Management of Muscle Spasticity in Children with Cerebral Palsy by Means of Extracorporeal Shockwave Therapy: A Systematic Review of the Literature

Corrado, Bruno; Luise, Carla Di; Iammarrone, Clemente Servodio

doi:10.1080/17518423.2019.1683908

Cited by 19 publications

(15 citation statements)

References 47 publications

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“…During the past few decades, extracorporeal shock wave lithotripsy ( 17 ) has been widely used and has evolved to be standard therapy used for urinary calculi due to its excellent efficacy, non-invasiveness, and lack of obvious complications. At present, extracorporeal shock wave therapy (ESWT) has also been widely used for the treatment of various neurological and musculoskeletal diseases ( 18 , 19 ), such as cerebral palsy ( 20 ), multiple sclerosis ( 21 ), tendinopathy ( 22 ), chronic tennis elbow ( 23 ), and nonunion of long bone fracture ( 24 ). Recently, several studies ( 25 – 27 ) have indicated that ESWT could be used for decreasing hypertonia in strokes.…”

Section: Introductionmentioning

confidence: 99%

Effects of Radial Extracorporeal Shock Wave Therapy on Flexor Spasticity of the Upper Limb in Post-stroke Patients: Study Protocol for a Randomized Controlled Trial

Fan

Zhou

et al. 2021

Front. Neurol.

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Background: Flexor spasticity of the upper limb is common in poststroke patients and seriously affects the recovery of upper limb function. However, there are no standard management protocols for this condition. Radial extracorporeal shock wave therapy (rESWT) is widely used for various diseases, some studies reported the effects of ESWT on reducing spasticity, but the mechanism of ESWT to reduce spasticity by affecting the excitability of stretch reflex or non-neural rheological components in spastic muscles or both is not yet clear. A large randomized controlled trial with comprehensive evaluation indicators is still needed. The study is to observe the effect of rESWT on flexor spasticity of the upper limb after stroke and explore its mechanism.Methods: A prospective, randomized, double-blind controlled trial is to be performed. One hundred participants will be recruited from the Inpatient Department of Zhujiang Hospital. Eligible patients will be randomly allocated to either receive three sessions of active rESWT (group A) or sham-placebo rESWT (group B) with 3-day intervals between each session. Assessment will be performed at baseline and at 24 h after each rESWT (t1, t2, and t3). The primary assessment outcome will be the Modified Ashworth Scale, and other assessments include surface electromyography, MyotonPRO digital muscle function evaluation, and infrared thermal imaging. All data will be analyzed using intention-to-treat principles. Multiple imputation by chained equations will be used to address missing data caused by loss to follow-up and nonresponses. Per protocol, analyses will also be performed on the participants who complete other assessments. Statistical analysis will be performed using SPSS software (version 20.0) and the significance level set at p < 0.05.Discussion: This trial aims to analyze the application of rESWT for the management of spasticity after stroke via appropriate assessments. We hypothesized that after receiving active rESWT, patients would show greater improvement of upper limb muscles compared with patients within the sham-placebo group. The rESWT would be an alternative to traditional methods, and the results of this study may provide support for the further study of potential mechanisms.Clinical Trial Registration:www.chictr.org.cn, identifier: ChiCTR1800016144.

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Section: Introductionmentioning

confidence: 99%

Effects of Radial Extracorporeal Shock Wave Therapy on Flexor Spasticity of the Upper Limb in Post-stroke Patients: Study Protocol for a Randomized Controlled Trial

Fan

Zhou

et al. 2021

Front. Neurol.

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“…After this pilot study, there were regular research reports of using ESWT for the treatment of spasticity in children with CP. However, ESWT was mostly applied and found to be effective on spastic upper and lower extremity muscles (Corrado et al., 2021; El-Shamy et al., 2014; Kim et al., 2019; Picelli et al., 2017). In reviewing this literature, we found no study investigating the effectiveness of ESWT on paraspinal muscles in children with CP.…”

Section: Introductionmentioning

confidence: 99%

“…Many studies have treated paraspinal muscles with applied physiotherapy methods such as therapeutic taping, Kinesio® taping, functional electrical stimulation, and low-level laser therapy (Footer, 2006; Karabay et al., 2012; Şimşek et al., 2011). One of the most important advantages of ESWT is that it is safe, noninvasive, reproducible without loss of efficacy, and uncomplicated (Corrado et al., 2021; El-Shamy et al., 2014). Because trunk control and balance improvement are very important for the functional status of children with CP and are among the most important rehabilitation goals for these children, it is important to investigate ESWT as a new and different approach to increasing functional status and balance.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Extracorporeal Shock Wave Therapy on Postural Control and Balance in Children With Unilateral Cerebral Palsy: A Randomized Controlled Trial

Bilek

Teki̇n

2021

Percept Mot Skills

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The aim of this study was to investigate the effects of Extracorporeal Shock Wave Therapy (ESWT) applied to paraspinal muscles on balance and postural control in children with unilateral Cerebral Palsy (CP). A total of 32 children with unilateral CP were included in the study. The children participated in a one-session control to evaluate their reactions to ESWT before randomly assigning them into experimental and control groups. We evaluated children twice: before and after the treatment. We used the Trunk Control Measurement Scale, Trunk Impairment Scale, Pediatric Balance Scale (PBS), and Timed Up and Go (TUG) test in these assessments. Following the pre-test session, we applied Neuro-Developmental Treatment (NDT) programs to both groups at the rate of twice per week for eight weeks; additionally, we applied ESWT only to the experimental group at the rate of twice a week for eight weeks. While there were trends toward increased trunk control skills, PBS scores and TUG test performances from pre- to post-testing in both groups, these improvements were only statistically significant in the experimental group ( p < 0.05). We conclude that for children with unilateral CP, ESWT applied to paraspinal muscles has significant additive value when combined with NDT to improve postural control and balance.

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“…Physical therapy is a branch of rehabilitation and its aim is to preserve, enhance, or restore movement and physical function impaired or threatened by disease, injury, or disability, using therapeutic exercise, physical modalities, assistive devices, and patient education and training. Physiotherapy is an essential tool in the management of several neuromuscular diseases and genetic disorders, with quite strong evidence of effectiveness [ 20 , 21 , 22 , 23 , 24 ]; its usefulness is even more evident if those pathologies affect children [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

Evidence-Based Physical Therapy for Individuals with Rett Syndrome: A Systematic Review

2020

Self Cite

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Rett syndrome is a rare genetic disorder that affects brain development and causes severe mental and physical disability. This systematic review analyzes the most recent evidence concerning the role of physical therapy in the management of individuals with Rett syndrome. The review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A total of 17319 studies were found in the main scientific databases. Applying the inclusion/exclusion criteria, 22 studies were admitted to the final phase of the review. Level of evidence of the included studies was assessed using the Oxford Centre for Evidence-Based Medicine—Levels of Evidence guide. Nine approaches to physical therapy for patients with Rett syndrome were identified: applied behavior analysis, conductive education, environmental enrichment, traditional physiotherapy with or without aids, hydrotherapy, treadmill, music therapy, computerized systems, and sensory-based treatment. It has been reported that patients had clinically benefited from the analysed approaches despite the fact that they did not have strong research evidence. According to the results, a multimodal individualized physical therapy program should be regularly recommended to patients with Rett syndrome in order to preserve autonomy and to improve quality of life. However, more high-quality studies are needed to confirm these findings.

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Management of Muscle Spasticity in Children with Cerebral Palsy by Means of Extracorporeal Shockwave Therapy: A Systematic Review of the Literature

Cited by 19 publications

References 47 publications

Effects of Radial Extracorporeal Shock Wave Therapy on Flexor Spasticity of the Upper Limb in Post-stroke Patients: Study Protocol for a Randomized Controlled Trial

Effects of Radial Extracorporeal Shock Wave Therapy on Flexor Spasticity of the Upper Limb in Post-stroke Patients: Study Protocol for a Randomized Controlled Trial

Effectiveness of Extracorporeal Shock Wave Therapy on Postural Control and Balance in Children With Unilateral Cerebral Palsy: A Randomized Controlled Trial

Evidence-Based Physical Therapy for Individuals with Rett Syndrome: A Systematic Review

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