Effects of extracorporeal shock wave therapy on upper extremity muscle tone in chronic stroke patients

Park, Seung Kyu; Yang, Dae Jung; Uhm, Yo Han; Yoon, Jong Hyuk; Kim, Je Ho

doi:10.1589/jpts.30.361

Cited by 16 publications

(27 citation statements)

References 18 publications

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“…As supported by radiological [ 33 ] and histological [ 34 ] approaches, the structural changes in paraspinal muscles are in the foreground [ 7 ]. Furthermore, Park et al [ 35 ] found differences in cervical muscle frequency and stiffness between patients with cervicogenic headache and healthy individuals, but not in decrement as observed in our patients, which could mean that elasticity does fit the same behavior pattern as other mechanical properties when spinal muscles are assessed. This author also reported a case study [ 36 ] of an axSpA patient, analyzing cervical muscles pre- and post-treatment for central and unilateral posteroanterior mobilization.…”

Section: Discussionsupporting

confidence: 62%

Mechanical Properties of Lumbar and Cervical Paravertebral Muscles in Patients with Axial Spondyloarthritis: A Case-Control Study

et al. 2021

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Background: Axial spondyloarthritis (axSpA) affects spinal muscles, due to inflammation and structural damage. The mechanical properties of the muscles, such as tone or stiffness, could be altered in axSpA. The aim of this work is to analyze the mechanical properties of cervical and lumbar spine muscles in axSpA patients and their relationship with metrology measures, function, disease activity, structural damage and quality of life. Methods: axSpA patients and age/gender/BMI matched healthy controls were recruited. The muscle mechanical properties (MMPs), such as tone or frequency, stiffness, decrement (linear elastic properties), relaxation and creep (viscoelastic properties), of cervical (semispinalis capitis) and lumbar (erector spinae) muscles were bilaterally measured at rest using myotonometry. Additionally, conventional metrology, BASMI (metrology index), BASDAI (disease activity index), mSASSS (radiological structural damage index) and SF-12 (health-related quality of life questionnaire) were used in the axSpA group. Between-groups comparison, intra-group correlations and multivariable regression analyses were performed to achieve the study aims. Results: Thirty-four axSpA patients (mean age: 46.21 ± 8.53 y) and 34 healthy volunteers (mean age: 43.97 ± 8.49 y) were recruited. Both in cervical and lumbar spine, linear elastic parameters were significantly higher in axSpA patients in comparison with controls, while viscoelastic parameters were significantly lower. Lumbar muscle frequency, stiffness, relaxation, creep and cervical muscle elasticity were fair to strongly correlated (|0.346|<r<|0.774|) with age, functional status, activity of disease, structural damage and quality of life in axSpA patients. Furthermore, moderate to good fitted multivariate models (0.328<R2<0.697) were obtained combining age, conventional metrology, activity of the disease and function for the estimation of cervical and lumbar MMPs. Conclusion: Mechanical properties of spinal muscles of axSpA patients differ from controls. Lumbar and cervical muscles exhibit greater linear elastic properties and lower viscoelastic properties, which are related with age, clinical and psychophysiological features of axSpA.

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Section: Discussionsupporting

confidence: 62%

Mechanical Properties of Lumbar and Cervical Paravertebral Muscles in Patients with Axial Spondyloarthritis: A Case-Control Study

et al. 2021

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“…The enrolled studies were subdivided in terms of the localization of the spasticity into upper or lower limb. A total of 22 studies including 468 post-stroke adults—11 reports with the upper limb (267 patients) [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ] and 10 reports within the lower limb (201 patients) [ 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ], as well as one report including both upper and lower limbs [ 56 ]. Figure 1 presents low diagram for selection process and identification of studies for inclusion in this review.…”

Section: Resultsmentioning

confidence: 99%

“…Park et al (2018) [ 43 ] in their randomized study enrolled a group of 30 patients after stroke which was divided into ESWT group ( n = 15) and placebo-ESWT group ( n = 15). Both ESWT (wrist flexors = 1500 pulses, and plantar interosseous = 3200 pulses, 800 per each muscle; 1.5 bars and 0.03 mJ/mm 2 ) and sham-ESWT (only a sound of shocks) interventions were performed (eight sessions, two times per week).…”

Section: Resultsmentioning

confidence: 99%

The Current State of Knowledge on the Clinical and Methodological Aspects of Extracorporeal Shock Waves Therapy in the Management of Post-Stroke Spasticity—Overview of 20 Years of Experiences

Opara

Taradaj

Walewicz

et al. 2021

JCM

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In many patients after stroke, spasticity develops over time, resulting in a decrease in the patient’s independence, pain, worsening mood, and, consequently, lower quality of life. In the last ten years, a rich arsenal of physical agents to reduce muscle tone such as extracorporeal shock therapy (ESWT) wave has come through. The aim of this narrative review article is to present the current state of knowledge on the use of ESWT as a supplement to the comprehensive rehabilitation of people after stroke suffering from spasticity. The PubMed and PEDro databases were searched for papers published in English from January 2000 to December 2020, 22 of which met inclusion criteria for clinical studies related to post-stroke spasticity management with ESWT. A total of 22 studies including 468 post-stroke patients—11 reports with the upper limb (267 patients) and 10 reports within the lower limb (201 patients), as well as one report including both upper and lower limb. We focused our attention on clinical and methodological aspects. Therefore, we performed the assessment of enrolled studies in terms of methodological quality using the PEDro and level of evidence using the National Institute for Health and Clinical Excellence (NICE) guidelines. Furthermore, we indicated implications for clinical practice in using ESWT for post-stroke spasticity management. Moreover, we discussed a suggestion for future research directions. In conclusion, an ESWT effectively reduces muscle tone in people with spastic limb after stroke. Further, ESWT is safe and free of undesirable side effects. The mechanism of action of ESWT on muscles affected by spasticity is still unknown. To date, no standard parameters of ESWT in post-stroke spasticity regarding intensity, frequency, location, and the number of sessions has been established. Further research, meeting the highest standards, is needed to establish uniform muscle stimulation parameters using ESWT.

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“…The PRISMA diagram (see Figure 1) summarizes the results of the scientific literature search. Sixteen randomized controlled trials were included: these were by Bae et al, 15 Santamato et al, 16 Fouda et al, 17 Dymarek et al, 18 Kim et al, 19 Li et al, 20 Yoon et al, 21 Duan et al, 22 Guoxing et al, 23 Guo et al, 24 Fouda et al, 25 Kamaluddin et al, 26 Park et al, 27 Wu et al, 28 Ahmed et al, 29 and Li et al 30 Studied identified but not included are shown in Appendix 2. No author responded when contacted for additional information.…”

Section: Resultsmentioning

confidence: 99%

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

et al. 2020

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Objective: To assess the effectiveness of Extracorporeal Shock Wave Therapy for reducing spasticity and improving functionality of the upper limb in stroke survivors. Data sources: A systematic review of MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, PEDro, REHABDATA, Scielo, Scopus, Web of Science, Tripdatabase and Epistemonikos from 1980 to April 2020 was carried out. Review methods: The bibliography was screened to identify randomized controlled clinical trials that applied extracorporeal shock waves to upper limb spastic muscles in post-stroke individuals. Two reviewers independently screened references, selected relevant studies, extracted data and assessed risk of bias using the PEDro scale. The primary outcome was spasticity and functionality of the upper limb. Results: A total of 1,103 studies were identified and 16 randomized controlled trials were finally included (764 individuals) were analyzed. A meta-analysis was performed and a beneficial effect on spasticity was found. The mean difference (MD) on the Modified Ashworth Scale for comparison extracorporeal shock wave versus sham was −0.28; with a 95% confidence interval (CI) from −0.54 to −0.03. The MD of the comparison of extracorporeal shock wave plus conventional physiotherapy versus conventional physiotherapy was −1.78; 95% CI from −2.02 to −1.53. The MD for upper limb motor-function using the Fugl Meyer Assessment was 0.94; 95% CI from 0.42 to 1.47 in the short term and 0.97; 95% CI from 0.19 to 1.74 in the medium term. Conclusion: The extracorporeal shock wave therapy is effective for reducing upper limb spasticity. Adding it to conventional therapy provides an additional benefit.

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Effects of extracorporeal shock wave therapy on upper extremity muscle tone in chronic stroke patients

Cited by 16 publications

References 18 publications

Mechanical Properties of Lumbar and Cervical Paravertebral Muscles in Patients with Axial Spondyloarthritis: A Case-Control Study

Mechanical Properties of Lumbar and Cervical Paravertebral Muscles in Patients with Axial Spondyloarthritis: A Case-Control Study

The Current State of Knowledge on the Clinical and Methodological Aspects of Extracorporeal Shock Waves Therapy in the Management of Post-Stroke Spasticity—Overview of 20 Years of Experiences

The effectiveness of extracorporeal shock wave therapy for improving upper limb spasticity and functionality in stroke patients: a systematic review and meta-analysis

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