Effectiveness of Shock Wave Therapy as a Treatment for Spasticity: A Systematic Review.

Isabel María Martínez,Nuria Sempere-Rubio,Raquel Faubel,Olga Navarro

doi:10.3390/brainsci11010015

Abstract

Background: The purpose of this study was to collect and analyse the available scientific evidence on the effectiveness of shock wave therapy as a treatment for spasticity. Methods: the search was performed in the following databases: PubMed, PEDro, Cochrane, Embase, and the Virtual Health Library. All publications from November 2009 to November 2019 were selected that included a sample of patients with spasticity and prior suspension of botulinum toxin, to whom shock wave therapy was applied. The methodological quality of the articles was evaluated using the Jadad scale and the pyramid of quality of scientific evidence. Results: 25 studies involving 866 participants with spasticity were selected. The results obtained suggest that shock wave therapy appears to be effective in reducing spasticity levels irrespective of the age of the participants, the type of injury, and the tool used to measure the effect. Conclusions: shock wave therapy reports evidence of improvement in motor function, motor impairment, pain, and functional independence, applied independently of botulinum toxin. However, due to the heterogeneity of the protocols, there is no optimum protocol for its application, and it would be appropriate to gain more high-quality scientific evidence through primary studies.

Highlights

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.Spasticity is a frequent complication in neurological diseases and a great clinical challenge [1], which causes a high burden of care and economic implications [2]
Its prevalence is linked to associated pathology; it is estimated that it affects around 20–40% of survivors of stroke after 12 months [1,6,9,11,12,13,14,15], 60–90% of people with multiple sclerosis [9], and 80% of patients with cerebral palsy (CP) [5,16]
The results obtained through the variables studied, such as motor function, motor impairment, pain, functional independence, and electrodiagnostic techniques, suggest that shock wave therapy could reduce levels of spasticity regardless of the age of the participants and the type of injury

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.Spasticity is a frequent complication in neurological diseases and a great clinical challenge [1], which causes a high burden of care and economic implications [2]. The most common complications related to spasticity include: chronic neuropathic pain, sensory disorders, bone deformities with demineralisation, severe muscle spasms, fibrosis of muscle fibres, and muscular atrophy with rheological changes [1,5,6,7]. It interferes with daily life by impairing physical capabilities (restricted range of joint movement, loss of dexterity, impaired balance and walking) [8,9], which, together with the emotional impact (on character, mood, and self-esteem), can lead to social isolation [10]. Due to the heterogeneity of the protocols, there is no optimum protocol for its application, and it would be appropriate to gain more high-quality scientific evidence through primary studies

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