The dose effectiveness of extracorporeal shockwave on plantar flexor spasticity of ankle in stroke patients: a randomized controlled trial.
Shu-Mei Yang, Yen-Hua Chen, You-Lin Lu and 3 others
PMID 39354619WHAT IT FOUND
Doubling the shockwave dose improved walking time and daily function more than the standard dose, but it did not reduce muscle spasticity scores any further.
Both groups received traditional rehabilitation alongside the shockwave treatment.
Key findings
01The primary measure of spasticity did not differ significantly between the double-dose and standard-dose groups at any follow-up time point.
02Participants in the double-dose group showed significantly greater improvements in walking speed (Timed Up and Go) and daily independence (Barthel Index) compared to the control group.
03Muscle stiffness, measured by elastography, was significantly lower in the double-dose group only at the one-week follow-up, with no difference seen at later time points.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was small (39 participants), which may limit the generalizability of the findings. Both groups received traditional rehabilitation, which may have masked the specific effects of the ESWT dose difference on the primary spasticity outcome. The study did not compare focused ESWT to radial ESWT or other treatments like botulinum toxin. Participants had varying post-stroke durations, which could influence treatment response.
Declared interests
The study was funded by the National Taiwan University Hospital Hsin-Chu Branch. No other conflicts of interest were reported.
The easy way to misread this
Do not conclude that double-dose ESWT is superior for reducing spasticity itself. The primary outcome (MAS) showed no difference between doses. The benefits were seen in functional tests, which may be influenced by the concurrent traditional rehabilitation both groups received.