Positive Effects of Extracorporeal Shock Wave Therapy on Spasticity in Poststroke Patients: A Meta-Analysis

Guo, Peipei; Gao, Fuqiang; Zhao, Tingting; Sun, Wei; Wang, Bailiang; Li, Zirong

doi:10.1016/j.jstrokecerebrovasdis.2017.08.019

Cited by 53 publications

(50 citation statements)

References 31 publications

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“…An earlier meta-analysis by Guo et al 41 has also shown that ESWT is useful for the treatment of spasticity in poststroke patients. However, the authors used the MAS as only one method for spasticity assessment and did not consider important factors that may potentially affect the results, such as ESWT frequency, therapy site, total ESWT sessions, and muscles subjected to ESWT sessions.…”

Section: Limited Data On Shock Wavesmentioning

confidence: 98%

“…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).…”

Section: Current Evidence On Shock Wavesmentioning

confidence: 99%

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<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: Limited Data On Shock Wavesmentioning

confidence: 98%

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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“…Physical factor therapy has been widely used in the treatment of limb spasm after stroke, and has achieved certain effects, but its exact mechanism is still unclear, and there is a lack of evidence-based medical evidence for large-sample clinical research. In addition, the implementation of physical factor therapy has not yet been standardized or clinical guidelines set; the operation depends on personal preferences and experience, and the intensity of stimulation and dose in different clinical reports varies [12][13][14][15][16]. Orthosis and rehabilitation robots, with their good sustainability and rhythm, can assist in alleviating hand spasm after stroke and reduce the workload of therapists to some extent, but their sensitivity and regulation ability are poor, and they are expensive.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture of fascia points to relieve hand spasm after stroke: a study protocol for a multicenter randomized controlled trial

Zhang

et al. 2020

Trials

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Background: The loss of functional ability of patients after stroke is mostly caused by dysfunction of the upper limbs, especially the hands. Hand functional exercise is the premise of alleviating hand dysfunction, and the relief of hand spasm is the basis of timely and effective hand functional exercise. Previous clinical observation have shown that fascial-point needling can effectively alleviate hand spasm immediately after stroke, but further evidence from large-sample studies is needed. The overall objective of this trial is to further evaluate the clinical efficacy of fascialpoint acupuncture on hand spasm after stroke. Methods/design: This multicenter randomized controlled trial will compare the efficacy of fascial-point acupuncture versus sham acupuncture and routine rehabilitation therapy in stroke patients with hand spasm. Patients will be randomized to undergo either the fascial-point acupuncture, the sham acupuncture or the control (routine rehabilitation therapy). We will recruit 210 stroke inpatients who meet the trial criteria and observe the remission of hand spasm and improvement of limb function after 4 weeks of intervention. The first evaluation indices are the remission of hand spasm and the duration of spasm remission. The second evaluation indices are the hand function of the affected limbs and the activities of daily living. When the accumulative total number of cases included reaches 120, a mid-term analysis will be conducted to determine any evidence that experimental intervention does have an advantage. Discussion: Our aim is to evaluate the efficacy of fascial-point acupuncture in relieving hand spasm after stroke. The results should provide more evidence for the clinical application of this therapy in the future.

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“…Physical factor therapy has been widely used in the treatment of limb spasm after stroke, and has achieved a certain effect, but its exact mechanism is still unclear, and lack of evidence-based medical evidence for large sample clinical research. In addition, the implementation of physical factor therapy has not yet been standardized or clinical guidelines, the operation depends on personal preferences and experience, the intensity of stimulation and dose of clinical reports are different [12][13][14][15][16] . Orthosis and rehabilitation robots, with their good sustainability and rhythm, can assist in alleviating hand spasm after stroke and reduce the workload of therapists to some extent, but their sensitivity and regulation ability are poor, and their price is expensive.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture of fascia points to relieve hand spasm after stroke: a study protocol for a multicenter randomized controlled trial

Zhang

Wei²,

et al. 2019

Preprint

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Background: The loss of life ability of patients after stroke is mostly caused by the dysfunction of upper limbs, especially hands. Hand functional exercise is the premise of alleviating hand dysfunction, and the relief of hand spasm is the basis of timely and effective hand functional exercise. Previous clinical observation showed that fascial point needling could effectively alleviate hand spasm immediately after stroke, but further evidence from large sample studies is needed. The overall

show abstract

Positive Effects of Extracorporeal Shock Wave Therapy on Spasticity in Poststroke Patients: A Meta-Analysis

Cited by 53 publications

References 31 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>

Acupuncture of fascia points to relieve hand spasm after stroke: a study protocol for a multicenter randomized controlled trial

Acupuncture of fascia points to relieve hand spasm after stroke: a study protocol for a multicenter randomized controlled trial

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