Effects of Extracorporeal Shock Wave Therapy in Different Output Pressures on Triceps Surae Spasticity after Stroke / 中国康复理论与实践

ABSTRACT

Objective:To evaluate the effects of different output pressures of extracorporeal shock wave therapy (ESWT) on triceps surae spasticity after stroke, and to explore the electrophysiologic mechanism involved. Methods:From January, 2015 to December, 2017, 90 hemiplegic stroke patients with triceps surae spasticity were randomly assigned into control group (n = 30), treatment group 1 (n = 30) and treatment group 2 (n = 30). All the patients accepted routine medicine and rehabilitation, while the treatment groups 1 and 2 received ESWT of 1.5 bar and 2.0 bar in addition, respectively, for four weeks. They were assessed with Composite Spasticity Scale (CSS), passive range of motion (PROM), 10-meter walk test (10MWT), and H reflex latency and the Hmax/Mmax ratio before and after treatment, and the two treatment groups were assessed with Visual Analogue Scale (VAS) immediately after ESWT. Results:All the groups improved in scores of CSS, PROM and 10MWT after treatment (t > 7.261, P < 0.001), and improved more in scores of CSS and 10MWT in the two treatment groups than in the control group (P < 0.05), and the 10MWT was less in the treatment group 2 than in the treatment group 1 (P < 0.05). H reflex latency lengthened (t > 15.025, P < 0.001) and Hmax/Mmax ratio decreased (t > 14.850, P < 0.001) after treatment in the two treatment groups, and the H reflex latency was longer in the two treatment groups than in the control group (P < 0.01). There was no significant difference in VAS between the two treatment groups (t = 0.735, P > 0.05). Conclusion:ESWT of both 2.0 bar and 1.5 bar can improve triceps surae spasticity after stroke, and ESWT of 2.0 bar may more benefit the ability of walking. Further study is needed to explore the involved electrophysiologic mechanism.