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Updated: Feb 5, 2026

The Combined Use of Transcranial Direct Current Stimulation and Robotic Therapy for the Upper Limb
Published on: September 23, 2018
Clinical study of combined mirror and extracorporeal shock wave therapy on upper limb spasticity in poststroke
Junyi Guo1, Shuyan Qian, Yisu Wang
1Department of Rehabilitation, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Abstract:
Mirror therapy is a simple, inexpensive, and patient-oriented method that has been shown to reduce phantom sensations and pain caused by amputation and improve range of motion, speed, and accuracy of arm movement and function. Extracorporeal shock wave therapy (ESWT) is a new, reversible, and noninvasive method for the treatment of spasticity after stroke. To investigate the therapeutic effect of the combination of mirror and extracorporeal shock wave therapy on upper limb spasticity in poststroke patients. We randomly assigned 120 patients into four groups: A, B, C, and D. All groups received conventional rehabilitation training for 30 min per day, five times a week, for 4 weeks. Moreover, participants in groups A, B, and C also added mirror therapy, ESWT, and a combination of mirror and ESWT, respectively, for 20 min per day. Motor recovery and spasticity were measured using Fugl-Meyer assessment and modified Ashworth scale. The differences in the Fugl-Meyer assessment and modified Ashworth scale scores in group C were significantly greater than those of group D at all observed time points after treatment and were significantly greater than those of groups A and B (P<0.05), but no significant differences were observed between groups A and B until 12 months. Upper extremity spasticity was improved by combined mirror and ESWT.
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