Effect of Shock Wave Therapy in Patients Affected by Stroke with Upper Limb Spasticity: Neurophysiologic and Clinical Study

Aim of the study is to investigate the effect and the duration of extracorporeal shock wave therapy (ESWT) on the muscle spasticity of the hand and the wrist. We studied 15 patients affected by stroke associated to severe spasticity in upper limb. Clinical examination, neurological scales (NIH scale and Ashworth scales) and a video were performed before and immediately after the placebo and real stimulation. The placebo stimulation was performed before the real stimulation in each stimulation. The patients were monitored after one, four, twelve weeks from the real treatment. After four weeks needle EMG was studied. After real ESWT the patients had greater improvement in flexor tone of wrist and fingers than after placebo stimulation. After 12 weeks from the therapy ten of the fifteen patients showed persistent reduction in muscle tone. No sign of muscle denervation was recorded in all patients. There were no adverse events associated with ESWT. ESWT reduce spasticity of the wrist and finger muscles lasting at least 12 weeks from the treatment.