Comparison of Therapeutic Ultrasound and Radial Shock Wave Therapy in the Treatment of Plantar Flexor Spasticity After Stroke: A Prospective, Single-blind, Randomized Clinical Trial

Background: This study aimed to compare the effects of therapeutic ultrasound (US) and radial extracorporeal shock wave therapy (rESWT) in the treatment of plantar flexor spasticity after stroke. Materials and Methods: In this prospective, single-blind, randomized clinical trial, 32 patients (age range 42-78 years; male 19) with stroke were randomly divided into two groups: The US group (n = 16) received the continuous ultrasound, intensity 1.5 w/cm(2), frequency 1 MHz, and duration 10 minutes. The rESWT group (n = 16) was treated with rESWT, 0.340 mJ/mm(2), 2000 shots. Both groups received the treatments for 1 session. The H-reflex tests of H-max/M-max ratio and H-reflex latency, the Modified Modified Ashworth Scale (MMAS), active range of motion (AROM), passive range of motion (PROM), passive plantar flexor torque (PPFT), and the timed "up and go" test (TUG) were blinded assessed at baseline (T0), immediately post-treatment (T1), and one hour follow-up (T2). Results: The H-reflex tests did not improve across the groups. However, the MMAS spasticity scores, AROM and PROM, PPFT, and TUG improved significantly within groups. The results found no significant differences between groups for all outcome measures. Conclusions: The US and rESWT had similar effects, and the rESWT was not more effective than the US in improving ankle plantar flexor spasticity after stroke.