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Published on: October 11, 2024
Radial extracorporeal shock wave therapy improves upper limb function in chronic stroke patients: a randomized
Marta Imamura1, Andre Tadeu Sugawara1, Artur Cesar Aquino Santos2
1Departamento de Medicina Legal, Bioetica, Medicina do Trabalho e Medicina Fisica e Reabilitacao, Faculdade de Medicina HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil; Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Radial Extracorporeal Shock Wave Therapy (rESWT) improved upper limb function in chronic stroke survivors. This treatment enhanced proximal muscle function and overall recovery, suggesting peripheral mechanisms may be involved.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Stroke frequently leads to upper limb disability.
- Radial Extracorporporeal Shock Wave Therapy (rESWT) shows promise in reducing spasticity and improving upper limb function post-stroke.
Purpose of the Study:
- To evaluate the efficacy of rESWT in enhancing functional recovery of the upper extremity following ischemic stroke.
- To investigate the impact of rESWT on motor recovery in patients with middle cerebral artery territory ischemic stroke.
Main Methods:
- A randomized, double-blind, sham-controlled trial was conducted.
- Participants received weekly sessions of 5,000 rESWs over four weeks, targeting forearm and hand muscles.
- A sham device delivering no shockwaves served as the control.
Main Results:
- Significant improvements were observed in the Fugl-Meyer Assessment for Upper Limb (FMA-UE) proximal muscle scores (p = 0.004) and overall FMA-UE scores (p = 0.038).
- Muscle strength, assessed by the Medical Research Council (MRC) scale, also showed significant improvement (p = 0.012).
- The study was limited by a small sample size (16 per-protocol participants).
Conclusions:
- Four weekly rESWT sessions effectively improved functional recovery in chronic stroke patients with absent motor-evoked potentials (MEPs) at baseline.
- rESWT may enhance proximal muscle function through peripheral mechanisms, leading to overall functional gains.
