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Published on: August 2, 2024
Effect of shock wave stimulation on hypertonic plantar flexor muscles in patients with cerebral palsy: a
Ernesto Amelio1, Paolo Manganotti
1Shock Wave Unit, Hand Surgery Department, Verona University Hospital, Verona, Italy.
Insights
Extracorporeal shock wave therapy significantly reduced muscle hypertonia in children with cerebral palsy. This treatment improved muscle flexibility and plantar surface area for up to four weeks.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Extracorporeal shock wave therapy (ESWT) shows efficacy in reducing adult muscle hypertonia.
- Cerebral palsy (CP) is a common condition characterized by muscle spasticity.
Purpose of the Study:
- To assess the impact of shock wave treatment on spastic muscles in pediatric CP patients.
- Investigate ESWT's effectiveness in managing lower limb spasticity in children.
Main Methods:
- A study involving twelve children with spastic equinus foot (mean age 8 years).
- Clinical assessments included the Ashworth Scale and passive range of motion.
- Instrumental evaluation utilized pedobarography.
- A single active shock wave treatment session followed a placebo session.
Main Results:
- No effects were observed after placebo stimulation.
- A single active ESWT session significantly decreased Ashworth Scale scores (3 to 2).
- Passive range of motion increased (20° to 50°), and plantar surface area expanded (40.3 to 80.2 cm²).
- These improvements persisted for four weeks in all participants.
Conclusions:
- Single-session active ESWT effectively reduces hypertonia in the plantar flexors of children with CP.
- ESWT offers a promising, long-lasting therapeutic option for managing spasticity in pediatric CP.
- The treatment demonstrated significant clinical and instrumental benefits, improving motor function.
Background:
Extracorporeal shock wave therapy has been reported to be effective in reducing muscle hypertonia in adults.
Aim:
To evaluate the effect of shock wave treatment of spastic muscles in children with cerebral palsy.
Methods:
Twelve children with spastic equinus foot (6 boys,6 girls; mean age 8 years (standard deviation (SD) 2.31)) were monitored. Clinical (Ashworth Scale, passive range of motion) and instrumental (pedobarography) examination were performed. This is an open study with one placebo treatment session, followed 6 weeks later by one active shockwave treatment session. Gastrocnemius muscles and soleus muscles were treated.
Results:
After placebo stimulation no clinical or instrumental effect was seen. After a single active shock wave stimulation a significant decrease in the Ashworth Scale (from 3 to 2), an increase in the range of motion (from 20 degrees to 50 degrees), and an increase in the whole plantar surface area of the treated limb (from 40.3 to 80.2 cm2) were observed in all patients. This effect lasted for 4 weeks in all patients.
Conclusions:
A single active shock wave stimulation produced a significant long-lasting reduction in hypertonia in the plantar flexors in children with cerebral palsy.
