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 Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy

2015 ◽  
Vol 24 ◽  
pp. 154-159 ◽  
Author(s):  
Ludger Gerdesmeyer ◽  
Rainer Mittermayr ◽  
Martin Fuerst ◽  
Munjed Al Muderis ◽  
Richard Thiele ◽  
...  
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Therapy ◽  
Achilles Tendinopathy ◽  
Current Evidence ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave ◽  
Chronic Achilles Tendinopathy

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.

Pain and Muscles Properties Modifications After Botulinum Toxin Type A (BTX-A) and Radial Extracorporeal Shock Wave (rESWT) Combined Treatment

2019 ◽  
Vol 19 (8) ◽  
pp. 1127-1133 ◽  
Author(s):  
Megna Marisa ◽  
Marvulli Riccardo ◽  
Farì Giacomo ◽  
Gallo Giulia ◽  
Dicuonzo Franca ◽  
...  
Keyword(s):  
Shock Wave ◽  
Botulinum Toxin ◽  
Botulinum Toxin Injection ◽  
Botulinum Toxin Type A ◽  
Combined Treatment ◽  
Extracorporeal Shock Wave Therapy ◽  
Botulinum Toxin Type ◽  
Post Stroke ◽  
Extracorporeal Shock Wave ◽  
Group B

Background and Objective:Spasticity (most common disability in upper motor neuron syndrome or UMNS) caused an inability of patients’ to perform daily activities and a decrease inquality of life. One of the promising methods nowadays, but still not widely used in everyday practice, for spasticity reduction is extracorporeal shock wave. The aim of this study was to evaluate the objective clinical effects of combined treatment botulinum toxin type A and radial Extracorporeal Shock Wave Therapy in spasticity post stroke.Methods:We considered 30 subjects (14 female and 16 male) with post stroke spasticity of Biceps Brachii, Superficial Flexor Digitorum, Gastrocnemius Medialis and Lateralis and we divided patients into two groups (group A received botulinum toxin injection and physiotherapy while group B received botulinum toxin injection, rESWT and physiotherapy). Assessments were performed before treatment (t0), after 1 (t1), 2 (t2) e 3 (t3) months using Modified Ahworth Scale, Visual Analogical Scale for pain and MyotonPro® device (to assessed myometric evaluation of muscles tone and stiffness).Results:Visual Analogical Scale, Modified Ahworth Scale, muscles tone and stiffness statistically decreased until t3 in the group A and in the group B, but the differences between the two groups were significant at the t1 only.Conclusion:Radial Extracorporeal Shock Wave Therapy could be an effective physical treatment aimed at the reduction of upper and lower limbs spasticity and could lead to the improvement of trophic conditions of the spastic muscles in post-stroke.

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