Improvement of Hand Motor Function after Radial Shock Wave Therapy in Chronic Stroke Patients

Abstract

IIntroduction: 
 
 The Radial Shock Wave Therapy (RSWT) expected could improve spasticity and hand function in chronic stroke patients. This study aimed to find out the improvement of hand function after RSWT as an additional therapy in chronic stroke patients.
 
 Methods:
 
 Design study was a randomized controlled trial, in December 2018. The patients were assigned randomly to the experimental group (Infrared, Stretching, and RSWT) and control group (Infrared and Stretching) for six weeks. Hand motor function was measured using Fugl-Meyer Motor Assesment (FMA) before and after intervention.
 
 Results:
 
 The median values of wrist FMA scores in the experimental and control group before and after intervention were 2 vs 5 (p=0.001) and 3 vs 4 (p<0.001) respectively. The median values of hand FMA scores in the experimental and control group before and intervention were 4 vs 6 (p=0,.001) and 4 vs 5 (p<0.001). However, the delta between before and after intervention was higher in experimental group.
 
 Conclusion: The improvement of wrist and hand FMA scores after added treatment by RSWT was tend to higher.Keywords: Spasticity, Hand Function, Stroke, Radial Shock Therapy, Fugl-Meyer Motor Assesment

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

“…Only one study reported brain area stroke. 28 Most patients were in the chronic phase (>six months) except in the studies by Duan et al, 22 Guoxing et al, 23 Kamaluddin et al 26 which were in the subacute phase, Guo et al, 24 which were in late phase and Li et al 30 included both. All the studies included patients with a Modified Ashworth Scale 31 muscle spasticity score ⩾ 1, and excluded patients with fixed muscle contractures = 4 score points.…”

“…The PRISMA diagram (see Figure 1) summarizes the results of the scientific literature search. Sixteen randomized controlled trials were included: these were by Bae et al, 15 Santamato et al, 16 Fouda et al, 17 Dymarek et al, 18 Kim et al, 19 Li et al, 20 Yoon et al, 21 Duan et al, 22 Guoxing et al, 23 Guo et al, 24 Fouda et al, 25 Kamaluddin et al, 26 Park et al, 27 Wu et al, 28 Ahmed et al, 29 and Li et al 30 Studied identified but not included are shown in Appendix 2. No author responded when contacted for additional information.…”

“…24 Spasticity usually appears between one and six weeks after the stroke. 44 According to Duan et al, 22 Guoxing et al, 23 and Kamaluddin et al 26 the results would be optimal given the extracorporeal shock waves therapy at subacute phase. At this stage there is a cortical reorganization and an adaptive plasticity is more probable.…”

“…For the clinical assessment of spasticity, all studies used the Modified Ashworth Scale except Kamaluddin et al 26 Four studies used the Modified Tardieu Scale, 32 two used a myotonometer and another one used the Brunnstrom stages of motor recovery (see Table 2). The Modified Ashworth Scale quantifies the resistance felt when muscles are passively stretched.…”