The Role of Radial Shockwave Therapy in Reducing Spasticity and Improving Upper-Limb Function Following Stroke

Background: Spasticity resulting from a stroke usually develops within a few weeks or months of the incident and occurs in approximately 43 percent of patients. Recently, noninvasive radial shockwave therapy has been gaining increasing attention as a treatment for spastic muscles, leading to a decline in muscle tone. This study aims to evaluate the effectiveness of rESWT in reducing muscle tone and improving hand function in stroke patients with upper-limb spasticity. Methods: We conducted a study involving 62 stroke patients with upper-limb spasticity (MAS ≥ 2). The ESWT group received four sessions of radial shockwave therapy applied to the wrist flexor muscles (flexor carpi radialis, flexor carpi ulnaris, palmaris longus, pronator teres, pronator quadratus, and flexor digitorum superficialis) at 6-day intervals (3500 pulses, 8 Hz, 2.5 bar), combined with standard rehabilitation during hospitalization. The non-ESWT group followed a standard rehabilitation program. Assessments were performed using the following scales: FMA-UE, ADL, MAS, radiocarpal joint extension range of motion, and VAS. Measurements were obtained at three time points: before the intervention, one week after the first intervention, and one week after the fourth intervention. Results: The ESWT group showed improvements in upper-limb motor function (FMA-UE, p < 0.0001) and functional independence (ADL, p < 0.0001). They also experienced an increase in radiocarpal joint range of motion (ROM, p > 0.0001) and a reduction in spasticity (MAS, p < 0.0001). Conclusions: The intervention involving four ESWT sessions combined with conventional rehabilitation results in improved hand motor function, reduced spasticity, increased extension of the radiocarpal joint, and increased functional independence. Improvements in upper-limb function and reductions in spasticity may occur independently of changes in pain perception.