Short-Term Effects of Radial Extracorporeal Shock Wave Therapy in Addition to Physiotherapy on Spasticity, Walking Performance, and Quality of Life in Chronic Stroke: A Sham-Controlled Randomized Trial.

IntroductionThis study evaluated the short-term effects of adding a 4-week radial extracorporeal shock wave therapy (rESWT) program to standardized physiotherapy on spasticity, walking performance, lower-extremity motor function, and health-related quality of life in chronic stroke patients with plantar flexor spasticity.MethodsIn this prospective, single-blind, sham-controlled trial, 85 chronic stroke survivors were randomized to active rESWT (n = 43; 0.10-0.20 mJ/mm2, 4000-6000 pulses/session, 3 sessions/week) plus physiotherapy or sham rESWT plus physiotherapy for 4 weeks. Outcomes were assessed at baseline and Week 4. The primary outcome was the Modified Ashworth Scale (MAS). Secondary outcomes included the 10-Meter Walk Test (10MWT), Timed Up and Go (TUG) test, 6-Minute Walk Test (6MWT), Fugl-Meyer Assessment-Lower Extremity (FMA-LE), and Stroke-Specific Quality of Life (SS-QOL) scale. Between-group treatment effects were estimated with baseline-adjusted analysis of covariance and are reported with 95% confidence intervals.ResultsAdjusted mean differences favored the rESWT group for MAS (-0.56; 95% CI -0.77 to -0.35), 10MWT (-1.41 s; -1.87 to -0.96), TUG (-2.46 s; -3.19 to -1.74), FMA-LE (4.42; 3.62 to 5.23), and SS-QOL (11.73; 9.15 to 14.31), all p < 0.001. Median MAS decreased from 2 to 1 in the rESWT group versus no change in controls. The 6MWT did not differ significantly between groups (-6.26 m; -15.27 to 2.74). No adverse events occurred.ConclusionsAdding rESWT to physiotherapy produced short-term improvements in spasticity, walking, functional mobility, motor function, and quality of life. Long-term efficacy and safety require further study.Trial Registration: ClinicalTrials.gov Identifier: "This field has been blinded".