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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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European Journal of Physical and Rehabilitation Medicine 2017 Oct 25

DOI: 10.23736/S1973-9087.17.04801-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Comparison of the effect of focused and radial extracorporeal shock waves on spastic equinus in patients with stroke: a randomized controlled trial

Yah-Ting WU 1, Chih-Ning CHANG 1, Yi-Min CHEN 2, Gwo-Chi HU 1

1 Department of Rehabilitation Medicine, Mackay Memorial Hospital, Taipei, Taiwan; 2 Department of Neurology, Mackay Memorial Hospital, Taipei, Taiwan


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BACKGROUND: Recent studies have suggested that either focused or radial shock wave therapy is an effect method for the treatment of spasticity in patients with stroke. However, no previous study compared these two types of extracorporeal shock wave on spasticity in patients with stroke. This study aimed to compare the effect of focused and radial shock wave therapy for the treatment of spastic equinus in patients with stroke.
DESIGN: Randomized control trial.
SETTING: Outpatient rehabilitation center in a medical center.
POPULATION: 32 stroke patients with spastic equinus (18 males and 14 women; mean age, 60.1±10.6 years).
METHODS: Patients were randomly assigned to receive three sessions of either focused or radial shock wave therapy at 1-week intervals. The intensities that were used during focused shock wave therapy (0.12 mJ/mm2) and radial shock wave therapy (2.4 bar) were comparable. The patients were evaluated at baseline and at 1, 4, and 8 weeks after the final shockwave treatment. The primary outcome measure was change of modified Ashworth scale score of gastrocnemius muscle. The secondary outcome measures were Tardieu scale, ankle passive range of motion, dynamic foot contact area and gait speed. A linear mixed model with repeated measures was used to compare each outcome measure between the two groups.
RESULTS: Both groups improved significantly in terms of modified Ashworth scale score and Tardieu scale, and no differences were found between the two groups. In terms of ankle passive range of motion and plantar contact area during gait, the radial shock wave therapy yielded a significantly greater improvement than the focused shock wave therapy. No significant changes were observed in gait speed in either group.
CONCLUSIONS: Our study suggested that focused and radial shock wave therapy resulted in similar significant improvements in the modified Ashworth scale score and Tardieu scale, but those in the radial shock wave therapy group experienced greater improvements in the ankle passive range of motion and plantar contact area during gait.
CLINICAL REHABILITATION IMPACT: Both focused and radial shock wave therapy yielded similar improve the spasticity of gastrocnemius muscle. Radial shock wave therapy is superior to focused shock wave therapy in terms of improving the ankle passive range of motion and plantar contact area during gait in patients with stroke.


KEY WORDS: High energy shock waves - Muscle spasticity - Equinus deformity - Stroke

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Publication History

Article first published online: October 25, 2017
Manuscript accepted: October 25, 2017
Manuscript revised: October 13, 2017
Manuscript received: May 4, 2017

Per citare questo articolo

Wu YT, Chang CN, Chen YM, Hu GC. Comparison of the effect of focused and radial extracorporeal shock waves on spastic equinus in patients with stroke: a randomized controlled trial. Eur J Phys Rehabil Med 2017 Oct 25. DOI: 10.23736/S1973-9087.17.04801-8

Corresponding author e-mail

kung527@gmail.com