Yang Shu-Mei, Chen Yen-Hua, Lu You-Lin, Wu Chueh-Hung, Chen Wen-Shiang, Lin Meng-Ting
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Neuroeng Rehabil. 2024 Oct 1;21(1):176. doi: 10.1186/s12984-024-01473-z.
Extracorporeal shockwave therapy (ESWT) has been proven beneficial for post-stroke spasticity (PSS) of ankle plantar flexor muscles. This study aims to investigate the dose-response effectiveness of focused-ESWT and the duration of its effect on the treatment of ankle PSS in stroke patients.
In this double-blinded randomized controlled trial, stroke patients diagnosed with PSS in the ankle plantar flexor muscles were randomly assigned to two groups. The experimental group received double-dose ESWT (4000 pulses per session) targeting spastic calf muscles, while the control group received half the dose (2000 pulses per session). Both groups underwent four sessions over two weeks. The outcomes, including modified Ashworth Scale (MAS), modified Tardieu Scale (MTS), passive range of motion (PROM) of the ankle, Timed Up and Go (TUG) Test, Barthel index and strain elastography were evaluated at baseline, 1st, 4th, 12th, and 24th week after ESWT.
Within-group analysis revealed significant improvements in MAS, PROM, TUG Test, and Barthel index for the double-dose ESWT group and improvements in Barthel index for the control group. Between-group analysis revealed greater improvements in TUG Test, Barthel Index and strain elastography for the double-dose ESWT group. Generalized estimating equations analysis indicated that the double-dose ESWT group achieved superior outcomes in the TUG Test, Barthel Index, and strain elastography across various time points and groups.
Double-dose ESWT showed better functional improvement and elastography compared to the control group. ESWT demonstrated dose-response effectiveness for PSS of ankle-equinus.
NCT05878223.
体外冲击波疗法（ESWT）已被证明对中风后踝关节跖屈肌痉挛（PSS）有益。本研究旨在探讨聚焦式ESWT的剂量反应有效性及其对中风患者踝关节PSS治疗效果的持续时间。
在这项双盲随机对照试验中，将被诊断为踝关节跖屈肌PSS的中风患者随机分为两组。实验组接受针对痉挛小腿肌肉的双倍剂量ESWT（每次治疗4000脉冲），而对照组接受一半剂量（每次治疗2000脉冲）。两组均在两周内进行四次治疗。在ESWT治疗后的基线、第1、4、12和24周评估各项结果，包括改良Ashworth量表（MAS）、改良Tardieu量表（MTS）、踝关节被动活动范围（PROM）、计时起立行走测试（TUG）、Barthel指数和应变弹性成像。
组内分析显示，双倍剂量ESWT组的MAS、PROM、TUG测试和Barthel指数有显著改善，对照组的Barthel指数有改善。组间分析显示，双倍剂量ESWT组在TUG测试、Barthel指数和应变弹性成像方面有更大改善。广义估计方程分析表明，双倍剂量ESWT组在不同时间点和组别的TUG测试、Barthel指数和应变弹性成像方面取得了更好的结果。
与对照组相比，双倍剂量ESWT显示出更好的功能改善和弹性成像效果。ESWT对马蹄内翻足的PSS显示出剂量反应有效性。
NCT05878223。
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