Effectiveness of radial extracorporeal shock wave therapy in post-stroke spasticity patients: Evaluation with shear wave elastography.

Abstract

Objectives: This study aimed to evaluate the effectiveness of radial extracorporeal shock wave therapy (ESWT) in treating spasticity in post-stroke patients using shear wave elastography (SWE).

Patients and methods: This randomized controlled trial was conducted with 42 patients (29 males, 13 females; mean age: 64.0±8.5 years; range, 47 to 80 years) between June 2022 and August 2023. Stroke patients with biceps muscle spasticity were randomly assigned to either an active ESWT treatment group or a control group. Both groups underwent conventional rehabilitation programs. The ESWT group received four treatment sessions once a week for four weeks. Primary assessment criteria included SWE measurement values. Secondary criteria included the Modified Ashworth Scale, Modified Tardieu Scale, Fulg-Meyer Upper Extremity Assessment, and Functional Independence Measures. Evaluations were performed before treatment, immediately after treatment, one month after treatment, and three months after treatment.

Results: In the ESWT group, significant decreases in Modified Ashworth Scale and Modified Tardieu Scale scores observed one month after treatment were not maintained at three months. Improvements in Fulg-Meyer Upper Extremity Assessment and Functional Independence Measures scores were noted immediately after treatment and at one and three months after treatment, whereas these improvements were only observed at three months in the control group. Significant decreases in SWE measurements at 90° flexion and 180° extension observed one month after treatment in the ESWT group were not sustained at three months.

Conclusion: Our study highlights the short-term efficacy of ESWT as an adjunct to conventional rehabilitation in reducing spasticity in post-stroke patients with biceps muscle involvement. The correlation of SWE with physical examination methods emphasizes its potential role in the assessment and follow-up of spasticity treatment.