Radial Extracorporeal Shock Wave Therapy Decreases Hand Spasticity After Stroke

Introduction: Hand spasticity after a stroke reduces residual hand functions and decreases independence in everyday activities. It is a cause of pain, discomfort and one of the biggest obstacles encountered during the rehabilitation of patients with stroke consequences. Radial extracorporeal shock wave therapy (RESWT) is an enticing non-invasive treatment option for this medical problem. Objectives: The main goal of this clinical study was to evaluate the effects of RESWT in the treatment of hand spasticity after a stroke. Material and methods: This prospective controlled clinical study included 90 patients with post-stroke hand spasticity. At the beginning of the study, patients who met the inclusion criteria were divided into two groups: an examined group (EG) that received RESWT and a standard rehabilitation and a control group (CG) that received only a standard rehabilitation. In order to evaluate the efficiency of the treatment, the following clinical scales were used: Modified Ashworth Scale (MAS) and Disability Assessment Scale (DAS). Clinical findings were evaluated at the same time points in both groups of patients: before the start of the rehabilitation, immediately at the end of the 2nd, 6th and 14th week after the start of the rehabilitation (i.e., for the EG before the application of RESWT, immediately after the completion of RESWT, and at one and three months after the completion of RESWT). Results: The results indicated a significantly lower MAS score in the EG.DAS results from the analysis of all domains (hygiene, dressing, hand position, pain) indicated a significant decrease in disability in the EG compared to the CG by more than one average score in all control time measurement points. Conclusions: RESWT significantly reduced hand and fingers spasticity at the 2nd, 6th and 14th week following the start of the rehabilitation for more than one average MAS score (p<0.05). RESWT contributed to a significant decrease in disability of hygiene maintenance, dressing, hand position, and pain after the 2nd, 6th and 14th week of the start of the rehabilitation of post-stroke hand spasticity (p<0.05). No side effects were observed during and after application of RESWT. It is a safe, non-invasive therapeutic modality for hand spasticity after stroke.