Wardhani Rizky Kusuma, Wahyuni Luh Karunia, Laksmitasari Budiati, Lakmudin Alvin
Department of Physical Medicine and Rehabilitation, University of Indonesia, Jakarta, Indonesia.
J Pediatr Rehabil Med. 2022;15(1):159-164. doi: 10.3233/PRM-200796.
To evaluate the efficacy and safety of radial extracorporeal shock wave therapy (rESWT) according to total number of pulses on hamstring muscle spasticity in children with spastic type cerebral palsy (CP).
This study is a randomized controlled trial consisting of thirteen patients with spastic CP, 9 males and 4 females, aged 5 to 14 years (mean age 9.2). Twenty-five spastic hamstring muscles were divided in four groups. Group I: 500 pulses, Group II: 1,000 pulses, Group III: 1,500 pulses, and Group IV: 2,000 pulses. Australian Spasticity Assessment Scale (ASAS) was measured at four different time points (pre-ESWT, post-ESWT, 2 weeks post-ESWT, and 4 weeks post-ESWT).
All four groups showed improvement in ASAS relative to pre-treatment, although only significant in Group III (1,500 pulses). There were no statistically significant differences in ASAS between all four groups in pre-ESWT [|2(2) = 3.907, p = 0.272], immediately post-ESWT [|2(2) = 1.250, p = 0.741], 2 weeks post-ESWT vs pre-ESWT [|2(2) = 3.367, p = 0.338], and 4 weeks post-ESWT vs pre-ESWT [|2(2) = 1.566, p = 0.667].
The effect of rESWT on spastic hamstring in children with spastic CP is not dependent on the number of pulses.
根据脉冲总数评估桡侧体外冲击波疗法（rESWT）对痉挛型脑瘫（CP）患儿腘绳肌痉挛的疗效和安全性。
本研究为一项随机对照试验，纳入13例痉挛型CP患儿，其中男9例，女4例，年龄5至14岁（平均年龄9.2岁）。25条痉挛的腘绳肌被分为四组。第一组：500次脉冲；第二组：1000次脉冲；第三组：1500次脉冲；第四组：2000次脉冲。在四个不同时间点（ESWT前、ESWT后、ESWT后2周和ESWT后4周）测量澳大利亚痉挛评估量表（ASAS）。
与治疗前相比，所有四组的ASAS均有改善，尽管仅第三组（1500次脉冲）有显著改善。在ESWT前[|2(2)=3.907，p=0.272]、ESWT后即刻[|2(2)=1.250，p=0.741]、ESWT后2周与ESWT前比较[|2(2)=3.367，p=0.338]以及ESWT后4周与ESWT前比较[|2(2)=1.566，p=0.667]时，四组之间的ASAS均无统计学显著差异。
rESWT对痉挛型CP患儿痉挛腘绳肌的作用不依赖于脉冲次数。
