Spasticity and Electrophysiologic Changes after Extracorporeal Shock Wave Therapy on Gastrocnemius
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Objective To evaluate the spasticity and electrophysiologic effects of applying extracorporeal shock wave therapy (ESWT) to the gastrocnemius by studying F wave and H-refl ex. Method Ten healthy adults and 10 hemiplegic stroke patients with ankle plantarflexor spasticity received one session of ESWT on the medial head of the gastrocnemius. The modified Ashworth scale (MAS), tibial nerve conduction, F wave, and H-refl ex results were measured before and immediately after the treatment. The Visual Analogue Scale (VAS) was used during ESWT to measure the side eff ects, such as pain. Results There were no significant effects of ESWT on the conduction velocity, distal latency and amplitude of tibial nerve conduction, minimal latency of tibial nerve F wave, latency, or H-M ratio of H-reflex in either the healthy or stroke group. However, the MAS of plantarfl exor was signifi cantly reduced from 2.67±1.15 to 1.22±1.03(p<0.05) after applying ESWT in the stroke group. Conclusion After applying ESWT on the gastrocnemius in stroke patients, the spasticity of the ankle plantarfl exor was significantly improved, with no changes of F wave or H-reflex parameters. Further studies are needed to evaluate the mechanisms of the antispastic effect of ESWT.
Abstract
Objective To evaluate the spasticity and electrophysiologic effects of applying extracorporeal shock wave therapy (ESWT) to the gastrocnemius by studying F wave and H-refl ex. Method Ten healthy adults and 10 hemiplegic stroke patients with ankle plantarflexor spasticity received one session of ESWT on the medial head of the gastrocnemius. The modified Ashworth scale (MAS), tibial nerve conduction, F wave, and H-refl ex results were measured before and immediately after the treatment. The Visual Analogue Scale (VAS) was used during ESWT to measure the side eff ects, such as pain. Results There were no significant effects of ESWT on the conduction velocity, distal latency and amplitude of tibial nerve conduction, minimal latency of tibial nerve F wave, latency, or H-M ratio of H-reflex in either the healthy or stroke group. However, the MAS of plantarfl exor was signifi cantly reduced from 2.67±1.15 to 1.22±1.03(p<0.05) after applying ESWT in the stroke group. Conclusion After applying ESWT on the gastrocnemius in stroke patients, the spasticity of the ankle plantarfl exor was significantly improved, with no changes of F wave or H-reflex parameters. Further studies are needed to evaluate the mechanisms of the antispastic effect of ESWT.
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