Optimizing extracorporeal shock wave with the orthogonal array design in the treatment of the spasticity of cerebral palsy

Objective: To study the dose-response relationship between different treatment parameters of extracorporeal shock wave (ESW) and their effects on spasticity in children with cerebral palsy by the orthogonal design and to select the best parameter scheme for clinical efficacy. Methods: From March 2020 to December 2020, 80 children with spastic cerebral palsy were randomly divided into eight groups of 10 cases. Patients in each group received ESW with varying wave intensities (A), wave frequencies (B), number of shocks (C), and treatment frequencies (D), which were determined by a 4-factor-2-level orthogonal array design. Modified Ashworth Scale (MAS) and GMFM were scored before and after the study, and the difference during the study was calculated to evaluate the performance of each group. Results: The R-value of DMAS was RA > RD > RC > RB and that of Delta GMFM was RA > RC > RD > RB. The influence of the two levels for each factor was A1 > A2, B2 > B1, C2 > C1, D2 > D1. By the analysis of variance, the differences in factors A, C, and D were statistically significant (P < 0.05). The optimal combination of ESW treatment parameters for the spasticity of cerebral palsy was 1.5 bar, 10 Hz, 2000 times, and twice a week. Conclusion: ESW is an effective treatment for spastic cerebral palsy and is worthy of clinical application. (c) 2022 The Authors. Published by Elsevier Ltd on behalf of Tsinghua University Press. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).