Long-term Effects of Extracorporeal Shock Wave Therapy on Poststroke Spasticity: A Meta-analysis of Randomized Controlled Trials

2020 ◽  
Vol 29 (3) ◽  
pp. 104591 ◽  
Author(s):  
Gongwei Jia ◽  
Jingxi Ma ◽  
Sanrong Wang ◽  
Dandong Wu ◽  
Botao Tan ◽  
...  
Keyword(s):  
Shock Wave ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Extracorporeal Shock Wave Therapy ◽  
Controlled Trials ◽  
Long Term Effects ◽  
Shock Wave Therapy ◽  
Randomized Controlled ◽  
Extracorporeal Shock Wave

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

2020 ◽  
Vol 34 (9) ◽  
pp. 1141-1156 ◽  
Author(s):  
Rosa Cabanas-Valdés ◽  
Pol Serra-Llobet ◽  
Pere Ramón Rodriguez-Rubio ◽  
Carlos López-de–Celis ◽  
Mercé Llauró-Fores ◽  
...  
Keyword(s):  
Shock Wave ◽  
Upper Limb ◽  
Meta Analysis ◽  
Extracorporeal Shock Wave Therapy ◽  
Controlled Trials ◽  
Shock Wave Therapy ◽  
Randomized Controlled ◽  
Extracorporeal Shock Wave ◽  
Limb Spasticity ◽  
Conventional Physiotherapy

Objective: To assess the effectiveness of Extracorporeal Shock Wave Therapy for reducing spasticity and improving functionality of the upper limb in stroke survivors. Data sources: A systematic review of MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, PEDro, REHABDATA, Scielo, Scopus, Web of Science, Tripdatabase and Epistemonikos from 1980 to April 2020 was carried out. Review methods: The bibliography was screened to identify randomized controlled clinical trials that applied extracorporeal shock waves to upper limb spastic muscles in post-stroke individuals. Two reviewers independently screened references, selected relevant studies, extracted data and assessed risk of bias using the PEDro scale. The primary outcome was spasticity and functionality of the upper limb. Results: A total of 1,103 studies were identified and 16 randomized controlled trials were finally included (764 individuals) were analyzed. A meta-analysis was performed and a beneficial effect on spasticity was found. The mean difference (MD) on the Modified Ashworth Scale for comparison extracorporeal shock wave versus sham was −0.28; with a 95% confidence interval (CI) from −0.54 to −0.03. The MD of the comparison of extracorporeal shock wave plus conventional physiotherapy versus conventional physiotherapy was −1.78; 95% CI from −2.02 to −1.53. The MD for upper limb motor-function using the Fugl Meyer Assessment was 0.94; 95% CI from 0.42 to 1.47 in the short term and 0.97; 95% CI from 0.19 to 1.74 in the medium term. Conclusion: The extracorporeal shock wave therapy is effective for reducing upper limb spasticity. Adding it to conventional therapy provides an additional benefit.

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.

Sign in / Sign up

Export Citation Format

Share Document