Key result
Double-dose extracorporeal shockwave therapy (4000 pulses/session) achieved superior improvements in TUG Test, Barthel Index, and strain elastography compared to 2000 pulses/session.
Why the study?
Does double-dose extracorporeal shockwave therapy improve functional outcomes and spasticity in stroke patients with ankle plantar flexor spasticity compared to half-dose therapy?
RCT
Double-blind
randomly assigned
Does double-dose extracorporeal shockwave therapy improve functional outcomes and spasticity in stroke patients with ankle plantar flexor spasticity compared to half-dose therapy?
Answers are grounded in this paper and cite their sources.
Double-dose ESWT (4000 pulses) provides superior functional improvement and elastography outcomes compared to half-dose (2000 pulses) for post-stroke ankle spasticity.
BACKGROUND: Extracorporeal shockwave therapy (ESWT) has been proven beneficial for post-stroke spasticity (PSS) of ankle plantar flexor muscles. This study aims to investigate the dose-response effectiveness of focused-ESWT and the duration of its effect on the treatment of ankle PSS in stroke patients. METHODS: In this double-blinded randomized controlled trial, stroke patients diagnosed with PSS in the ankle plantar flexor muscles were randomly assigned to two groups. The experimental group received double-dose ESWT (4000 pulses per session) targeting spastic calf muscles, while the control group received half the dose (2000 pulses per session). Both groups underwent four sessions over two weeks. The outcomes, including modified Ashworth Scale (MAS), modified Tardieu Scale (MTS), passive range of motion (PROM) of the ankle, Timed Up and Go (TUG) Test, Barthel index and strain elastography were evaluated at baseline, 1st, 4th, 12th, and 24th week after ESWT. RESULTS: Within-group analysis revealed significant improvements in MAS, PROM, TUG Test, and Barthel index for the double-dose ESWT group and improvements in Barthel index for the control group. Between-group analysis revealed greater improvements in TUG Test, Barthel Index and strain elastography for the double-dose ESWT group. Generalized estimating equations analysis indicated that the double-dose ESWT group achieved superior outcomes in the TUG Test, Barthel Index, and strain elastography across various time points and groups. CONCLUSIONS: Double-dose ESWT showed better functional improvement and elastography compared to the control group. ESWT demonstrated dose-response effectiveness for PSS of ankle-equinus. TRIAL REGISTRATION: NCT05878223.
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Yang et al. (2024) conducted an RCT in post-stroke spasticity of ankle plantar flexor muscles. Extracorporeal shockwave therapy (ESWT) vs. 2000 pulses per session, 4 sessions over 2 weeks was evaluated on modified Ashworth Scale, modified Tardieu Scale, passive range of motion, Timed Up and Go Test, Barthel index, and strain elastography. Double-dose extracorporeal shockwave therapy (4000 pulses/session) achieved superior improvements in TUG Test, Barthel Index, and strain elastography compared to 2000 pulses/session.
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