Extracorporeal Shock Wave Therapy for Limb Dysfunction After Stroke: A Systematic Review and Meta-analysis

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Stroke frequently causes spasticity, pain, and motor dysfunction, significantly impacting patient quality of life.
• Extracorporeal shock wave therapy (ESWT) presents a noninvasive therapeutic option for post-stroke limb dysfunction.
• Optimizing ESWT parameters is crucial for maximizing its clinical benefits in stroke recovery.

Purpose of the Study:

• To systematically evaluate the effectiveness of ESWT in alleviating spasticity, pain, and motor dysfunction post-stroke.
• To identify optimal shock wave parameters (frequency, pressure, type) for improved outcomes.
• To synthesize evidence from randomized controlled trials (RCTs) on ESWT for stroke rehabilitation.

Main Methods:

• Systematic literature search of major databases (PubMed, Embase, Web of Science, etc.) up to February 1, 2023.
• Inclusion of nine RCTs involving 327 patients with post-stroke limb dysfunction.
• Data analysis using RevMan v.5.4 for quantitative synthesis.

Main Results:

• ESWT demonstrated significant improvements in spasticity, pain, and motor function.
• Enhanced passive range of motion in lower limbs was observed.
• Treatment effects were maximized with shock wave frequency <8 Hz and pressure <2 bar.
• Released extracorporeal shock waves showed superior outcomes compared to focused waves.

Conclusions:

• ESWT is an effective treatment for improving spasticity, pain, and motor function after stroke.
• Optimal treatment parameters include shock wave frequency <8 Hz, pressure <2 bar, and the use of released shock waves.
• These findings support the targeted application of ESWT in stroke rehabilitation protocols.