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Extracorporeal shockwave therapy (ESWT) benefits in spastic children with cerebral palsy (CP)
1"Dr. Nicolae Robănescu" National Centre of Neuro-Psychomotor Clinical Rehabilitation, Bucharest, Romania ; "Bagdasar-Arseni" Clinical Emergency Hospital, Bucharest, Romania.
Insights
Extracorporeal Shock Wave Therapy (ESWT) significantly reduced spasticity and pain in children with cerebral palsy (CP). This treatment also improved their gross motor function, offering a promising therapeutic option.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Physical Therapy
Background:
- Extracorporeal Shock Wave Therapy (ESWT) is utilized in medical practice.
- ESWT has shown potential as a tool for managing spasticity in children with cerebral palsy (CP).
Purpose of the Study:
- To evaluate the efficacy of a three-session ESWT protocol on spastic muscles in the upper and lower limbs of children with CP.
Main Methods:
- A study involving 63 children (mean age ~8 years) with CP.
- Focused ESWT was administered in three sessions using consistent parameters (0.15 mJ/mm², 500 shocks/session, 10 Hz).
- Assessments included the Modified Ashworth Scale (MAS), Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure 66 (GMFM-66), and a pain questionnaire (QPS) before and after treatment.
Main Results:
- A significant reduction in the Modified Ashworth Scale (MAS) scores was observed in the ESWT group.
- Concomitant decrease in the Questionnaire on Pain caused by spasticity (QPS) scores.
- Improvement in Gross Motor Function Measure 66 (GMFM-66) scores.
Conclusions:
- Three sessions of ESWT, with specific parameters, can effectively decrease spasticity and associated pain in children with CP.
- ESWT demonstrates potential for improving gross motor function in pediatric CP patients.
Introduction:
ESWT refers to the use of Shock Waves in medical practice. It was used as an important tool in spasticity management of children with CP. The aim of our study was to evaluate the effect of a 3 session of ESWT on spastic upper and lower limbs muscles in children with CP.
Methods:
Sixty-three children (37 boys and 26 girls), mean age 99.57±53.74 months, were included in the study. We used focused ESWT, applied in 3 sessions during the admission of each child, on the mainly affected muscles, using the same parameters on all patients (energy - 0.15 mJ/mm2, shot dose - 500 shocks/ session, frequency - 10 Hz). All patients were assessed two times: once, in admission (before any physical or ESWT appliance) and second, at discharge (after receiving the entire prescribed treatment), following: Modified Ashworth Scale (MAS), Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure 66 (GMFM-66) and also a Questionnaire on Pain caused by spasticity (QPS).
Results:
We found a better and significant decrease of MAS level in the ESWT treated group, thus leading to a concomitant decrease of QPS score and also increase of GMFM-66 score.
Conclusion:
ESWT, applied in 3 sessions, with 0.15 mJ/ mm2, using 500 shocks/ min and 10 Hz as frequency may decrease children spasticity level and pain caused by it and improve the gross motor function.
