Article

Extracorporeal shock wave therapy is a treatment of choice in patients with
musculoskeletal disorders. The aim of this study was to investigate the effect of
radial shock wave therapy (RSWT) on muscle spasticity of plantar flexor muscles
in children with cerebral palsy. This was an open, controlled, observational
study with one placebo treatment session, followed 4 weeks later by one active
treatment session. Procedures and measurements were performed on inpatients of
the Physical and Rehabilitation department of the Medical University Hospital,
Plovdiv, Bulgaria. Twenty-five children, mean age 4.84+/-3.11 years, with spastic
diplegia and hemiplegia participated in the study. They received a single session
of RSWT to the plantar flexors of the foot. The following clinical methods were
used for outcome assessment before, after, and 2 and 4 weeks later: passive range
of motion, Modified Ashworth Scale. Baropodometric measurements were performed
before and after the placebo and active session. After placebo application, no
changes measured by clinical or instrumental methods were found. After RSWT, a
significant increase in passive range of motion was observed: 47.00+/-2.29
degrees versus 33.25+/-2.20 degrees (P<0.001), which persisted at the second
(46.87+/-2.08 degrees , P<0.001) and fourth week (44.12+/-1.93 degrees , P<0.001)
after treatment. The Modified Ashworth Scale score decreased from 2.77 to 2.00
points (P<0.001), which persisted at the second (mean 2.05+/-0.07 points,
P<0.001) and fourth week (2.15+/-0.76 points, P<0.001) after treatment.
Baropodometric measurement showed a significant increase in the contact plantar
surface area of the affected foot (from 81.32+/-6.14 to 101.58+/-5.41 cm,
P<0.001) and in heel pressure (from 50.47+/-6.61 to 75.17+/-3.42 N/cm, P<0.001).
There is a significant reduction in the spasticity of plantar flexor muscles in
children with cerebral palsy after a single session of RSWT and this improvement
remains at the 4-week follow-up.

Langue : ANGLAIS