Use of extracorporeal shock wave therapy in patients with spasticity related to stroke: a pilot study
DOI:
https://doi.org/10.33233/fb.v21i1.3273Keywords:
stroke, spasticity, lithotripsyAbstract
Introduction: This research aims to show the reduction of muscular tonus by using extracorporeal shock wave lithotripsy in order to recover normal movements. Methods: 10 patients over 50 and under 80 years of age presenting spasticity participated in this pilot study, which used three methods: 1) the Ashworth scale, 2) the digital goniometer and 3) the dislocation of muscle tissue, before and after the shock waves. To check the dislocation of muscle tissue, a current pulse was applied, measured by a LTM 165 class 2 Laser. This approach is similar and consists of measuring the dislocation on a laser sensor basis. The Ortho-lithotripsy equipment used was a Direx Integra. The dose/intensity was 1000 cps – 0.030 mJ/mm². Results: We also observed a better quality of muscle contraction (Scale Ashworth p=0.05). At digital goniometry, the shoulder abduction developed 35° in 7 of the patients and 15° in 3 of them (p<0.05). Conclusion: The muscles do not become hypotonic with the shock waves treatment, (they present an adequate tonus). The patients who presented micro-shortening and did not undergo to regular physiotherapy showed a minor improvement (15° goniometry).
References
Figueiredo MV, Chaves L, Rodrigues ARS, Silva EB. Eficácia do taping associado a cinesioterapia na melhora da espasticidade e velocidade da marcha em hemiplégicos. RBCEH 2011;8(3):355-62. doi: 10.5335rbeh.2012.1531
Cescon C, Madeleine P, Graven-Nielsen T, Marletti R, Farina D. Two-dimensional spatial distribution of surface mechanomyographical response to single motor unit activity. J Neurosci Methods 2007;159(1):19-25. doi: 10.1016/jneumeth.2016.06.011
Amélio E, Manganotti P. Effect shock wave stimulation ON hypertonic plantar flexor muscles in patients with cerebral palsy: A placebo-controlled study. J Reabil Med 2010;42(04):339-43. doi: 10.2340116501977-0522
Kim WY, Shin JC, Yoon JG, Kim YK. Usefulness of radial extracorporeal shock wave therapy for the spasticity of the subscapularis in patients with stroke: a pilot study. Chin Med J 2013;126(24):4238-4643. doi: 10.3760/cma.j.issn.0366-6999.2013.11.29
Manganotti P, Amélio E. Long term effect of shock waves therapy on upper limb hypertonic in patients by stroke. Am Heart J 2005;36(9):1967-71. doi: 10.1161/01.STR.0000177880.06663.5c
Lohse-Busch H, Kraemer M, Reime U. Pilotuntersuchung zur wirkung von niedrigenergetischen, extrakorporalen stowellen auf muskelfunktionsstörungen bei spastischen bewegungsstörugen von kindern. Schmerz 1997;11(2):108-12. doi: 10.1007/s004820050071
Mariotto S, Cavalieri E, Amelio E, Ciampa AR, Prati AC, Marlinghaus E et al. Extracorporeal shock-waves: from lithotripsy to anti-inflammatory action by NO production. Nitric Oxid 2004;12(5):89-96. doi: 10.1016/J.NIOX.2004.12.005
Dahmane R, Valencic V, Knez N, Ersen I. Evaluation of the ability to make non-invasive estimation of muscle contractile properties on the basis of the muscle belly response. Med Biol Eng Comput 2001;39(1):51-5. doi: 10.1007/BF02345266
Moon SW, Kim JH, Jung JM, Som S, Lee JH, Shin H et al. The effect of Extracorporeal shock wave therapy on lower limb spasticity in subacute stroke patients. Ann Rehabil Med 2013;37(4):461-70. doi: 10.5535arm2013.37.4.461
Xiang J, Wang W, Jiang W, Qian Q. Effects of extracorporeal shock wave therapy on spasticity in post-stroke patients: a systematic review and meta-analysis of randomized controlled trials. Journal of rehabilitation medicine 2018;50(10): 852-9. doi: 10.2340/16501977-2485
Lauer U, Bürgelt E, Squire Z, Messmer K, Hofschneider PH, Gregor et al. Shock waves permeabilization as a new gene transfer method. Gene Ther 1997;4(7):710-15. doi: 10.1038/sj.gt.3300462
Ciampa RA, Prati AC, Amélio E, Cavalieri E, Persichini T, Colasanti T et al. Nitric oxide mediates anti-inflammatory action of extracorporeal shock waves. Febs Lett 2005;590:(30):6839-45. doi: 10.1016/j.febset.2005.11.023
McAndrew D, Gorelick M, Brown JMM. Muscles within muscles: A mechanomyographic analysis of muscle segment contractile properties within human gluteus maximus. J Musculoskelet Res 2006;10(1):23-35. doi: 10.1142/50218957706001704
Bohannon RW, Smith MB. Interrater reliability of modified Ashworth scale of muscle spasticity. Phys Ther 1987;67(2):206-7. doi: 10.1093/ptj/67.2.206
Krijaj D, Grabljevec K, Simunic B. Evaluation of muscle dynamic response measured before and after treatment of spastic muscle with a BTX-A a case study. Med Biol Eng Comput 2007;16(11):393-396. doi: 10.1007/978-3-540-73044-6
Wu RY, Chang CN, Chen YM, Hu GC. Comparison of effect of focused and radial extracorporeal shock waves spastic equinus patients with stroke a randomized controlled trial. Euro J Phys Rehabil Med 2018;54(4):518-25. doi: 10.23736/S1973-9087.17.04801-8
Gotte G, Amélio E, Russo S, Marlinghaus E, Misci G, Suzuki H. Short-time non-enzymatic nitric oxide synthesis from hydrogen peroxide induced by shock waves treatment. Febs Lett 2002;520(1):153-5.doi: 10.1016/50014-5793(02)02807-7
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Copyright (c) 2020 Claudio Francisco Kluppel Bieszczad, Rodrigo Florêncio da Silva, Renata Rothenbuhler, Angelo Contar Palmar, José Carlos Ludwig
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