The dose effectiveness of extracorporeal shockwave on plantar flexor spasticity of ankle in stroke patients: a randomized controlled trial.

IF 5.2 2区医学 Q1 ENGINEERING, BIOMEDICAL Journal of NeuroEngineering and Rehabilitation Pub Date : 2024-10-01 DOI:10.1186/s12984-024-01473-z

Shu-Mei Yang, Yen-Hua Chen, You-Lin Lu, Chueh-Hung Wu, Wen-Shiang Chen, Meng-Ting Lin

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Abstract

Background: Extracorporeal shockwave therapy (ESWT) has been proven beneficial for post-stroke spasticity (PSS) of ankle plantar flexor muscles. This study aims to investigate the dose-response effectiveness of focused-ESWT and the duration of its effect on the treatment of ankle PSS in stroke patients.

Methods: In this double-blinded randomized controlled trial, stroke patients diagnosed with PSS in the ankle plantar flexor muscles were randomly assigned to two groups. The experimental group received double-dose ESWT (4000 pulses per session) targeting spastic calf muscles, while the control group received half the dose (2000 pulses per session). Both groups underwent four sessions over two weeks. The outcomes, including modified Ashworth Scale (MAS), modified Tardieu Scale (MTS), passive range of motion (PROM) of the ankle, Timed Up and Go (TUG) Test, Barthel index and strain elastography were evaluated at baseline, 1st, 4th, 12th, and 24th week after ESWT.

Results: Within-group analysis revealed significant improvements in MAS, PROM, TUG Test, and Barthel index for the double-dose ESWT group and improvements in Barthel index for the control group. Between-group analysis revealed greater improvements in TUG Test, Barthel Index and strain elastography for the double-dose ESWT group. Generalized estimating equations analysis indicated that the double-dose ESWT group achieved superior outcomes in the TUG Test, Barthel Index, and strain elastography across various time points and groups.

Conclusions: Double-dose ESWT showed better functional improvement and elastography compared to the control group. ESWT demonstrated dose-response effectiveness for PSS of ankle-equinus.

Trial registration: NCT05878223.

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体外冲击波对中风患者踝关节跖屈痉挛的剂量效应：随机对照试验。

背景：体外冲击波疗法（ESWT体外冲击波疗法（ESWT）已被证实对中风后踝关节跖屈肌痉挛（PSS）有益。本研究旨在探讨聚焦体外冲击波疗法治疗中风患者踝关节 PSS 的剂量反应效果及其持续时间：在这项双盲随机对照试验中，被诊断为踝关节跖屈肌 PSS 的中风患者被随机分配到两组。实验组接受针对痉挛性小腿肌肉的双剂量 ESWT（每次 4000 脉冲），而对照组接受一半剂量（每次 2000 脉冲）。两组均在两周内接受了四次治疗。在 ESWT 治疗后的基线、第 1 周、第 4 周、第 12 周和第 24 周，对包括改良阿什沃斯量表 (MAS)、改良塔迪厄量表 (MTS)、踝关节被动活动范围 (PROM)、定时上下楼 (TUG) 测试、巴特尔指数和应变弹性成像在内的结果进行了评估：组内分析显示，双剂量 ESWT 组的 MAS、PROM、TUG 测试和 Barthel 指数均有明显改善，而对照组的 Barthel 指数则有所改善。组间分析显示，双剂量 ESWT 组在 TUG 测试、巴特尔指数和应变弹性成像方面有更大改善。广义估计方程分析表明，双剂量 ESWT 组在 TUG 测试、巴特尔指数和应变弹性成像方面取得了不同时间点和组间的更好结果：结论：与对照组相比，双剂量 ESWT 组的功能改善和弹性成像效果更好。ESWT对踝关节-奎努斯的PSS显示出剂量反应的有效性：试验注册：NCT05878223。

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来源期刊

Journal of NeuroEngineering and Rehabilitation 工程技术-工程：生物医学

CiteScore

9.60

自引率

3.90%

发文量

122

审稿时长

24 months

期刊介绍： Journal of NeuroEngineering and Rehabilitation considers manuscripts on all aspects of research that result from cross-fertilization of the fields of neuroscience, biomedical engineering, and physical medicine & rehabilitation.