Effects of radial extracorporeal shockwave therapy on spasticity of upper-limb agonist/antagonist muscles in patients affected by stroke: a randomized, single-blind clinical trial.

Abstract

the effects of radial extracorporeal shock wave therapy (rESWT) were assessed on agonist/antagonist muscles in stroke patients with elbow spasticity, the duration of effects and influence on function. patients were randomly assigned into groups: control (A, n = 25), rESWT on agonist muscles (B, n = 27) and rESWT on antagonist muscles (C, n = 30) groups. Conventional physical therapy was given to three groups for 3weeks, six times a week, and besides, rESWT was given at 4-day intervals for five consecutive treatments, B received rESWT on agonist muscles and C received rESWT on antagonist muscles. The primary outcome was Modified Ashworth Scale (MAS) scores. Modified Tardieu Scale, Visual Analogue Scale (VAS), Fugl-Meyer Assessment and swelling scale (SS) scores were secondary outcomes. Indicators were assessed at baseline, after five treatments and after 4weeks follow-up. the rate of treatment was determined by changes in MAS, which was 16.0 (A), 70.4 (B) and 63.3% (C) after rESWT treatments, and was 24.0 (A), 74.1 (B) and 66.7% (C) after 4weeks follow-up. Improvements were achieved for R1 (P < 0.01), R2 (P < 0.01) and VAS (P < 0.01) after five rESWT interventions. At 4weeks, significant improvements were achieved for R1 (P < 0.01) and VAS (P < 0.01). rESWT is an effective therapy for spasticity after stroke, with lasting effects on both agonist and antagonist muscles after 4weeks. rESWT relieved pain but had no effect on active function or swelling of the upper limbs.