Özbek İlhan Celil, Tıkız Canan
Department of Physical Medicine and Rehabilitation, Manisa Celal Bayar University Faculty of Medicine, Manisa, Türkiye.
Turk J Phys Med Rehabil. 2024 Dec 27;71(2):206-215. doi: 10.5606/tftrd.2025.14800. eCollection 2025 Jun.
This study aimed to evaluate the effectiveness of radial extracorporeal shock wave therapy (ESWT) in treating spasticity in post-stroke patients using shear wave elastography (SWE).
This randomized controlled trial was conducted with 42 patients (29 males, 13 females; mean age: 64.0±8.5 years; range, 47 to 80 years) between June 2022 and August 2023. Stroke patients with biceps muscle spasticity were randomly assigned to either an active ESWT treatment group or a control group. Both groups underwent conventional rehabilitation programs. The ESWT group received four treatment sessions once a week for four weeks. Primary assessment criteria included SWE measurement values. Secondary criteria included the Modified Ashworth Scale, Modified Tardieu Scale, Fulg-Meyer Upper Extremity Assessment, and Functional Independence Measures. Evaluations were performed before treatment, immediately after treatment, one month after treatment, and three months after treatment.
In the ESWT group, significant decreases in Modified Ashworth Scale and Modified Tardieu Scale scores observed one month after treatment were not maintained at three months. Improvements in Fulg-Meyer Upper Extremity Assessment and Functional Independence Measures scores were noted immediately after treatment and at one and three months after treatment, whereas these improvements were only observed at three months in the control group. Significant decreases in SWE measurements at 90° flexion and 180° extension observed one month after treatment in the ESWT group were not sustained at three months.
Our study highlights the short-term efficacy of ESWT as an adjunct to conventional rehabilitation in reducing spasticity in post-stroke patients with biceps muscle involvement. The correlation of SWE with physical examination methods emphasizes its potential role in the assessment and follow-up of spasticity treatment.
本研究旨在使用剪切波弹性成像（SWE）评估桡侧体外冲击波疗法（ESWT）治疗中风后患者痉挛的有效性。
本随机对照试验于2022年6月至2023年8月期间对42例患者（29例男性，13例女性；平均年龄：64.0±8.5岁；范围47至80岁）进行。患有肱二头肌痉挛的中风患者被随机分配至积极ESWT治疗组或对照组。两组均接受常规康复计划。ESWT组每周接受一次共四次治疗，持续四周。主要评估标准包括SWE测量值。次要标准包括改良Ashworth量表、改良Tardieu量表、Fulg-Meyer上肢评估和功能独立性测量。在治疗前、治疗后即刻、治疗后1个月和治疗后3个月进行评估。
在ESWT组中，治疗后1个月观察到的改良Ashworth量表和改良Tardieu量表评分显著降低在3个月时未持续。Fulg-Meyer上肢评估和功能独立性测量评分在治疗后即刻、治疗后1个月和3个月时有所改善，而对照组仅在3个月时观察到这些改善。ESWT组在治疗后1个月观察到的90°屈曲和180°伸展时SWE测量值显著降低在3个月时未持续。
我们的研究强调了ESWT作为常规康复辅助手段在减轻肱二头肌受累的中风后患者痉挛方面的短期疗效。SWE与体格检查方法的相关性强调了其在痉挛治疗评估和随访中的潜在作用。
