Abstract
BackgroundStroke patients often present with upper limb spasticity which impairs the functional status of patients. Recently, extracorporeal shock wave therapy (ESWT) is reported to be a safe, non-invasive, alternative treatment for spasticity. Many articles have been published on the effect of ESWT on lower limb spasticity, but only few of them had focused on upper limb spasticity, so the aim of this study is to evaluate the clinical and electrophysiological effect of ESWT on wrist and hand spasticity of chronic stroke patients and its impact on functional performance. In this monocentric study, forty chronic stroke patients with upper limb spasticity were recruited and randomly allocated into two groups. Both groups continued to receive conventional stroke rehabilitative program, while group I received three sessions of radial extracorporeal shock wave therapy (rESWT) 1 week apart.ResultsThere was a significant decrease in wrist and hand spasticity after treatment and at follow-up in group I compared to group II (Modified Ashworth Scale after rESWT 1.45 ± 0.16, 2.90 ± 0.18 and follow-up 1.55 ± 0.13, 3.00 ± .0.15 in groups I and II, respectively). Also, there was a significant improvement of wrist control and hand function after treatment and at follow-up in group I compared to group II (p < 0.001). The improvement of pinch grip was noticed at follow-up with a significant difference relative to baseline in group I (p < 0.05). Hmax/Mmax ratio was significantly decreased at follow-up in group I compared to group II (p < 0.001).ConclusionESWT is a valuable adjuvant treatment for spasticity of the hand and wrist in stroke patients which is reflected as improvement of functional activity.Trial registrationClinicalTrials.gov, NCT04312581. Registered on 18 March 2020.
Highlights
Stroke patients often present with upper limb spasticity which impairs the functional status of patients
Outcome measurements There was a significant improvement of Modified Ashworth Scale (MAS) and Fugl-Meyer Assessment (FMA) at 2 weeks after radial extracorporeal shock wave therapy (rESWT) and at 3-month follow-up in the first group compared to the second
There was a significant improvement of MAS and FMA in patients of the first group after treatment and at follow-up relative to baseline, but there was no significant difference at followup compared to after treatment except for hand function of FMA
Summary
Stroke patients often present with upper limb spasticity which impairs the functional status of patients. Many articles have been published on the effect of ESWT on lower limb spasticity, but only few of them had focused on upper limb spasticity, so the aim of this study is to evaluate the clinical and electrophysiological effect of ESWT on wrist and hand spasticity of chronic stroke patients and its impact on functional performance. Forty chronic stroke patients with upper limb spasticity were recruited and randomly allocated into two groups Both groups continued to receive conventional stroke rehabilitative program, while group I received three sessions of radial extracorporeal shock wave therapy (rESWT) 1 week apart. The rESWT is less invasive than fESWT and more appropriate for physiotherapy purposes [3]
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