Study regarding the effectiveness of extracorporeal shock wave therapy on spasticity

Objective Stroke and its clinical and functional consequences are the leading causes for long-term disability in Europe, offering an everyday challenge for all rehabilitation specialists. Every month, our clinic welcomes 10 to 15 post-stroke patients in the post-acute to chronic stage and more than half of them face an increase in spasticity leading to an augmentation of the disability level and a decline of their quality of life. For a better approach they must be involved in a complex spasticity management program. Material/patients and methods We have studied the effect of extracorporeal shock wave therapy in the spasticity management for 25 in-patients between January and March 2017 after a stroke within the last 3 years. They came for assessment and treatment of pain, spasticity and limitations in their daily activities. We used Ashworth scale to assess spasticity, Visual Analog Scale to measure the pain and Activities of Daily Living score for evaluation before and after the rehabilitation program. The therapy was applied two times a week for 2 weeks on the palmar flexors for the upper limb and the muscular junction of the gastrocnemius muscle for the lower limb. Results Statistical data was analyzed using SPSS for Windows version 10.0 and Epi Info 7. Data analysis was given in mean ± standard deviation, minimum and maximum. The correlation test and paired t -test were used for the comparison of parametric and non-parametric results. P -values of less than 0.01 were considered statistically significant. Short-term results for most patients showed improvement in pain, especially a decrease in spasticity followed by better tolerance to the physical therapy program, but with no major changes in ADL score. Discussion – conclusion The limits of the study are given by the small number of patients included, a lack of a medium and long-term assessment of the therapeutic effect evaluation and the absence of a placebo controlled group.