EFFECTIVENESS OF RADIAL EXTRACORPOREAL SHOCKWAVE THERAPY IN THE LOCAL MANAGEMENT OF HYPERTONIA (SPASTICITY AND DYSTONIA) IN PATIENTS WITH CEREBRAL PALSY

BIEDERMANN VILLAGRA T, TUR SEGURA M, GIMENO ESTEVE F, JIMENEZ REDONDO J, GARCÍA RODRÍGUEZ N, MILÀ VILLARROEL R • Journal of Rehabilitation Medicine - Clinical Communications • 2024 • Radial ESWT

Summary

This pre-post intervention study evaluated the effectiveness of radial extracorporeal shockwave therapy (rESWT) for treating hypertonia in patients with cerebral palsy. The treatment showed significant improvements in muscle extensibility and functional outcomes that lasted up to 24 weeks, with the most notable benefits being increased passive range of motion and improved mobility and gait speed.

Key Findings

"A statistically significant increase in the degrees of extensibility (V1) of all treated muscles was observed at T1 and T2, with a progressive decline at T3 that did not return to baseline values (T0)."

"The main hypothesis for these results is that the cavitation produced in the muscles treated with radial shock waves has led to a reduction in muscle tone."

"Functional improvement in patients treated with extracorporeal shockwave therapy has been observed to last up to 24 weeks."

Treatment Categories

Neurological Hypertonia

moderate effectiveness

rESWT demonstrated significant improvements in muscle extensibility and functional outcomes in cerebral palsy patients with hypertonia. The treatment effects were maintained for up to 24 weeks, showing particular efficacy for improving range of motion and mobility.

Related Conditions

Spasticity Cerebral Palsy Muscle Tone Disorders Neurological Disorders

Specific Findings

rESWT improves muscle extensibility and functional mobility in patients with cerebral palsy

Pre-post intervention study with 45 participants showing statistically significant improvements in Tardieu scale measurements, TUG test, and 10-meter walk test

Patient Type

Mixed (ages 8-56, various CP classifications)

Shockwave Type

Radial ESWT

Protocol

sessions: 3 sessions, 1 week apart

energyFluxDensity: 2.2 Bars for calf muscles, 3.5 Bars for hamstrings

impulses: 2000 impulses per session

frequency: 8 Hz

Outcomes

Pain Reduction: Not specifically measured

Functional Improvement: Significant improvements in TUG test and 10-meter walk test maintained up to 24 weeks

Tissue Healing: Hypothesized improvements in muscle tissue via mechanotransduction, angiogenesis, and antifibrotic effects

Return to Activity: Improved mobility and gait parameters

Compared To: Baseline measurements (no control group)

Limitations

No control group, lack of blinding, potential measurement errors with manual instruments

Study Limitations

No control group due to ethical considerations
Lack of randomization and blinding during data collection
Potential measurement errors with manual inclinometer and handheld stopwatch
Uncertain translation of improvements in controlled functional tests to daily life activities

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