Khan Mohammed A, Aljohani Nada M, AlSehemi Saad A, Abdelhamid Salma A, Alahmadi Omar A, Altohami Abdulmajeed Y, Shweikan Abdullah A, Aljohani Mohammad K
Physical Therapy, Physioplans Physical therapy and Rehabilitation Centre, Medina, SAU.
Physical Therapy, King Salman Medical City, Medina, SAU.
Cureus. 2025 May 16;17(5):e84260. doi: 10.7759/cureus.84260. eCollection 2025 May.
This literature review investigates the therapeutic potential of radial extracorporeal shockwave therapy (rESWT) for managing spasticity in children with cerebral palsy (CP), with a focus on its clinical efficacy, safety profile, and implications for functional rehabilitation. Synthesizing findings from six randomized controlled trials, the review reveals that rESWT consistently produces statistically significant reductions in spasticity, as measured by the Modified Ashworth Scale (MAS), along with notable improvements in gross motor function, joint range of motion, gait symmetry, plantar contact area, and manual dexterity. These benefits were maintained for varying durations, with some studies demonstrating sustained effects for up to 12 weeks post-treatment. Importantly, rESWT was well-tolerated, with no serious adverse events reported across all included studies, highlighting its safety and feasibility in pediatric populations. Despite the consistent reporting of positive outcomes, considerable heterogeneity exists in treatment protocols, target muscle groups, outcome measurement timing, and reporting of participant characteristics, which complicates direct comparisons and limits the generalizability of findings. The review also emphasizes the need for incorporating multidimensional outcome domains, including those related to posture, balance, and gross motor performance, in future studies to better reflect real-world functional gains. Although promising, the current evidence base remains constrained by methodological inconsistencies and limited use of objective assessment tools. To optimize clinical application, future research should aim to standardize rESWT protocols, extend follow-up periods, and incorporate validated biomechanical and functional performance assessments. Collectively, these findings support rESWT as a non-invasive, clinically effective, and safe adjunct to conventional therapies in pediatric neurorehabilitation, with the potential to enhance both motor and functional outcomes in children with CP.
本综述探讨了桡侧体外冲击波疗法（rESWT）治疗脑瘫（CP）患儿痉挛的潜在疗效，重点关注其临床疗效、安全性以及对功能康复的影响。通过综合六项随机对照试验的结果，该综述发现，根据改良Ashworth量表（MAS）测量，rESWT能持续显著降低痉挛程度，同时在粗大运动功能、关节活动范围、步态对称性、足底接触面积和手部灵活性方面有显著改善。这些益处持续了不同的时间，一些研究表明治疗后长达12周仍有持续效果。重要的是，rESWT耐受性良好，所有纳入研究均未报告严重不良事件，突出了其在儿科人群中的安全性和可行性。尽管一致报告了积极结果，但在治疗方案、目标肌肉群、结果测量时间和参与者特征报告方面存在相当大的异质性，这使得直接比较变得复杂，并限制了研究结果的普遍性。该综述还强调，未来研究需要纳入多维度结果领域，包括与姿势、平衡和粗大运动表现相关的领域，以更好地反映实际功能改善。尽管前景广阔，但目前的证据基础仍受方法学不一致和客观评估工具使用有限的限制。为了优化临床应用，未来的研究应旨在规范rESWT方案、延长随访期，并纳入经过验证的生物力学和功能表现评估。总体而言，这些发现支持rESWT作为儿科神经康复中传统疗法的一种非侵入性、临床有效且安全的辅助手段，有可能改善CP患儿的运动和功能结果。
