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 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 Clinical intervention studies of orofacial motricity: an analysis of the methodological quality of brazilian studies

Revista CEFAC ◽  
2018 ◽  
Vol 20 (3) ◽  
pp. 388-399
Author(s):  
James Tomaz-Morais ◽  
Jully Anne Soares de Lima ◽  
Brunna Thaís Luckwu-Lucena ◽  
Rebecca Rhuanny Tolentino Limeira ◽  
Sâmara Munique Silva ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Methodological Quality ◽  
Speech Therapy ◽  
Scientific Evidence ◽  
Clinical Intervention ◽  
Brazilian Literature ◽  
Jadad Scale ◽  
Final Sample ◽  
Quality Checklist

ABSTRACT Purpose: to evaluate the methodological quality of clinical trials published in Brazilian journals. Methods: four trained independent researchers conducted a systematic literature search of all Brazilian speech therapy-related journals over the last ten years, whether the journals were active or inactive. All journal volumes published during that period were selected, and each researcher conducted an individual analysis to identify articles that focused primarily on orofacial motricity. The tools used were the Downs and Black Quality Checklist and the Jadad scale. Results: after the studies were selected and categorized, the final sample comprised six articles, all of which were classified as clinical trials. The observed methodological limitations included a lack of sample planning, randomization and blinding. Mean scores of 16.3 points on the Downs and Black Quality Checklist and 2.3 on the Jadad scale were obtained. Conclusion: the randomized controlled trials in the area of orofacial motricity are scarce in Brazilian literature, suggesting that studies in this area adopting this research design should be expanded and their quality should be improved to promote clinical practice based on scientific evidence.

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 Impact on the Quality of Erections after Completing a Low-Intensity Extracorporeal Shock Wave Treatment Cycle on a Group of 710 Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Héctor A. Corredor Ayala ◽  
José Pablo Saffon Cuartas ◽  
Diana Cerquera Cleves
Keyword(s):  
Shock Wave ◽  
Erectile Dysfunction ◽  
Sexual Health ◽  
Extracorporeal Shock Wave Therapy ◽  
Shock Wave Therapy ◽  
Low Intensity ◽  
Health Clinics ◽  
Extracorporeal Shock Wave ◽  
Sexual Health Clinics

Objective. The aim of this study is to evaluate the response to low-intensity extracorporeal shock wave therapy in a group of patients with organic vascular erectile dysfunction. Materials and Methods. This is an observational retrospective study. The researchers reviewed 710 patients with a clinical diagnosis of organic vascular erectile dysfunction (ED) of more than 3-month duration from male sexual health clinics of the Boston Medical Group from 12 cities in Spain and 4 in Mexico. Patients received 5 outpatient shock wave therapy sessions. They were evaluated with the erection hardness score (EHS) before the first session (n = 710), at the end of the last session (n = 710), and one month after the last session (n = 412). Results. In the first examination, the EHS improved in 43.1% (306/710) of subjects compared to the baseline measurement and ability to penetrate increased from 26.8% to 44% (p<0.0001). In the second examination, the ability to penetrate was 37.9%, lower than in the first (p=0.042) but higher than the baseline (p=0.0001). Conclusions. The results suggest that the shock wave therapy with or without concomitant treatments improved the quality of erections in patients with erectile dysfunction treated in specialised male sexual health clinics. This trial is registered with NCT03237143.

scholarly journals Botulinum Toxin a Injection Combined with Radial Extracorporeal Shock Wave Therapy in Children with Spastic Cerebral Palsy: Shear Wave Sonoelastographic Findings in the Medial Gastrocnemius Muscle, Preliminary Study

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1059
Author(s):  
Dong Rak Kwon ◽  
Dae Gil Kwon
Keyword(s):  
Shock Wave ◽  
Cerebral Palsy ◽  
Botulinum Toxin ◽  
Gastrocnemius Muscle ◽  
Botulinum Toxin A ◽  
Extracorporeal Shock Wave Therapy ◽  
Spastic Cerebral Palsy ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave ◽  
Group 1

Therapeutic strategies to boost the effect of botulinum toxin may lead to some advantages, such as long lasting effects, the injection of lower botulinum toxin dosages, fewer side effects, and lower costs. The aim of this study is to investigate the combined effect of botulinum toxin A (BTA) injection and extracorporeal shock wave therapy (ESWT) for the treatment of spasticity in children with spastic cerebral palsy (CP). Fifteen patients with spastic CP were recruited through a retrospective chart review to clarify what treatment they received. All patients received a BTA injection on gastrocnemius muscle (GCM), and patients in group 1 underwent one ESWT session for the GCM immediately after BTA injection and two consecutive ESWT sessions at weekly intervals. Ankle plantar flexor and the passive range of motion (PROM) of ankle dorsiflexion were measured by a modified Ashworth scale (MAS) before treatment and at 1 and 3 month(s) post-treatment. In group 1, the shear wave velocity (SWV) of GCM was measured. The PROM and MAS in group 1 and 2 before treatment significantly improved at 1 and 3 month(s) after treatment. The change in PROM was significantly different between the two groups at 1 and 3 month(s) after treatment. The SWV before treatment significantly decreased at 1 month and 3 months after treatment in group 1. Our study has shown that the combination of BTA injection and ESWT would be effective at controlling spasticity in children with spastic CP, with sustained improvement at 3 months after treatment.

scholarly journals A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Romy Lauche ◽  
Holger Cramer ◽  
Winfried Häuser ◽  
Gustav Dobos ◽  
Jost Langhorst
Keyword(s):  
Systematic Reviews ◽  
Methodological Quality ◽  
Fibromyalgia Syndrome ◽  
Data Extraction ◽  
Scientific Evidence ◽  
Cochrane Library ◽  
Overview Of Reviews ◽  
Systematic Overview ◽  
Complementary And Alternative

Objectives.This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS).Methods.The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument.Results.Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment.Conclusions.Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety.

Evidence for the Efficacy of Ultra-High Diluted Homoeopathic Medicines in the Management of Influenza-Like Illness: A Narrative Review

2020 ◽  
Vol 33 (04) ◽  
pp. 257-262
Author(s):  
Anupam Mukherjee ◽  
Neeti Sinha ◽  
Joy Kumar Dey ◽  
Arun Bhargav Jadhav
Keyword(s):  
Clinical Trials ◽  
Placebo Group ◽  
Significant Role ◽  
Methodological Quality ◽  
Randomised Controlled Trials ◽  
Narrative Review ◽  
Controlled Trials ◽  
Jadad Scale ◽  
Randomised Controlled

Abstract Introduction In view of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the rise in cases of influenza-like illness (ILI), there is urgent need of developing and scientifically establishing treatment strategies. Homoeopathy has been used effectively in various pandemics for a long-time showing potential of combating such outbreaks effectively. This study aims at evaluating the methodological quality of the clinical trials conducted with a motive of assessing the efficacy of homoeopathy in management of ILI. Methods The randomised clinical research manuscripts from various databases were included for the narrative review. In this study, the Jadad scale was applied as an assessment tool with the criteria of randomisation, blinding and withdrawals to evaluate the methodological quality of the selected randomised controlled trials. Results The seven randomised controlled trials fulfilling the inclusion criteria evaluated on Jadad scale lay between the ranges of 2 to 5 with a mean score of 3.71 implicating the efficacy of homoeopathy in ILI. Six studies showed significant role of homoeopathy in the faster recovery of ILI symptoms. One trial, however, reported no noticeable difference in intergroup (treatment and placebo group) improvement but distinct intragroup comparison was observed. Conclusion It was concluded from this narrative review that homoeopathy has significant role in faster recovery of ILI symptoms in comparison to placebo group, and it can be employed as a potential treatment strategy in the recurrent pandemics of ILI and the currently prevailing coronavirus disease 2019 (COVID-19) crisis. It is suggested that more clinical trials with standard methodology should be conducted in this regard.

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