Effects of extracorporeal shock wave therapy on upper extremity muscle tone in chronic stroke patients.
Seung Kyu Park, Dae Jung Yang, Yo Han Uhm and 2 others
PMID 29581652WHAT IT FOUND
In chronic stroke upper-limb hypertonia, patients receiving ESWT plus general physical therapy and development therapy twice weekly for 8 weeks had lower measured tone, stiffness and elasticity in forearm and finger flexors than sham plus the same therapy.
Key findings
01After 8 weeks, post-treatment tone, stiffness and elasticity values in the ESWT group were lower than the sham group values for flexor carpi ulnaris, flexor carpi radialis and flexor digitorum.
02All patients also received general physical therapy including development therapy, so the study cannot separate the contribution of ESWT from the other therapy.
03The paper says further studies are needed to investigate upper extremity muscle activity and daily activities, so it does not report those outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 30 patients were studied, all at least six months after stroke and with modified Ashworth scale grades 1-2, so the results cannot be applied confidently to more acute, more severely stiffened or non-hemiplegic stroke patients. All patients also received general physical therapy including development therapy, so the paper cannot separate the contribution of ESWT from that background therapy. The study measured tone, stiffness and elasticity of forearm and finger flexor muscles only, so it does not show effects on other muscles or on whole-limb movement. The paper says further studies are needed to investigate upper extremity muscle activity and daily activities, so it does not report those outcomes. The paper does not report dropouts, allocation concealment or whether assessors were blinded, so there is limited information about possible bias.
Declared interests
The research was conducted with a grant from Sehan University in 2018, and the authors declared no conflict of interest.
The easy way to misread this
Do not conclude that ESWT alone improves hand function or daily activities. Patients also received general physical therapy and development therapy, and the paper did not report post-treatment Fugl-Meyer scores or daily-activity outcomes.