Extracorporeal shock wave therapy alleviates spasticity in the triceps surae after stroke / 中华物理医学与康复杂志

ABSTRACT

Objective To evaluate the effect of applying extracorporeal shock wave therapy (ESWT) to alleviate triceps surae spasticity after a stroke and to explore the electrophysiological mechanisms involved.Methods Sixty hemiplegic stroke patients with triceps surae spasticity were recruited and randomly assigned to either an ESWT group or a control group,each of 30.Both groups were given routine medication and rehabilitation training.The ESWT group additionally received 3000 shots of ESWT at 0.089 mJ/mm2,1.5 bars and 8 Hz applied once a week for 4 weeks.Before the treatment,immediately afterward,and then 1 and 4 weeks later the subjects were assessed using the composite spasticity scale (CSS),passive range of motion (PROM) measurements,the 10-meter walk test (10MWT),H reflex latency and the Hmax/Mmax ratio.Results The ESWT group showed significant improvement in their average CSS,PROM and 10MWT results at t1,t2 and t3 compared with t0,while the control group had significant improvement in their average CSS and 10MWT scores,but their average PROM score improved significantly only at t1 and t2.The ESWT group showed significantly better progress in terms of their average CSS score at t1 and t2.The groups' average PROM scores were not significantly different,but the ESWT group had faster 10MWT times at t1,t2 and t3.In the ESWT group H reflex latency had lengthened significantly by t1 and the Hmax/Mmax ratio had decreased significantly,but the only significant difference from the controls was in the average H reflex latency at t1.The ESWT was well tolerated and did not cause any severe adverse effects.Conclusions ESWT improves triceps surae spasticity effectively after stroke quite safely.