Peng Hui-Hui, Sung Ming-Jie, Lee Yu-Hao, Huang Shih-Wei, Lin Lien-Chieh
School of Medicine, College of Medicine, Taipei Medical University, Taipei, ROC.
Department of Medical Education, Taipei Medical University Hospital, Taipei, ROC.
Disabil Rehabil. 2025 Jun 7:1-10. doi: 10.1080/09638288.2025.2514261.
This study aims to evaluate extracorporeal shockwave therapy (ESWT) on spasticity, balance, gait patterns, and motor function in individuals with cerebral palsy (CP). PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov were systematically searched up to 11 April 2025. Meta-analyses were conducted using Review Manager. The primary outcomes were Modified Ashworth Scale (MAS) and gait speed. Ten randomized controlled trials (RCTs) involving 341 individuals with CP were included. Comparison between the ESWT and control groups revealed significant improvements in MAS (standardized mean difference [SMD]: -0.84, 95% confidence intervals [CIs]: -1.23 to -0.46, < 0.001), gait speed (MD: 0.12, 95% CI: 0.02-0.23, = 0.02), cadence (MD: -3.01, 95% CI: -6.03 to 0, = 0.05), stride length (MD: 0.22, 95% CI: 0.16-0.28, < 0.001), Pediatric Balance Scale (MD: 2.3, 95% CI: 0.4-4.19, = 0.02), and Gross Motor Function Measure-88 (MD: 9.72, 95% CI: 7.36-12.08, < 0.001). Combining ESWT with conventional physiotherapy, botulinum toxin type A (BTX-A) injection, or ankle-foot orthotics positively affects spasticity, gait, balance, and motor function. In addition, spasticity significantly decreases, particularly with focused ESWT or ESWT targeting the upper limbs.
本研究旨在评估体外冲击波疗法（ESWT）对脑瘫（CP）患者痉挛、平衡、步态模式和运动功能的影响。截至2025年4月11日，对PubMed、EMBASE、Cochrane图书馆、科学网和ClinicalTrials.gov进行了系统检索。使用Review Manager进行荟萃分析。主要结局指标为改良Ashworth量表（MAS）和步速。纳入了10项涉及341例CP患者的随机对照试验（RCT）。ESWT组与对照组比较显示，MAS（标准化均数差[SMD]：-0.84，95%置信区间[CI]：-1.23至-0.46，P＜0.001）、步速（MD：0.12，95%CI：0.02 - 0.23，P = 0.）、步频（MD：-3.01，95%CI：-6.03至0，P = 0.05）、步长（MD：0.22，95%CI：0.16 - 0.28，P＜0.001）、儿童平衡量表（MD：2.3，95%CI：0.4 - 4.19，P = 0.02）和粗大运动功能测量-88（MD：9.72，95%CI：7.36 - 12.08，P＜0.001）均有显著改善。将ESWT与传统物理治疗、A型肉毒毒素（BTX - A）注射或踝足矫形器相结合，对痉挛、步态、平衡和运动功能有积极影响。此外，痉挛明显减轻，尤其是聚焦式ESWT或针对上肢的ESWT。" 请注意，原文中“步速（MD：0.12，95%CI：0.02 - 0.23，P = 0.”这里的P值似乎不完整，翻译时保留了原文的样子。
