scholarly journals Effects of Extracorporeal Shockwave Therapy on Clinical and Neurophysiological Indices of Spasticity Inpatients With Upper Motor Neuron Lesions: A Systematic Review and Meta-analysis

2021 ◽  
Vol 22 (1) ◽  
pp. 28-47
Author(s):  
Fereshteh Poursaeed ◽  
◽  
Nahid Tahan ◽  
Farideh Dehghan Manshadi ◽  
Ali Reza Akbarzade Bagheban ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Shock Wave ◽  
Clinical Trials ◽  
Cerebral Palsy ◽  
Motor Neuron ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Shock Wave Therapy ◽  
Shockwave Therapy

Objective: Spasticity is one of the components of an Upper Motor Neuron (UMN) lesion that occurs usually after a period of flaccidity in the form of velocity-dependent resistance to passive stretch. Spasticity is a significant cause of limited mobility and disability in neurological diseases. There are several clinical approaches to control spasticity. Recently, Shock Wave Therapy (SWT) has been reported to be a new, safe, and effective method for reducing spasticity for people with upper motor neuron lesions. We conducted a meta-analysis of relevant clinical trials to assess the effect of applying SWT on spasticity in UMN lesions. Materials & Methods: An electronic search was performed in PubMed, ISI Web of Science, Scopus, Science Direct, MEDLINE, and Google scholar from January 2005 to January 2020. Studies were included if they measured spasticity with the Modified Ashworth Scale (MAS) or/and neurophysiological indices in patients with stroke, multiple sclerosis, and cerebral palsy. The keywords of muscle hypertonia or spasticity, extracorporeal shock wave therapy, stroke, multiple sclerosis, and cerebral palsy were used. Two independent researchers searched articles, screened eligible studies against the inclusion criteria, and assessed the methodological quality of included studies. The methodological quality of studies was evaluated using the Downs and Black tool. The difference between the means was considered as the effect size in the MAS and Hoffman reflex/motor response (H/M) ratio before and after the intervention with 95% CI in random-effects models. Analyzes were performed using STATA software version 11. Results: The initial search led to the retrieval of 98 studies based on the inclusion and exclusion criteria, of which 24 full-text articles were reviewed and 14 articles were included in the meta-analysis process. All 14 articles had examined the effects of shockwave on the MAS. Four studies with 120 patients had examined the effects of shockwave therapy on the H/M ratio. Significant reduction in MAS grade was observed immediately [I2 = 100%, P<0.001, SMD=1.38 with 95%CI: (0.80, 1.87)] and three months after SWT [I2 = 100%, P<0.001, SMD=1.13 with 95%CI: (0.50, 1.76)] in comparison with the baseline values. ESWT had no significant effects on the H/M ratio [I2 = 97.5%, P<0.001, SMD=1.09 with 95%CI: (-0.54, 2.73)]. Conclusion: SWT can improve spasticity based on the MAS. The lack of SWT effects on the neurophysiological parameter of spasticity supports this opinion that SWT acts on the non-neural component of spasticity. Differences observed in studies in terms of treatment sessions, intervals of treatment sessions, energy density, number of shocks, and follow-up duration need to be examined more closely. More randomized clinical trials are needed in the future to analyze the impact of these factors on the efficacy of SWT for spastic patients.

scholarly journals Effectiveness of Shock Wave Therapy as a Treatment for Spasticity: A Systematic Review

2020 ◽  
Vol 11 (1) ◽  
pp. 15
Author(s):  
Isabel María Martínez ◽  
Nuria Sempere-Rubio ◽  
Olga Navarro ◽  
Raquel Faubel
Keyword(s):  
Shock Wave ◽  
Botulinum Toxin ◽  
Methodological Quality ◽  
Scientific Evidence ◽  
Motor Impairment ◽  
Functional Independence ◽  
Shock Wave Therapy ◽  
Jadad Scale ◽  
Type Of Injury

Background: The purpose of this study was to collect and analyse the available scientific evidence on the effectiveness of shock wave therapy as a treatment for spasticity. Methods: the search was performed in the following databases: PubMed, PEDro, Cochrane, Embase, and the Virtual Health Library. All publications from November 2009 to November 2019 were selected that included a sample of patients with spasticity and prior suspension of botulinum toxin, to whom shock wave therapy was applied. The methodological quality of the articles was evaluated using the Jadad scale and the pyramid of quality of scientific evidence. Results: 25 studies involving 866 participants with spasticity were selected. The results obtained suggest that shock wave therapy appears to be effective in reducing spasticity levels irrespective of the age of the participants, the type of injury, and the tool used to measure the effect. Conclusions: shock wave therapy reports evidence of improvement in motor function, motor impairment, pain, and functional independence, applied independently of botulinum toxin. However, due to the heterogeneity of the protocols, there is no optimum protocol for its application, and it would be appropriate to gain more high-quality scientific evidence through primary studies.

scholarly journals The Contributions of Extracorporeal Shockwave Therapy to the Improvement of the Quality of Life in Patients with Scapulohumeral Periarthritis

GYMNASIUM ◽  
2020 ◽  
Vol XXI (1) ◽  
pp. 87
Author(s):  
Daniel-Lucian Dobreci ◽  
Adina Camelia Șlicaru
Keyword(s):  
Quality Of Life ◽  
Shock Wave ◽  
Rating Scale ◽  
Life Quality ◽  
Good Effect ◽  
Shock Wave Therapy ◽  
Extracorporeal Shockwave Therapy ◽  
Shockwave Therapy ◽  
Quality Scale

The main purpose of this study was to evaluate to what extent shock wave therapy (ESWT) can influence the quality of life of patients with scapular-humeral periarthritis (PSH). The study included 30 male and female PSH sufferers who had previously undergone various therapies without any success in disease progression. The VAS scale, the Roles-Maudsley score, and the Flanagan Life Quality Scale with seven points on the rating scale recommended by Andrews and Crandall were used to evaluate patient evolution. ESWT sessions were held on a seven-day session for 12 weeks. Between ESWT meetings each patient followed a home medical gymnastics program. Following the study, ESWT treatment had a good effect on the progression of PSH patients in terms of pain reduction and disappearance, as well as regaining mobility of the affected shoulder. The conclusion of this studio is that shock wave therapy can help improve the quality of life of PSH patients.

scholarly journals The Use of Green Coffee Extract as a Weight Loss Supplement: A Systematic Review and Meta-Analysis of Randomised Clinical Trials

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Igho Onakpoya ◽  
Rohini Terry ◽  
Edzard Ernst
Keyword(s):  
Weight Loss ◽  
Clinical Trials ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Significant Heterogeneity ◽  
Green Coffee ◽  
Significant Difference ◽  
Using Data

The purpose of this paper is to assess the efficacy of green coffee extract (GCE) as a weight loss supplement, using data from human clinical trials. Electronic and nonelectronic searches were conducted to identify relevant articles, with no restrictions in time or language. Two independent reviewers extracted the data and assessed the methodological quality of included studies. Five eligible trials were identified, and three of these were included. All studies were associated with a high risk of bias. The meta-analytic result reveals a significant difference in body weight in GCE compared with placebo (mean difference: kg; 95%CI: , ). The magnitude of the effect is moderate, and there is significant heterogeneity amongst the studies. It is concluded that the results from these trials are promising, but the studies are all of poor methodological quality. More rigorous trials are needed to assess the usefulness of GCE as a weight loss tool.

RE:EXTRACORPOREAL SHOCK WAVE THERAPY FOR PEYRONIE'S DISEASE: EXPLORATORY META-ANALYSIS OF CLINICAL TRIALS

2004 ◽  
Vol 172 (5) ◽  
pp. 2083-2083
Author(s):  
E.W. Hauck ◽  
U.O. Mueller ◽  
T. Bschleipfer ◽  
H.U. Schmelz ◽  
T. Diemer ◽  
...  
Keyword(s):  
Shock Wave ◽  
Clinical Trials ◽  
Meta Analysis ◽  
Peyronie’S Disease ◽  
Shock Wave Therapy ◽  
Peyronie's Disease

Extracorporeal Shock Wave Therapy for Peyronie's Disease: Exploratory Meta-Analysis of Clinical Trials

2004 ◽  
Vol 171 (2) ◽  
pp. 740-745 ◽  
Author(s):  
EKKEHARD W. HAUCK ◽  
ULRICH O. MUELLER ◽  
THOMAS BSCHLEIPFER ◽  
HANS U. SCHMELZ ◽  
THORSTEN DIEMER ◽  
...  
Keyword(s):  
Shock Wave ◽  
Clinical Trials ◽  
Meta Analysis ◽  
Extracorporeal Shock Wave Therapy ◽  
Peyronie’S Disease ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave ◽  
Peyronie's Disease

scholarly journals Exercise Interventions for Improving Flexibility in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis

Medicina ◽  
2019 ◽  
Vol 55 (11) ◽  
pp. 726
Author(s):  
Torres-Pareja ◽  
Sánchez-Lastra ◽  
Iglesias ◽  
Suárez-Iglesias ◽  
Mendoza ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Range Of Motion ◽  
Methodological Quality ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Preliminary Evidence ◽  
Control Group ◽  
Exercise Interventions

Background and objectives: People with multiple sclerosis (MS) often experience limitations in joint range of motion, which is linked to spasticity and continued inactivity. Low flexibility levels in this population have been linked to postural problems and muscular pain. Therefore, the purpose of this study was to conduct a systematic review and a meta-analysis aimed at identifying the characteristics and methodological quality of investigations studying the effects of exercise interventions on the flexibility levels of people with MS. Materials and Methods: Three electronic databases (MEDLINE/PubMed, SPORTDiscus and Scopus) were systematically searched up to May 2019 for intervention studies focused on the effects of exercise on the flexibility levels of people with MS. A meta-analysis, including randomized controlled trials (RCT), which reported information regarding the effects of exercise on flexibility, was also conducted. The methodological quality of included studies was assessed using the Physiotherapy Evidence Database, and the Quality Assessment Tool for Before–After Studies, with no control group. The quality of the information reported, regarding the programs conducted, was assessed by means of the Consensus on Exercise Reporting Template (CERT) scale. Results: Seven studies, four RCTs and three uncontrolled investigations were finally selected. The methodological quality of the RCTs was considered “poor” in one study, and “good” and “excellent” in two studies and one investigation, respectively. The three uncontrolled studies showed a methodological quality between “fair” and “poor”. Following the CERT scale, four studies were graded as “high” and three as “low”. Findings from the meta-analysis indicated no significant effects on hamstring flexibility, or the range of motion in the hips, knees or ankles. Conclusions: There is preliminary evidence from individual studies which indicates that people with MS can improve their lower limb flexibility following participation in physical exercise programs, but the meta-analysis did not confirm these findings.

The effects of clinical interventions on health-related quality of life in multiple sclerosis: a meta-analysis

2012 ◽  
Vol 18 (12) ◽  
pp. 1686-1704 ◽  
Author(s):  
Ayse Kuspinar ◽  
Ana Maria Rodriguez ◽  
Nancy E Mayo
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Methodological Quality ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

The objective is to estimate the extent to which existing health care interventions designed specifically to target health-related quality of life (HRQL) in persons with multiple sclerosis (MS) achieve this aim. The structured literature search was conducted using multiple electronic databases including Ovid MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trial, for the years 1960 to 2011. The methodological quality of selected randomized controlled trials (RCTs) was assessed using the Cochrane Collaboration’s recommended domain-based method. Effect size (ES) was used to measure the effect of each intervention on HRQL. The studies were combined using a random-effects model to account for inter-study variation. Heterogeneity was tested for using the I-test and publication bias was assessed using funnel plots and the Egger weighted regression statistic. Thirty-nine RCTs met the criteria, all with acceptable methodological quality. Six major types of interventions were identified through the search. The smallest effect was observed for self-management and complementary and alternative medicine (ES=0.2), followed by medication (ES=0.3) then cognitive training and exercise (ES=0.4), and psychological interventions to improve mood (ES=0.7). The magnitude of positive effect on HRQL varied between the different types of interventions. The extent to which interventions are able to improve HRQL depends on delivering a potent intervention to those persons who have the potential to benefit.

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