The Effect of Extracorporeal Shock Wave Therapy on Lower Limb Spasticity in Subacute Stroke Patients.
10.5535/arm.2013.37.4.461
- Author:
Seung Won MOON
1
;
Jin Hoan KIM
;
Mi Jin JUNG
;
Seungnam SON
;
Joong Hoon LEE
;
Heesuk SHIN
;
Eun Shin LEE
;
Chul Ho YOON
;
Min Kyun OH
Author Information
1. Department of Rehabilitation Medicine and Institute of Health Sciences, Gyeongsang National University Graduate School of Medicine, Jinju, Korea. solioh21@naver.com
- Publication Type:Original Article
- Keywords:
High-energy shock waves;
Muscle spasticity;
Stroke
- MeSH:
Animals;
Ankle;
High-Energy Shock Waves;
Humans;
Lower Extremity;
Muscle Spasticity;
Muscles;
Range of Motion, Articular;
Salicylamides;
Shock;
Stroke;
Torque
- From:Annals of Rehabilitation Medicine
2013;37(4):461-470
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the effect of extracorporeal shock wave therapy (ESWT) on lower limb spasticity in subacute stroke patients. METHODS: We studied thirty hemiplegic subacute stroke patients with ankle plantar flexor spasticity. ESWT was applied for 1 session/week, with a total of 3 sessions at the musculotendinous junction of medial and lateral gastrocnemius muscles. Patients were evaluated both clinically and biomechanically at baseline, after sham stimulation, and at immediately 1 week and 4 weeks after ESWT. For clinical assessment, Modified Ashworth Scale (MAS), clonus score, passive range of motion of ankle, and Fugl-Myer Assessment for the lower extremity were used. A biomechanical assessment of spasticity was conducted by an isokinetic dynamometer. Two parameters, peak eccentric torque (PET) and torque threshold angle (TTA), were analyzed at the velocities of 60degrees/sec, 180degrees/sec, and 240degrees/sec. RESULTS: After sham stimulation, there were no significant changes between each assessment. MAS and PET (180degrees/sec and 240degrees/sec) were significantly improved immediately and 1 week after ESWT. However, these changes were not significant at 4 weeks after ESWT. PET (60degrees/sec) and TTA (60degrees/sec, 180degrees/sec, and 240degrees/sec) were significantly improved immediately after ESWT. Yet, these changes were not significant at 1 week and 4 weeks after ESWT as well. CONCLUSION: Lower limb spasticity in subacute stroke patients was significantly improved immediately after ESWT. Although the therapeutic effect of ESWT reduced with time and therefore was not significant at 4 weeks after ESWT, the degree of spasticity was lower than that of the baseline. Future studies with a larger sample of patients are warranted in order to verify the protocols which can optimize the effect of ESWT on spasticity.
