Extracorporeal Shock Wave Therapy reduces upper limb spasticity and improves motricity in patients with chronic hemiplegia: A case series

BACKGROUND: Extracorporeal Shock Wave Therapy (ESWT) has been proposed for treatment of abnormal muscle tone only in the last years. The effects on motor impairment are unknown. OBJECTIVE: To assess the long-term effects of ESWT on muscle tone and motricity in upper limb in patients with chronic hemiplegia. METHODS: Twelve patients were selected and treated with two sessions of ESWT. Participants were assessed at baseline, after the treatment, and at 3 and 6 months. Muscle tone of shoulder adductors, elbow, wrist and finger flexors was evaluated at all assessment points using the Modified Ashworth Scale (MAS), while motricity, passive range of motion (PROM) and pain sub-scores of upper extremity part of the Fugl-Meyer scale were used to assess motor recovery. The degree of perceived benefit from treatment was assessed on a visual analogue scale. RESULTS: MAS showed a significant reduction of spasticity and Fugl-Meyer scores improved immediately after treatment. Persistent effects were observed at 3 and 6 months for MAS, and for motricity and PROM subscores of the Fugl-Meyer scale. Clinical improvement was not correlated to the patients' perceived benefit. CONCLUSIONS: Two sessions of ESWT seem to have long-term effects in reducing muscle tone and enhancing motor impairment.