Shockwave therapy in persons with a spinal cord injury and spasticity: A multiple single-case experimental design study

ObjectiveTo determine whether ESWT is able to safely and positively influence specific ADL activities in people with SCI and spasticity, measured by Goal Attainment Scaling (GAS). Study DesignMultiple single-case experimental design with a randomized baseline length. SettingRehabilitation centre. SubjectsThis study included 11 participants with SCI, aged >18 years (mean (SD) 63 (12.2) years), mean (SD) duration after injury 9 (8.1) years, with hindering spasticity in the upper or lower limb. MethodsDuring the 3-week treatment phase, radial ESWT in the plantar flexors of the calf (n = 6) or in the flexors of the wrist/hand (n = 5) was applied weekly, followed by a 12-week follow-up phase. The primary outcome measure consisted of the Goal Attainment Scaling (GAS), in which three individual goals were set. Secondary outcome measures included range of joint motion, pain (0-10), 10-m walking test and Van-Lieshout-hand-function-test-for-Tetraplegia (short form). ResultsAt descriptive level, in total, 28 of the 33 GAS items improved after ESWT and these effects generally were maintained during the follow-up phase. The results of all secondary outcome measures varied. No serious adverse events occurred. ConclusionsIn this study, ESWT resulted in improved performance of specific ADL items in most persons with SCI. More research is needed to confirm these results in a larger cohort.