Effect of shockwave intensity on upper limb spasticity in patients with stroke.

Background and Aim: Spasticity following upper motor neuron lesions has adverse effects on patients' quality of life and performance. Shockwave therapy is a non-invasive treatment to reduce muscle tone. The purpose of this study was to evaluate the efficacy of shockwave intensity on the improvement of upper limb spasticity in patients with stroke. Materials and Methods: In the present study, 20 patients with stroke were randomly divided into two treatment groups. Shockwave was applied for 1 session at the musculotendinous junction of flexor carpi ulnaris and radialis muscles using a low level of energy for group one (0.03 mj/mm2) and a high level of energy for group two (0.8 mj/mm2). The patients were evaluated at baseline and one week after the intervention. Upper limb spasticity and active range of motion of wrist extension were evaluated by Modified Ashworth Scale and goniometer, respectively. Results: Upper limb spasticity and range of motion of wrist extension were significantly improved immediately and a week after high-intensity shockwave therapy. A significant decrease in upper limb spasticity and a non-significant increase in the range of motion of wrist extension were observed in the group receiving low-intensity shock waves. Conclusion: High energy shockwave appeared to provide a beneficial effect on upper limb spasticity and range of motion of wrist extension, compared with low energy shockwave. It seems that treating with the appropriate intensity of shockwave may be an alternative method to other spasticity treatments.