The effect of extracorporeal shock wave therapy on spasticity in post-stroke patients has been evaluated in several clinical trials. In addition, a recent meta-analysis suggests that such therapy is effective; however, the measurement of spasticity was based mainly on the modified Ashworth scale, which is insufficient, and a lack of randomized controlled trials studies in the study design may have biased the results. Therefore, considering the potential limitations of the previous meta-analysis, the aim of the current study was to perform a systematic review and meta-analysis of randomized controlled trials to evaluate the effectiveness of extracorporeal shock wave therapy on spasticity in post-stroke patients. Furthermore, subgroup analysis was performed to identify potential moderators or mediators. Objective: To evaluate whether extracorporeal shock wave therapy significantly improves spasticity in post-stroke patients. Design: Systematic review and meta-analysis. Data sources: PubMed, EMBASE, EBSCO, Web of Science, Cochrane CENTRAL electronic databases. Study selection: Randomized controlled trials assessing the effect of extracorporeal shock wave therapy on post-stroke patients with spasticity were selected for inclusion. Data extraction: Two authors independently screened the literature, extracted data, and assessed the quality of included studies. Primary outcome was modified Ashworth scale (MAS). Secondary outcomes were Modified Tardieu Scale (MTS), H/M ratio and range of motion. Data synthesis: Eight randomized controlled trial studies (n = 385 patients) were included in the meta-analysis. There was a high level of evidence that extracorporeal shock wave therapy significantly ameliorates spasticity in post-stroke patients according to the 4 parameters: MAS (standard mean difference (SMD) −1.22; 95% confidence interval (95% CI): −1.77 to −0.66); MTS (SMD 0.70; 95% CI 0.42-0.99,); H/M ratio (weighted mean difference (WMD)-0.76; 95% CI-1.19 to-0.33); range of motion (SMD 0.69; 95% CI 0.06-1.32). However, there was no statically significant difference on the MAS at 4 weeks (SMD-1.73; 95% CI-3.99 to 0.54). Conclusion: Extracorporeal shock wave therapy has a significant effect on spasticity in post-stroke patients.

Background Nonverbal cognitive training for aphasia has gained popularity. Prior research has found that cognitive status correlates with language function. Objective To determine whether nonverbal computer‐assisted executive control training (CAET) to improve cognitive status affects language performance in patients with aphasia (PWA) and executive dysfunction. Design A single blind randomized trial. Setting Department of Rehabilitation, Affiliated Hospital of Xuzhou Medical University. Participants A total of 68 individuals were randomized, underwent treatment and were included in the analysis (CAET group, n = 33; control group, n = 35). Interventions The experimental group was treated with 4 weeks of traditional speech and language therapy (SLT) combined with CAET. The control group underwent SLT only. Main Outcome Measures Western Aphasia Battery [WAB]) with executive dysfunction (as assessed by the verbal fluency test [VFT], the Proverbs Test, the Tower of London Test [TLT], the Stroop Color and Word Test [SCWT], and the Trail Making Test [TMT]). Results Differences between pre‐ and posttreatment language outcomes except oral naming (group × time, p = .236) were significantly greater in the experimental group compared with the control group: spontaneous speech (group × time, p = .026), auditory comprehension (group × time, p < .001), speech repetition (group × time, p = .001), and aphasia quotient (AQ; group × time, p < .001). A similar effect was observed for cognitive function such as Trial Making Test (TMT)‐A (group × time, p = .006), TMT‐B (group × time, p = .005), and verbal fluency test (VFT‐V; group × time, p = .018). Conclusion The study demonstrates that CAET combined with SLT can yield favorable language outcomes for PWA, especially improvements in auditory comprehension and AQ. CAET combined with SLT generates benefits in both cognitive function and language performance.