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Effect of extracorporeal shock wave therapy on spastic equinus foot in children with unilateral cerebral palsy
Hatem A Emara1, Ahmed H Al-Johani2, Osama A Khaled3
1Department of Physical Therapy for Growth and Developmental Disorders in Children and its Surgery, Faculty of Physical Therapy, Cairo University, Egypt.
Insights
Radial extracorporeal shock wave therapy significantly improved motor control, spasticity, and balance in children with unilateral cerebral palsy. This therapy offers a valuable approach for enhancing functional outcomes in pediatric patients.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Biomedical Engineering
Background:
- Unilateral cerebral palsy (UCP) significantly impacts motor function in children.
- Spasticity, impaired selective motor control, and balance deficits are common challenges in UCP.
- Current therapeutic interventions aim to mitigate these functional limitations.
Purpose of the Study:
- To evaluate the efficacy of radial extracorporeal shock wave therapy (rESWT) in children with UCP.
- To assess the impact of rESWT on spasticity, selective motor control, gross motor function, and balance.
- To determine if rESWT offers benefits beyond traditional exercise regimens.
Main Methods:
- A randomized controlled trial involving 34 children (aged 7-9) with spastic UCP.
- Participants were allocated to a control group (traditional exercises) or a study group (traditional exercises + rESWT).
- rESWT was applied weekly to the calf muscle for 12 weeks; assessments included Modified Ashworth Scale, isokinetic dynamometry, Gross Motor Function Measure, Trost Selective Motor Control test, and single leg standing test.
Main Results:
- The study group demonstrated significant improvements in eccentric peak torque and torque threshold angles compared to the control group.
- Significant enhancements were observed in gross motor function, selective motor control, and balance in the rESWT group.
- Statistical analysis (mixed ANOVA, Mann-Whitney) confirmed these significant differences (p < 0.05).
Conclusions:
- Radial extracorporeal shock wave therapy shows promise as an adjunct treatment for pediatric UCP.
- rESWT may effectively reduce spasticity and improve motor control and balance.
- This therapy could be a valuable tool for enhancing functional abilities in children with unilateral cerebral palsy.
Objectives:
This study aims to investigate the effects of radial extracorporeal shock wave therapy on selective motor control, spasticity, gross motor function, and balance in children with unilateral cerebral palsy.
Methods:
This randomised controlled study recruited 34 children aged 7-9 with spastic unilateral cerebral palsy. They were randomly allocated to either the control or study group. Both groups undertook traditional exercises for 12 weeks. The study group received shock waves (one session/week) on the calf muscle (1500 shocks, frequency of 4 Hz, energy of 0.030 mJ/mm2). All children were evaluated at baseline and after 12 weeks using the Modified Ashworth Scale, a Biodex System 4 isokinetic dynamometer, dimensions D (standing) and E (walking) of the Gross Motor Function Measure - 88, the Trost Selective Motor Control test, and the single leg standing test.
Results:
Mixed analysis of variance and Mann-Whitney results showed significant improvement in eccentric peak torque, torque threshold angles, gross motor function, selective motor control, and balance in the study group compared with the control group (p < 0.05).
Conclusions:
Shock wave therapy may be a valuable instrument for reducing spasticity, improving the ability to isolate and control movement, and consequently, improving balance and gross motor function in children with unilateral cerebral palsy.
