Extracorporeal Shock Wave Stimulation as Alternative Treatment Modality for Wrist and Fingers Spasticity in Poststroke Patients: A Prospective, Open-Label, Preliminary Clinical Trial

Abstract

Objective.To evaluate the effectiveness of radial shock waves (rESW) for wrist and fingers flexors spasticity in stroke patients.Methods.Twenty patients with upper limb muscle spasticity were enrolled in the study and treated with a single session of rESW. The spasticity level of the radio carpal (RC) and finger (FF) joints was assessed using Modified Ashworth Scale (MAS). The resting bioelectrical activity of the flexor carpi radialis (FCR) and flexor carpi ulnaris (FCU) was examined using surface electromyography (sEMG). Trophic conditions were measured using infrared thermal (IRT) imaging. All measurements were conducted at baseline (t0), immediately after rESW (t1), and 1 (t2) and 24 (t3) hours following rESW.Results.Significant reduction in MAS was observed for the RC joint int1, as well as for the FF joints int1,t2, andt3. A significant decrease in sEMG was shown for the FCR muscle int1andt2, as well as for the FCU muscle int1andt3. Also, a significant increase in IRT value was observed int3only.Conclusions.A single session of rESW could be an effective alternative treatment for reduction of limb spasticity and could lead to improvement of trophic conditions of the spastic muscles.