Effect of Extracorporeal Shock Wave Therapy on Gait Pattern in Hemiplegic Cerebral Palsy

El-Shamy, Shamekh Mohamed; Eid, Mohamed A.; ElBanna, Mohamed

doi:10.1097/phm.0000000000000133

Cited by 39 publications

(59 citation statements)

References 25 publications

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“…In the last five years, a few review studies have provided primary evidence to support the use of ESWT for the upper and lower limb spasticity: one meta-analysis of clinical trials on all types of spasticity in patients after brain injury, 40 two meta-analyses of randomized controlled trials (RCTs) on spasticity in post-stroke patients, 41,42 one narrative review on muscle hypertonia and dystonia, 43 and one authorized narrative review on upper and lower limb spasticity in post-stroke patients. 44 Additionally, several studies have confirmed utility of ESWT in reducing spasticity among patients with cerebral palsy (CP, 8 studies on the total sample of 124 patients, 4 used fESWT and 4 rESWT) [45][46][47][48][49][50][51][52] and multiple sclerosis (MS, 1 study involved a group of 34 patients treated with rESWT). 53…”

Section: Current Evidence On Shock Wavesmentioning

confidence: 99%

<p>Shock Waves as a Treatment Modality for Spasticity Reduction and Recovery Improvement in Post-Stroke Adults – Current Evidence and Qualitative Systematic Review</p>

Dymarek

Ptaszkowski

Ptaszkowska

et al. 2020

CIA

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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.

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Section: Current Evidence On Shock Wavesmentioning

confidence: 99%

<p>Shock Waves as a Treatment Modality for Spasticity Reduction and Recovery Improvement in Post-Stroke Adults – Current Evidence and Qualitative Systematic Review</p>

Dymarek

Ptaszkowski

Ptaszkowska

et al. 2020

CIA

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“… 2 7 2000 + + + − − + − − + + Tornese et al 95 + Epos Ultra (Dornier) EM 0.22 (?) 3 7 1800 + − + − − + + − + + Saxena et al 96 + Duolith SD 1 (Storz) EM 0.24 (EFD total ) 3 7 2000 + + + − − − + − + + Spasticity El-Shamy et al 97 + Modulith SLK (Storz) EM 0.03 (?) 12 7 1500 + + + − − + − − + ...…”

Section: Resultsunclassified

Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database

et al. 2015

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BackgroundExtracorporeal shock wave therapy (ESWT) is an effective and safe non-invasive treatment option for tendon and other pathologies of the musculoskeletal system.Sources of dataThis systematic review used data derived from the Physiotherapy Evidence Database (PEDro; , 23 October 2015, date last accessed).Areas of agreementESWT is effective and safe. An optimum treatment protocol for ESWT appears to be three treatment sessions at 1-week intervals, with 2000 impulses per session and the highest energy flux density the patient can tolerate.Areas of controversyThe distinction between radial ESWT as ‘low-energy ESWT’ and focused ESWT as ‘high-energy ESWT’ is not correct and should be abandoned.Growing pointsThere is no scientific evidence in favour of either radial ESWT or focused ESWT with respect to treatment outcome.Areas timely for developing researchFuture randomized controlled trials should primarily address systematic tests of the aforementioned optimum treatment protocol and direct comparisons between radial and focused ESWT.

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“…In recent years, studies have reported that ESWT is a safe, noninvasive, alternative treatment for spasticity that does not cause muscle weakness or unpleasant effects in patients with stroke, 6 – 15 cerebral palsy, 16 – 19 and multiple sclerosis. 20 Although a recent small meta-analysis (including only 5 studies) reported that ESWT had a significant effect on improving spasticity 4 weeks after treatment compared with baseline in patients with brain injury, 21 the effect of ESWT on spasticity cannot be determined because most studies to date have enrolled small patient numbers, and have lacked placebo-controlled groups and/or long-term follow-up.…”

Section: Introductionmentioning

confidence: 99%

Effect of Radial Shock Wave Therapy on Spasticity of the Upper Limb in Patients With Chronic Stroke

et al. 2016

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Recently, studies have reported that extracorporeal shock wave therapy (ESWT) is a safe, noninvasive, alternative treatment for spasticity. However, the effect of ESWT on spasticity cannot be determined, because most studies to date have enrolled small patient numbers and have lacked placebo-controlled groups and/or long-term follow-up. In addition, whether varying the number of ESWT sessions would affect the duration of the therapeutic effect has not been investigated in a single study. Hence, we performed a prospective, randomized, single blind, placebo-controlled study to investigate the long-term effect of radial ESWT (rESWT) in patients with poststroke spasticity and surveyed the outcome of functional activity.Sixty patients were randomized into 3 groups. Group A patients received 1 session of rESWT per week for 3 consecutive weeks; group B patients received a single session of rESWT; group C patients received one session of sham rESWT per week for 3 consecutive weeks. The primary outcome was Modified Ashworth Scale of hand and wrist, whereas the secondary outcomes were Fugl-Meyer Assessment of hand function and wrist control. Evaluations were performed before the first rESWT treatment and immediately 1, 4, 8, 12, and 16 weeks after the last session of rESWT.Compared to the control group, the significant reduction in spasticity of hand and wrist lasted at least 16 and 8 weeks in group A and B, respectively. Three sessions of rESWT had a longer-lasting effect than one session. Furthermore, the reduction in spasticity after 3 sessions of rESWT may be beneficial for hand function and wrist control and the effect was maintained for 16 and 12 weeks, respectively.rESWT may be valuable in decreasing spasticity of the hand and wrist with accompanying enhancement of wrist control and hand function in chronic stroke patients.

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Effect of Extracorporeal Shock Wave Therapy on Gait Pattern in Hemiplegic Cerebral Palsy

Abstract: Shock wave therapy may be a useful tool for improving spasticity and gait pattern in children with hemiplegic cerebral palsy.

Cited by 39 publications

References 25 publications

<p>Shock Waves as a Treatment Modality for Spasticity Reduction and Recovery Improvement in Post-Stroke Adults – Current Evidence and Qualitative Systematic Review</p>

<p>Shock Waves as a Treatment Modality for Spasticity Reduction and Recovery Improvement in Post-Stroke Adults – Current Evidence and Qualitative Systematic Review</p>

Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database

Effect of Radial Shock Wave Therapy on Spasticity of the Upper Limb in Patients With Chronic Stroke

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