Purpose: This systematic review examines intervention studies using extracorporeal shock wave therapy (ESWT) application in post-stroke muscle spasticity with particular emphasis on the comparison of two different types of radial (rESWT) and focused shock waves (fESWT). Methods: PubMed, PEDro, Scopus, and EBSCOhost databases were systematically searched. Studies published between the years 2000 and 2019 in the impact factor journals and available in the English full-text version were eligible for inclusion. All qualified articles were classified in terms of their scientific reliability and methodological quality using the PEDro criteria. The PRISMA guidelines were followed and the registration on the PROSPERO database was done. Results: A total of 17 articles were reviewed of a total sample of 303 patients (age: 57.87 ±10.45 years and duration of stroke: 40.49±25.63 months) who were treated with ESWT. Recent data confirm both a subjective (spasticity, pain, and functioning) and objective (range of motion, postural control, muscular endurance, muscle tone, and muscle elasticity) improvements for post-stroke spasticity. The mean difference showing clinical improvement was: Δ=34.45% of grade for fESWT and Δ=34.97% for rESWT that gives a slightly better effect of rESWT (Δ=0.52%) for spasticity (p<0.05), and Δ=38.83% of angular degrees for fESWT and Δ=32.26% for rESWT that determines the more beneficial effect of fESWT (Δ=6.57%) for range of motion (p<0.05), and Δ=18.32% for fESWT and Δ=22.27% for rESWT that gives a slightly better effect of rESWT (Δ=3.95%) for alpha motor neuron excitability (p<0.05). The mean PEDro score was 4.70±2.5 points for fESWT and 5.71±2.21 points for rESWT, thus an overall quality of evidence grade of moderate ("fair" for fESWT and "good" for rESWT). Three studies in fESWT and four in rESWT obtained Sackett's grading system's highest Level 1 of evidence. Conclusion: The studies affirm the effectiveness of ESWT in reducing muscle spasticity and improving motor recovery after stroke.
Many studies have shown that unilateral transfemoral amputation involves asymmetric gait. Transfemoral amputation leads to muscle atrophy in a tight stump resulting in asymmetry in muscle torque between the amputated and intact limb. This research is aimed at verifying if a relationship between torque values of hip joint flexors and extensors and gait asymmetry in patients with TFA exists. Fourteen adult subjects with unilateral TFA took part in the experiment. Gait symmetry was evaluated based on the ground reaction force (GRF). Measurements of muscle torque of hip flexors and extensors were taken with a Biodex System. All measurements were taken under isokinetic (60°/s and 120°/s) and isometric conditions. The symmetry index of vertical GRF components was from 7.5 to 11.5%, and anterio-posterior GRF from 6.2 to 9.3%. The symmetry index for muscle torque was from 24.3 to 44% for flexors, from 39 to 50.5% for extensors, and from 28.6 to 50% in the flexor/extensor ratio. Gait asymmetry correlated with muscle torque in hip joint extensors. Therapy which enhances muscle torque may be an effective form of patient therapy. The patient needs to undergo evaluation of their muscle strength and have the therapy programme adjusted to their level of muscle torque deficit.
Low back pain (LBP) is the leading cause of disability worldwide, placing a significant economic burden on healthcare systems. Radial extracorporeal shock wave therapy (rESWT) is useful in the rehabilitation of orthopedic diseases; however, there is still limited evidence for patients with LBP. The aim of this study was to assess the effect of rESWT on pain level, functional efficiency, and parameters of postural control in patients with LBP. Participants were randomized into group A (n = 20) treated with rESWT and group B (n = 20) treated with sham rESWT (placebo). Both groups received conventional physiotherapy, including core stability exercises. The following tests were performed: the Laitinen Pain Scale (LPS), the Roland–Morris Questionnaire (RMQ), the original Schober Test (OST), and a stabilometric platform for the assessment of postural sway, including total sway path (TSP). We found that the analgesic effect was higher after rESWT, especially in the follow-up’s (p < 0.05). Similar results were found for functional efficiency and range of motion (p < 0.05). The improved posture stability in placebo group B was not statistically significant (p > 0.05). The stabilometric parameters in group A were still gradually improved and statistically significant, even in follow-ups (p < 0.05). In conclusion, the rESWT had a significant effect on the reduction of pain and the improvement of functional condition compared to a conventional physiotherapy program. Also, rESWT with core stability exercises led to significant improvements in postural sway compared with conventional physiotherapy in patients with LBP.
Summary Study aim: The aim of this study was to assess proportion and symmetry between torque in muscles that affect the hip joint in the non-amputated and the amputated limb in persons both engaged in and not engaged in sports. Material and methods: Study participants comprised 12 persons with above-knee leg amputation. The group of participants was divided into two subgroups: persons engaged in sports and physically inactive persons. The strength and the speed capacity of hip joint flexors and hip joint extensors were measured using a Biodex System 4 dynamometer. The measurement was conducted at two angular velocities (60°/s and 120°/s) and during isometric activity of the non-amputated and the amputated limb. Results: Maximal torque of hip joint flexors in the amputated limb of physically active persons constituted 65.3% of the corresponding value in persons without amputation and was higher than in physically inactive persons (55.9%). Similar values were obtained for extensors. The time to reach maximal muscle torque in the amputated limb during the extension of the hip joint at 60°/s equalled 400 ms in physically active persons and 900 ms in physically inactive persons and during flexion, equalled 400 ms and 600 ms, respectively. Conclusions: Physically active persons showed greater dynamics in generating maximal muscle torque, especially during the extension of the hip joint. Physical activity benefits the strength and speed capacity of muscles that affect the hip joint in persons with above-knee amputation, thus decreasing asymmetry and disproportion between limbs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.