Effectiveness of Extracorporeal Shock Wave Therapy on Postural Control and Balance in Children With Unilateral Cerebral Palsy: A Randomized Controlled Trial

Abstract

The aim of this study was to investigate the effects of Extracorporeal Shock Wave Therapy (ESWT) applied to paraspinal muscles on balance and postural control in children with unilateral Cerebral Palsy (CP). A total of 32 children with unilateral CP were included in the study. The children participated in a one-session control to evaluate their reactions to ESWT before randomly assigning them into experimental and control groups. We evaluated children twice: before and after the treatment. We used the Trunk Control Measurement Scale, Trunk Impairment Scale, Pediatric Balance Scale (PBS), and Timed Up and Go (TUG) test in these assessments. Following the pre-test session, we applied Neuro-Developmental Treatment (NDT) programs to both groups at the rate of twice per week for eight weeks; additionally, we applied ESWT only to the experimental group at the rate of twice a week for eight weeks. While there were trends toward increased trunk control skills, PBS scores and TUG test performances from pre- to post-testing in both groups, these improvements were only statistically significant in the experimental group ( p < 0.05). We conclude that for children with unilateral CP, ESWT applied to paraspinal muscles has significant additive value when combined with NDT to improve postural control and balance.

Extracorporeal Shock Wave Therapy with Low-Energy Flux Density Treatment Applied to Hemiplegia Patients on Somatosensory Functions and Spatiotemporal Parameters

“… 35 Radinmehr et al 24 found no significant difference in TUG scores in patients with hemiplegia treated with ESWT. Bilek and Tekin 36 did not see a statistically significant difference in TUG scores between groups. Our study found statistically significant differences in the TUGs before and after the treatment.…”

A Comprehensive Review of the Effects of Extracorporeal Shock Wave Therapy on Stroke Patients: Balance, Pain, Spasticity

“…ESWT may help improve balance by targeting the affected muscles and neural pathways, promoting neuromuscular re-education, and facilitating motor recovery [ 33 ]. The mechanical stimulation induced by ESWT can increase blood flow [ 28 ], promote cellular responses, and enhance the functionality of affected muscles and joints, thereby improving overall balance and stability [ 34 ]. Several clinical trials and systematic reviews have investigated the effects of ESWT on balance ( Table 1 ) [ 35 ].…”

Neurodevelopmental Treatment in Children With Cerebral Palsy: A Review of the Literature

“…A randomized controlled trial (RCT) in 2021 suggested that extracorporeal shock wave therapy given to paraspinal muscles offers significant additive value when paired with NDT in improving balance and postural control in children with hemiplegic CP. Thirty-two CP children were included in the study and the tools used were the trunk control measurement scale, timed up and go, pediatric balance scale, and trunk impairment scale [ 35 ].…”

“…Viking speech scale (VSS) [34] 38 Trunk control measurement scale [35,57] 39 Mobility questionnaire [37] 40 Goal Attainment Scale [36,38] 41 3D gait analysis [36] 42 Ultrasonography [37] 43 Mobility questionnaire (MobQue) [37] 44 Root mean square of head accelerations [38] 45 Hip radiographs to measure migration percentage [38] Parent questionnaire rating child mobility […”

“…These areas of improvement are summarized in Table1. Gross motor[7,10,11,12,13,14,15,17,18,22,23,24,25,32,37,38,44,45,46,47,51,52,55,60] 2Balance[7,8,28,30,35,43,51,57] 3 Postural control/trunk control[7,8,27,28,35,57]…”