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Shockwave therapy in persons with a spinal cord injury and spasticity: A multiple single-case experimental design
Boris S G Hellenbrand1, Charlotte C M van Laake-Geelen1,2, Henk A M Seelen1,2
1Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands.
Objective:
To determine whether ESWT is able to safely and positively influence specific ADL activities in people with SCI and spasticity, measured by Goal Attainment Scaling (GAS).
Study Design:
Multiple single-case experimental design with a randomized baseline length.
Setting:
Rehabilitation centre.
Subjects:
This study included 11 participants with SCI, aged >18 years (mean (SD) 63 (12.2) years), mean (SD) duration after injury 9 (8.1) years, with hindering spasticity in the upper or lower limb.
Methods:
During the 3-week treatment phase, radial ESWT in the plantar flexors of the calf (n = 6) or in the flexors of the wrist/hand (n = 5) was applied weekly, followed by a 12-week follow-up phase. The primary outcome measure consisted of the Goal Attainment Scaling (GAS), in which three individual goals were set. Secondary outcome measures included range of joint motion, pain (0-10), 10-m walking test and Van-Lieshout-hand-function-test-for-Tetraplegia (short form).
Results:
At descriptive level, in total, 28 of the 33 GAS items improved after ESWT and these effects generally were maintained during the follow-up phase. The results of all secondary outcome measures varied. No serious adverse events occurred.
Conclusions:
In this study, ESWT resulted in improved performance of specific ADL items in most persons with SCI. More research is needed to confirm these results in a larger cohort.
