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Effect of extracorporeal shock wave therapy on gait pattern in hemiplegic cerebral palsy: a randomized controlled
Shamekh Mohamed El-Shamy1, Mohamed Ahmed Eid, Mohamed Fawzy El-Banna
1From the Faculty of Physical Therapy, Department of Physical Therapy for Disturbance of Growth and Development in Children and its Surgery, Cairo University, Giza, Egypt.
Insights
Shock wave therapy significantly improved gait and reduced spasticity in children with hemiplegic cerebral palsy. This non-invasive treatment offers a promising approach for enhancing mobility and function in affected children.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Biomedical Engineering
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder affecting movement and posture.
- Hemiplegic CP, affecting one side of the body, presents significant challenges in gait and motor function.
- Spasticity is a hallmark symptom that impedes effective rehabilitation.
Purpose of the Study:
- To evaluate the efficacy of shock wave therapy (SWT) in improving gait patterns in children with hemiplegic cerebral palsy.
- To assess the impact of SWT on spasticity levels in the affected limbs.
- To compare the outcomes of SWT with conventional physical therapy.
Main Methods:
- A randomized controlled trial involving 30 children with hemiplegic CP.
- The study group received SWT (1500 shots/muscle, 5Hz, 0.030 mJ/mm, weekly sessions) for 3 months.
- The control group underwent a standard physical therapy program for the same duration. Assessments included the Modified Ashworth Scale and 3D gait analysis.
Main Results:
- The SWT group demonstrated statistically significant improvements in gait parameters compared to the control group (P < 0.005).
- Post-treatment, the SWT group showed reduced spasticity (Modified Ashworth scores: 1.63 vs. 1.86).
- Key gait improvements in the SWT group included increased stride length (0.74m vs. 0.5m), speed (0.75m/s vs. 0.6m/s), and stance phase percentage (55.9% vs. 50.4%).
Conclusions:
- Shock wave therapy is an effective therapeutic modality for managing spasticity in children with hemiplegic cerebral palsy.
- SWT significantly enhances gait parameters, contributing to improved motor function.
- This non-invasive treatment presents a valuable addition to the rehabilitation strategies for pediatric hemiplegic cerebral palsy.
Objective:
The aim of this study was to investigate the effects of shock wave therapy on gait pattern in children with hemiplegic cerebral palsy.
Design:
Fifteen children were assigned to the study group, whose members received shock wave therapy (1500 shots/muscle, frequency of 5Hz, energy of 0.030 mJ/mm, one session/wk). Another 15 were assigned to the control group, whose members participated in a conventional physical therapy exercise program for 3 successive months. Baseline and posttreatment assessments were performed using the Modified Ashworth Scale to evaluate spasticity degrees and using a three-dimensional gait analysis to evaluate gait parameters.
Results:
Children in the study group showed a significant improvement when compared with those in the control group (P < 0.005). The Modified Ashworth scores after treatment were 1.86 (0.22) and 1.63 (0.23) for the control and study groups, respectively. The gait parameters (stride length, cadence, speed, cycle time, and stance phase percentage) after treatment were 0.5 m, 125 steps/min, 0.6 m/sec, 0.48 sec, and 50.4% and 0.74 m, 119 steps/min, 0.75 m/sec, 0.65 sec, and 55.9% for the control group and the study group, respectively.
Conclusions:
Shock wave therapy may be a useful tool for improving spasticity and gait pattern in children with hemiplegic cerebral palsy.
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