke ◽  
Positive Effects ◽  
Extracorporeal Shock Wave

Spasticity is a common sequala of the upper motor neuron lesions. For instance, it often occurs in the first 4 weeks after stroke and is seen in more than one-third of stroke survivors after 12 months. In recent years, extracorporeal shock wave therapy (ESWT) has been recognized as a safe and effective method for reducing muscle spasticity. Possible/relevant mechanisms include nitric oxide production, motor neuron excitability reduction, induction of neuromuscular transmission dysfunction, and direct effects on rheological properties. There are two types of ESWT, focused and radial, with the radial type more commonly applied for treating muscle spasticity. Concerning the optimal location for applying ESWT, the belly muscles and myotendinous junction seem to produce comparable results. The effects of ESWT on spasticity are known to last at least four to six weeks, while some studies report durations of up to 12 weeks. In this review, the authors will focus on the current evidence regarding the effectiveness of ESWT in spasticity, as well as certain technical parameters of ESWT, e.g., the intensity, frequency, location, and number of sessions. The pertinent literature has been reviewed, with an emphasis on post-stroke upper limbs, post-stroke lower limbs, cerebral palsy, and multiple sclerosis. In short, while ESWT has positive effects on parameters such as the modified Ashworth scale, mixed results have been reported regarding functional recovery. Of note, as botulinum toxin injection is one of the most popular and effective pharmacological methods for treating spasticity, studies comparing the effects of ESWT and botulinum toxin injections, and studies reporting the results of their combination, are also reviewed in this paper.

scholarly journals Long-Term Efficacy of Extracorporeal Shock Wave Therapy on Lower Limb Post-Stroke Spasticity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 10 (1) ◽  
pp. 86
Author(s):  
Emanuela Elena Mihai ◽  
Luminita Dumitru ◽  
Ilie Valentin Mihai ◽  
Mihai Berteanu
Keyword(s):  
Systematic Review ◽  
Lower Limb ◽  
Meta Analysis ◽  
Extracorporeal Shock Wave Therapy ◽  
Shock Wave Therapy ◽  
Post Stroke ◽  
Randomized Controlled ◽  
Term Efficacy ◽  
Extracorporeal Shock Wave

The purpose of this systematic review and meta-analysis is to evaluate the long-term efficacy of Extracorporeal Shock Wave Therapy (ESWT) on reducing lower limb post-stroke spasticity in adults. A systematic electronic search of PubMed/ MEDLINE, Physiotherapy Evidence Database (PEDro), Scopus, Ovid MEDLINE(R), and search engine of Google Scholar was performed. Publications that ranged from January 2010 to August 2020, published in English, French, Spanish, Portuguese, and Italian language and available as full texts were eligible for inclusion and they were searched without any restrictions of country. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Two authors screened the references, extracted data, and assessed the risk of bias. The primary outcome was spasticity grade mainly assessed by the Modified Ashworth Scale (MAS). Secondary outcomes were passive range of motion (PROM), pain intensity, electrophysiological parameters, gait assessment, and adverse events. A total of seven recent randomized controlled trials (RCTs) were included in the systematic review and meta-analysis, and a beneficial effect on spasticity was found. The high level of evidence presented in this paper showed that ESWT ameliorates spasticity considering the parameters: MAS: standardized mean difference (SMD) = 0.53; 95% confidence interval (95% CI): (0.07–0.99); Modified Tardieu Scale (MTS): SMD = 0.56; 95% CI: (0.01–1.12); Visual Analogue Scale (VAS): SMD = 0.35; 95% CI: (−0.21–0.91); PROM: SMD = 0.69; 95% CI: (0.20–1.19). ESWT presented long-term efficacy on lower limb post-stroke spasticity, reduced pain intensity, and increased range of motion. The effect of this novel and non-invasive therapy was significant and the intervention did not present adverse events, proving a satisfactory safety profile.

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