Investigation of shock wave therapy dosages in the treatment of spasticity: An experimental study
Keywords:Cerebrovascular accident; Spasticity; Lithotripsy; Physical therapy modalities; Mechanical waves.
The different functions of the shock waves regarding dose, intensity, application time and selection of suitable patients are analyzed, that is, the indications, contraindications and their complications. It is necessary to improve methods of applying shock waves in spasticity in a safe and coherent way, 23 cases, aged between 20 and 76 years, are selected. Divided into two different groups. Group 1: Composed of 10 normal individuals, high dosages are used. Dose: 0.050mj/mm² to 0.060mj/mm². Group 2: Composed of 13 individuals with spasticity, the same high dosages of the first group are used to check the skin's resistance to the dosage. The measurements compared the moments before and after applications using the modified Ashworth scale, digital goniometry, accelerometer and skin inspection to check for signs of bruises or petechiae. When analyzing the average, before the applications, the degree of elbow flexion was (37.2) and after the applications, the elbow flexion evolved to (61.0), making the elbow freer and more malleable. The second joint that showed improvement was shoulder abduction. The abduction that presented (40.2) started to present (49.6) degrees. Maximum acceleration improved comparing moments before and after shock wave applications (0.97-1.27). Petechiae, erythema and bruises are not observed in front of the equipment. At the end, a table with dosages and cycles and safe energy is shown. Conclusion: There was a decrease in spasticity in all assessments. The tolerance of patients to the equipment was satisfactorily observed in this study.
Arredondo A P, Ramires E C, & Mora P C. (2016). Baclofen in the therapeutic of sequele of traumatic brain injury: spasticity. Clin neuropharmacol, 39(6):311-315.
Ashworth B. (1964). Preliminary of trial corisodoprol in multiple sclerosis. NP, 2:192-520.
Bohannon R W, & Smith M B. (1987). Interrater reability of modified Ashworth scale of muscle spasticity. Phys Ther, 67(2):206-207.
Fleckenstein, J., Friton, M., Himmelreich, H., & Banzer, W. (2017). Effect of a single administration of focused extracorporeal shock wave in the relief of delayed-onset muscle soreness: results of a partially blinded randomized controlled trial. Archives of physical medicine and rehabilitation, 98(5), 923-930.
Guo P, Goo F Zao T, Sun W, & Wang B. (2017). Positive effect of extracorporeal shock wave therapy on spasticity in post stroke patients: a meta analysis. J Stroke Cerebrovasc Dis, 26(11):2470-2476.
Guo, J., Qian, S., Wang, Y., & Xu, A. (2019). Clinical study of combined mirror and extracorporeal shock wave therapy on upper limb spasticity in poststroke patients. International jornal of rehabilitation research internationale zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation, 42(1),31.
Hong, J. O., Park, J. S., Jeon, D. G., Yoon, W. H., & Park, J. H. (2017). Extracorporeal shock wave therapy versus trigger point injection in the treatment of myofascial pain syndrome in the quadratus lumborum. Annals of rehabilitation medicine, 41(4), 582.
Intiso, D., Santamato, A., & Di Rienzo, F. (2017). Effect of electrical stimulation as an adjunct to botulinum toxin type A in the treatment of adult spasticity: a systematic review. Disability and rehabilitation, 39(21), 2123-2133.
Kim, Y. W., Chang, W. H., Kim, N. Y., Kwon, J. B., & Lee, S. C. (2017). Effect of extracorporeal shock wave therapy on hamstring tightness in healthy subjects: a pilot study. Yonsei medical journal, 58(3), 644-649.
Kang, N., Zhang, J., Yu, X., & Ma, Y. (2017). Radial extracorporeal shock wave therapy improves cerebral blood flow and neurological function in a rat model of cerebral ischemia. American journal of translational research, 9(4), 2000.
Kang N. Zhang J, Yu X, & Ma Y. (2017). Radial extracorporeal therapy improves cerebral blood flow and neurological function in a rat model of cerebral ischemia. Am J Transl Res, 9(4) 2000-2012.
Li T, M D, Chang C, M D, Chou Y, Ph D, Chen L, Chu H, M D, Chiang S, Chang S, & Wu Y. (2016). Effect of Radial Shock WaveTherapy on Spasticity of the Upper Limb in Patients With Chronic Stroke, Medicine (Baltimore), 95(18):e3544.
Li D, Robin H A, Cleveland O,& J´erusalem A. (2018). 3D multicellular model of shock wave-cell interaction. Acta biomater, 41(4):1742-7061.
Lou J, Wang S, Liu S, & Xing G. (2017). Effectiviness of extracorporeal shock wave therapy whithout local anesthesia in patients: a meta-analysis of randomized controlled trials. Am J Phys Med Rehab, 96(8):529-534.
Mattyasovszky, S. G., Langendorf, E. K., Ritz, U., Schmitz, C., Schmidtmann, I., Nowak, T. E., & Drees, P. (2018). Exposure to radial extracorporeal shock waves modulates viability and gene expression of human skeletal muscle cells: a controlled in vitro study. Journal of orthopaedic surgery and research, 13(1), 75.
Maro A, Leo A, Russo M, Casella C, & Buda, A. (2017). Breakhoughs in thespasticity manangement: are non-pharmacological treatments the future. J Clin Neurosci, 39(16)27.
Mori, L., Marinelli, L., Pelosin, E., Gambaro, M., Trentini, R., Abbruzzese, G., & Trompetto, C. (2017). Radial shock wave therapy: effect on pain and motor performance in a paralympic athlete. European journal of physical and rehabilitation medicine, 53(2), 286-289.
Picceli A, Marchina E, Gajofatto F, Pontilllo A, Vangelista A, & Fillippina R. (2017). A sonographic and clinical effect of botulinum toxin type A combined with extracorporeal shock wave therapy on spastic muscle of children with cerebral palsy. Dev Neurohabil, 20(3):160-164.
Radinmehr H, Ansari N, Naghdi S, Obiali G, &Tabatabari A. (2017). Effect of one session radial extracorporeal shock wave therapy on post stroke plantar flexor spasticity a single-blind clinical trial. Desabil Rehabil, 39(5):483-490.
Shi, L., Gao, F., Sun, W., Wang, B., Guo, W., Cheng, L., ... & Wang, W. (2017). Short-term effects of extracorporeal shock wave therapy on bone mineral density in postmenopausal osteoporotic patients. Osteoporosis International, 28(10), 2945-2953.
Taheri P, Vahdatpour B, Mellat M, Ashtari F, & Akbari M. (2017). Effect of Extracorporeal Shock Wave Therapy on Lower Limb Spasticity in Stroke Patients. Arch Iran Med, 20(6):338 – 343.
Tsung-Ying L. Chih-Ya C, Yu-Ching C, Liang-Cheng C, Heng Y C, Shang-Ling C, Shin-Isu C, & Yung-Tsan W. (2016). Effect of radial shock wave therapy on spasticity of the upper limb in patients with chonic stroke. Medicine (Baltimore), 95(18)e3544.
Wang T, Dir L, Shan L, Dong H, Feng J, Kiessling M C, Angslman N B, Schmitz C, &Jia F. (2016). A prospective Case-control study of radial extracorporeal shock wave therapy for spastic plantar flexor muscle in very yong children with cerebral palsy. Medicine(Baltimore), 95(19)e3649.
Wu R Y, Chang C N, Chen Y M, & Hu G C. (2018). Comparasion of effect of focused and radial ewtracorporeal shock waves spastic equinus patients with stroke a randomized controlled trial. Euro j phys rehabil med 92(2):2-35.
Wu, Y. T., Yu, H. K., Chen, L. R., Chang, C. N., Chen, Y. M., & Hu, G. C. (2018). Extracorporeal Shock Waves Versus Botulinum Toxin Type A in the Treatment of Poststroke Upper Limb Spasticity: A Randomized Noninferiority Trial. Archives of physical medicine and rehabilitation, 99(11), 2143-2150.
Xiang, J., Wang, W., Jiang, W., & Qian, Q. (2018). Effects of extracorporeal shock wave therapy on spasticity in post-stroke patients: a systematic review and meta-analysis of randomized controlled trials. Journal of rehabilitation medicine, 50(10), 852-859.
Yalvaç B, Mesci N, Külcü D G, & Yurdakul O V. (2018). Comparison of ultrasound and extracorporeal shock wave therapy in lateral epicondylosis. Acta orthopaedica et traumatologica turcica, 52(5), 357-362.
Yoon S, M D, Shin M K, Choi E J, & Kang H J. (2017). Effective Site for the Application of Extracorporeal Shock-Wave Therapy on Spasticity in Chronic Stroke: Muscle Belly or Myotendinous Junction. Ann Rehabil Med, 41(4):547-555.
Zhang, Z. X., Zhang, D., Yu, X. T., & Ma, & Y. W. (2019). Efficacy of radial extracorporeal shock wave therapy for chronic pelvic pain syndrome: A nonrandomized controlled trial. American journal of men's health, 13(1), 1557988318814663.
Zhong Z, Liu B, Liu G, Chen J, Li Y, Chen J, & Hu, Y. (2019). A randomized controlled trial on the effects of low-dose extracorporeal shock wave therapy in patients with knee osteoarthritis. Archives of physical medicine and rehabilitation, 10, 1-31.
How to Cite
Copyright (c) 2021 Claudio Francisco Kluppel Bieszczad; Rodrigo Florêncio da Silva; Renata Rothenbuhler; Angelo Contar Palmar
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.