Radial extracorporeal shock wave therapy as an additional treatment modality for spastic equinus deformity in chronic hemiplegic patients. A randomized controlled study

Doaa Waseem Nada; Amira Mohamed El Sharkawy; Elham Mahmoud Elbarky; El Sayed Mohamed Rageh; Abdallah El Sayed Allam

doi:10.1080/09638288.2023.2278185

Radial extracorporeal shock wave therapy as an additional treatment modality for spastic equinus deformity in chronic hemiplegic patients. A randomized controlled study

Disabil Rehabil. 2023 Nov 5:1-9. doi: 10.1080/09638288.2023.2278185. Online ahead of print.

Authors

Doaa Waseem Nada¹, Amira Mohamed El Sharkawy¹, Elham Mahmoud Elbarky¹, El Sayed Mohamed Rageh¹, Abdallah El Sayed Allam¹

Affiliation

¹ Department of Rheumatology, Rehabilitation and Physical Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.

PMID: 37926696
DOI: 10.1080/09638288.2023.2278185

Abstract

Purpose: To evaluate the effectiveness of radial extracorporeal shock wave therapy (r ESWT) as an additional treatment modality for spastic equinus deformity in chronic hemiplegic patients.

Methods: 100 eligible stroke patients with calf muscles spasticity were randomized into 2 groups. Group I: 50 patients exposed to rESWT 1.500 pulses, 0.10 mJ to 0.3mJ/mm2, with a frequency 4 Hz once weekly for one month. Group II: 50 patients exposed to Sham rESWT once weekly for one month. Clinical, electrophysiological & musculoskeletal ultrasound assessments were done for all patients.

Results: After controlling baseline as covariate, the trend for modified Ashworth scale (MAS), Passive ankle dorsiflexion motion (PADFM), 10 meters walk test (10-MWT), and Ratio of maximum H reflex to maximum M response (H/M ratio) after one & two months was significantly different between the two groups, with improvement of all clinical and electrophysiological parameters in group I.

Conclusion: ESWT represents a useful non-invasive, additional modality for the reduction of foot spasticity and equinus deformity in stroke patients.

Keywords: Spasticity; equinus deformity; extracorporeal shock wave; hemiplegia; stroke.

Plain language summary

Extracorporeal shock wave therapy represents a useful non-invasive, additional modality for reduction of foot spasticity and equinus deformity in chronic stroke patients.The application of such a modality improves limb posture, range of motion, and muscle extensibility.Early extracorporeal shock wave rehabilitative intervention in stroke patients reduces fat infiltration and fibrosis replacement of spastic muscle.