Original Articles
Vol. 33 No. 3 (2023)
Conventional physical therapy combined with extracorporeal shock wave leads to positive effects on spasticity in stroke survivors: a prospective observational study
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 24 July 2023
Accepted: 31 July 2023
Accepted: 31 July 2023
2377
Views
1241
Downloads
21
HTML
Authors
The study aimed to evaluate the effectiveness of radial extracorporeal shock wave therapy (rESWT) and conventional physical therapy (CPT) protocol on the gait pattern in stroke survivors through a new gait analysis technology. Fifteen (n=15) stroke survivors took part in this prospective, observational study and were assessed clinically and through an instrumented treadmill before and after rESWT and CPT. Spasticity grade 95% CI 0.93 (0.79 +/- 1.08), pain intensity 95% CI 1.60 (1.19 +/- 2.01), and clonus score decreased significantly 95% CI 1.13 (0.72 +/- 1.54). The sensorimotor function 95% CI -2.53 (-3.42 +/- 1.65), balance 95% CI -5.67 (-6.64 +/- - 4.69), and gait parameters were enhanced at the end of the program. Step length 95% CI -3.47 (-6.48 +/- 0.46) and step cycle were improved 95% CI -0.09 (-0.17 +/- -0.01), and hip 95% CI -3.90 (-6.92 +/- -0.88), knee 95% CI -2.08 (-3.84 +/- -0.32) and ankle flexion-extension 95% CI -2.08 (-6.64 +/- -4.69) were augmented. Adding the quantitative analysis to the clinical assessment, we gained easy access to track progress and obtained an individualized therapeutic approach for stroke survivors.
Downloads
Download data is not yet available.
Citations
Donkor ES. Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke Res Treat. 2018 Nov 27;2018:3238165. PMID: 30598741; PMCID: PMC6288566.
Zhang M, You H, Zhang H, Zhao W, Han T, Liu J, Jiang S, Feng X. Effects of visual feedback balance training with the Pro-kin system on walking and self-care abilities in stroke patients. Medicine (Baltimore). 2020 Sep 25;99(39):e22425. PMID: 32991477; PMCID: PMC7523840. DOI: https://doi.org/10.1097/MD.0000000000022425
Bravi M, Massaroni C, Santacaterina F, Di Tocco J, Schena E, Sterzi S, Bressi F, Miccinilli S. Validity Analysis of WalkerViewTM Instrumented Treadmill for Measuring Spatiotemporal and Kinematic Gait Parameters. Sensors (Basel). 2021 Jul 14;21(14):4795. PMID: 34300534; PMCID: PMC8309770. DOI: https://doi.org/10.3390/s21144795
Mohan DM, Khandoker AH, Wasti SA, Ismail Ibrahim Ismail Alali S, Jelinek HF, Khalaf K. Assessment Methods of Post-stroke Gait: A Scoping Review of Technology-Driven Approaches to Gait Characterization and Analysis. Front Neurol. 2021 Jun 8;12:650024. PMID: 34168608; PMCID: PMC8217618. DOI: https://doi.org/10.3389/fneur.2021.650024
Papathanasiou J, Kashilska Y, Bozov H, Petrov I, Masiero S. The outbreak of the SARS-CoV-2 Omicron variant make imperative the adoption of telerehabilitation in the Bulgarian health care system. Eur J Transl Myol. 2022 Feb 2;32(1):10355. PMID: 35107088; PMCID: PMC8992671. DOI: https://doi.org/10.4081/ejtm.2022.10355
Mihai EE, Popescu MN, Beiu C, Gheorghe L, Berteanu M. Tele-Rehabilitation Strategies for a Patient With Post-stroke Spasticity: A Powerful Tool Amid the COVID-19 Pandemic. Cureus. 2021 Nov 2;13(11):e19201. PMID: 34877194; PMCID: PMC8642141. DOI: https://doi.org/10.7759/cureus.19201
Lindemann U. Spatiotemporal gait analysis of older persons in clinical practice and research : Which parameters are relevant? Z Gerontol Geriatr. 2020 Mar;53(2):171-178. English. Epub 2019 Feb 15. PMID: 30770991. DOI: https://doi.org/10.1007/s00391-019-01520-8
Ziagkas E, Loukovitis A, Zekakos DX, Chau TD, Petrelis A, Grouios G. A Novel Tool for Gait Analysis: Validation Study of the Smart Insole PODOSmart®. Sensors (Basel). 2021 Sep 6;21(17):5972. PMID: 34502861; PMCID: PMC8434608. DOI: https://doi.org/10.3390/s21175972
Zhang Y, Wang M, Awrejcewicz J, Fekete G, Ren F, Gu Y. Using Gold-standard Gait Analysis Methods to Assess Experience Effects on Lower-limb Mechanics During Moderate High-heeled Jogging and Running. J Vis Exp. 2017 Sep 14;(127):55714. PMID: 28994758; PMCID: PMC5752245. DOI: https://doi.org/10.3791/55714
Mihai EE, Berteanu M. Early Individualized Approach for a Patient with Spasticity of Stroke Origin. Curr Health Sci J. 2021 Oct-Dec;47(4):608-611. Epub 2021 Dec 31. PMID: 35444829; PMCID: PMC8987471.
Maccarone MC. Extracorporeal Shock Wave Therapy (ESWT). In: Papathanasiou J, Panayotov K, eds. Essentials of Physical and Rehabilitation Medicine for undergraduate medical students. Ruse, BG: Avangard Print; 2023. pp 135-142.
El-Shamy SM, Eid MA, El-Banna MF. Effect of extracorporeal shock wave therapy on gait pattern in hemiplegic cerebral palsy: a randomized controlled trial. Am J Phys Med Rehabil. 2014 Dec;93(12):1065-72. PMID: 24879552. DOI: https://doi.org/10.1097/PHM.0000000000000133
Mihai EE, Popescu MN, Iliescu AN, Berteanu M. A systematic review on extracorporeal shock wave therapy and botulinum toxin for spasticity treatment: a comparison on efficacy. Eur J Phys Rehabil Med. 2022 Aug;58(4):565-574. Epub 2022 Apr 12. PMID: 35412036; PMCID: PMC9980509. DOI: https://doi.org/10.23736/S1973-9087.22.07136-2
Radinmehr H, Ansari NN, Naghdi S, Tabatabaei A, Moghimi E. Comparison of Therapeutic Ultrasound and Radial Shock Wave Therapy in the Treatment of Plantar Flexor Spasticity After Stroke: A Prospective, Single-blind, Randomized Clinical Trial. J Stroke Cerebrovasc Dis. 2019 Jun;28(6):1546-1554. Epub 2019 Mar 30. PMID: 30935809. DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.03.008
Mihai EE, Dumitru L, Mihai IV, Berteanu M. Long-Term Efficacy of Extracorporeal Shock Wave Therapy on Lower Limb Post-Stroke Spasticity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med. 2020 Dec 29;10(1):86. PMID: 33383655; PMCID: PMC7795167. DOI: https://doi.org/10.3390/jcm10010086
Yang E, Lew HL, Özçakar L, Wu CH. Recent Advances in the Treatment of Spasticity: Extracorporeal Shock Wave Therapy. J Clin Med. 2021 Oct 14;10(20):4723. PMID: 34682846; PMCID: PMC8539559. DOI: https://doi.org/10.3390/jcm10204723
Kobsar D, Charlton JM, Tse CTF, Esculier JF, Graffos A, Krowchuk NM, Thatcher D, Hunt MA. Validity and reliability of wearable inertial sensors in healthy adult walking: a systematic review and meta-analysis. J Neuroeng Rehabil. 2020 May 11;17(1):62. doi: 10.1186/s12984-020-00685-3. PMID: 32393301; PMCID: PMC7216606. DOI: https://doi.org/10.1186/s12984-020-00685-3
Eltoukhy M, Oh J, Kuenze C, Signorile J. Improved kinect-based spatiotemporal and kinematic treadmill gait assessment. Gait Posture. 2017 Jan;51:77-83. Epub 2016 Oct 4. PMID: 27721202. DOI: https://doi.org/10.1016/j.gaitpost.2016.10.001
Xu X, McGorry RW, Chou LS, Lin JH, Chang CC. Accuracy of the Microsoft Kinect for measuring gait parameters during treadmill walking. Gait Posture. 2015 Jul;42(2):145-51. Epub 2015 May 14. PMID: 26002604. DOI: https://doi.org/10.1016/j.gaitpost.2015.05.002
McSweeney SC, Reed LF, Wearing SC. Reliability and minimum detectable change of measures of gait in children during walking and running on an instrumented treadmill. Gait Posture. 2020 Jan;75:105-108. Epub 2019 Oct 7. PMID: 31648119. DOI: https://doi.org/10.1016/j.gaitpost.2019.10.004
Mentiplay BF, Perraton LG, Bower KJ, Pua YH, McGaw R, Heywood S, Clark RA. Gait assessment using the Microsoft Xbox One Kinect: Concurrent validity and inter-day reliability of spatiotemporal and kinematic variables. J Biomech. 2015 Jul 16;48(10):2166-70. Epub 2015 May 28. PMID: 26065332. DOI: https://doi.org/10.1016/j.jbiomech.2015.05.021
Clark RA, Bower KJ, Mentiplay BF, Paterson K, Pua YH. Concurrent validity of the Microsoft Kinect for assessment of spatiotemporal gait variables. J Biomech. 2013 Oct 18;46(15):2722-5. Epub 2013 Aug 26. PMID: 24016679. DOI: https://doi.org/10.1016/j.jbiomech.2013.08.011
Mavrov M. The law institute of patient’s informed consent. 1st ed. Stovi Group Publishers:2018.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014 Dec;12(12):1495-9. Epub 2014 Jul 18. PMID: 25046131. DOI: https://doi.org/10.1016/j.ijsu.2014.07.013
Reed LF, Urry SR, Wearing SC. Reliability of spatiotemporal and kinetic gait parameters determined by a new instrumented treadmill system. BMC Musculoskelet Disord. 2013 Aug 21;14:249. PMID: 23964707; PMCID: PMC3766030. DOI: https://doi.org/10.1186/1471-2474-14-249
Amelio E, Manganotti P. Effect of shock wave stimulation on hypertonic plantar flexor muscles in patients with cerebral palsy: a placebo-controlled study. J Rehabil Med. 2010 Apr;42(4):339-43. PMID: 20358168. DOI: https://doi.org/10.2340/16501977-0522
Lin Y, Wang G, Wang B. Rehabilitation treatment of spastic cerebral palsy with radial extracorporeal shock wave therapy and rehabilitation therapy. Medicine (Baltimore). 2018 Dec;97(51):e13828. PMID: 30572548; PMCID: PMC6320024. DOI: https://doi.org/10.1097/MD.0000000000013828
Vidal X, Morral A, Costa L, Tur M. Radial extracorporeal shock wave therapy (rESWT) in the treatment of spasticity in cerebral palsy: a randomized, placebo-controlled clinical trial. NeuroRehabilitation. 2011;29(4):413-9. PMID: 22207070. DOI: https://doi.org/10.3233/NRE-2011-0720
Mihai EE, Mihai IV, Berteanu M. Effectiveness of Radial Extracorporeal Shock Wave Therapy and Visual Feedback Balance Training on Lower Limb Post-Stroke Spasticity, Trunk Performance, and Balance: A Randomized Controlled Trial. J Clin Med. 2021 Dec 28;11(1):147. PMID: 35011889; PMCID: PMC8745149. DOI: https://doi.org/10.3390/jcm11010147
Norvang OP, Askim T, Egerton T, Dahl AE, Thingstad P. Associations between changes in gait parameters, balance, and walking capacity during the first 3 months after stroke: a prospective observational study. Physiother Theory Pract. 2022 Apr;38(4):534-542. Epub 2020 Jun 10. PMID: 32569492. DOI: https://doi.org/10.1080/09593985.2020.1771802
How to Cite
Conventional physical therapy combined with extracorporeal shock wave leads to positive effects on spasticity in stroke survivors: a prospective observational study. (2023). European Journal of Translational Myology, 33(3). https://doi.org/10.4081/ejtm.2023.11607
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.