The Effects of Extracorporeal Shock Wave Therapy on Spasticity in Chronic Stroke Patients

Objective To evaluate the immediate and short term effects of extracorporeal shock wave therapy (ESWT) on elbow flexor spasticity after stroke, to compare the treatment effects according to the ESWT applied site (muscle group and musculotendinous junction group) and to assess the factors affecting the treatment effect. Method A total of 32 stroke patients were enrolled, 23 of them were ESWT group and 9 were control group. ESWT was applied 1 session/week, total 3 sessions and 12 patients were applied at biceps muscle belly and 11 patients were applied at biceps musculotendinosus junction. Patients were evaluated using modified Ashworth scale (MAS), modified Tardieu scale (MTS), Korean-modified Barthel index (K-MBI) at baseline, immediately, 1 week and 4 weeks after ESWT. Results MAS and MTS were significantly improved immediately after ESWT, but were not significantly changed at 1 week 4 weeks in ESWT group. The scores of K-MBI improved but were not different between ESWT group and control group. The treatment effect was greater in musculotendinous junction group than muscle belly group in MTS and MAS immediately after ESWT. We could not find out any significant factors affecting the effects of ESWT. Conclusion Spasticity after chronic stroke improved immediately after ESWT, but was not changed significantly at 1 week and 4 weeks after ESWT. Further studies about ESWT parameters for spasticity and factors affecting treatment effect are needed.