Novel Evidences of Extracorporeal Shockwave Therapy for Spasticity

Abstract

Spasticity is defined as ‘a disorder of sensorimotor control, resulting from an upper motor neuron (UMN) lesion, presenting as intermittent or sustained involuntary activation of muscles’. It is characterized by increased involuntary velocity-dependent tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex. In the recent years, a range of non-pharmacological interventions has been used to manage spasticity. Among the novel of all therapies, extracorporeal shock wave therapy (ESWT) is attractive for many researchers since the noninvasive, easy application after well training and safety property. Moreover, the evidences of regeneration of musculoskeletal tissues made ESWT more interesting than other novel therapies. This article will show the evidences, practical clinical use and precaution to guide treating for the clinicians in the novel therapy of ESWT for spasticity. The review of the scientific evidences including methodology components and main results of ESWT treatment on upper limb and lower limb muscles affected by post-stroke spasticity are demonstrated. However, reducing spasticity alone without addressing the negative components of the upper motor neuron syndrome will limit meaningful recovery. A combination of rehabilitation techniques is needed to facilitate functional improvements.