Using Radial Shock Wave Therapy to Control Cerebral Palsy-Related Dysfunctions: A Randomized Controlled Trial

Background: Radial Shock wave Therapy (rSWT) is one of the recent promising modalities that can effectively improve muscle tone, ROM, and enhance functional capacity. It can be used to augment the rehabilitation effectiveness in spastic CP children. So, enhance their engagement in community and participation in social activities and decrease economic burden of rehabilitation. Purpose: To investigate the effect of adding rSWT to standard physical therapy on muscular spasticity, ROM, gross motor function, and planter surface in spastic CP patients. Methods: A total of 70 children (48 girls and 22 boys) with spastic CP were randomly assigned into the control group (n= 35 and average age 8.82 +/- 0.91) which received standard physical therapy and the rSWT group (n=35 and average age 9.0 +/- 1.81) which received the standard physical therapy plus 1500 rSWT shocks with 2 bar pressure and Hz frequency applied over acupuncture points. Passive ankle ROM, calf muscle tone, gross motor function (D and E categories), plantar surface area (PSA), and peak pressure values at midfoot (PPMF), and hindfoot (PPHF) were assessed at baseline, post-treatment, and three-month follow-up. Results: Between-group comparisons demonstrated post-treatment statistically significant differences in ankle plantar flexion (APF), walking category of the GMFM (GMFM-E), PPHF, and PPMF with medium to high effect size values favoring the rSWTG (p=0.011, d=0.858; p=0.003, d=1.02; p=0.035, d=0.577; p=0.049, d= 0.216, respectively). At follow-up, all outcomes were statistically significantly different (p<0.05). Conclusion: rSWT is an effective addition to the standard physical therapy care for spastic CP children in favor of spasticity, ROM, and function.