Rehabilitation treatment of spastic cerebral palsy with radial extracorporeal shock wave therapy and rehabilitation therapy article summary

Posted on: February 24, 2019 | By: zknox | Filed under: Gross Motor Function Measure (GMFM)

The purpose of this article is to examine the use of radial extracorporeal shock wave therapy (rESWT) and rehabilitation therapy for the treatment of spastic cerebral palsy. Cerebral Palsy has a prevalence of 2.0-3.5 births out of every 100.  This is prospective randomized control study.

This study consisted of 82 children between the ages of 6 years to 12 years, this study was performed over the course of 3 years (2014-2017). Inclusion criteria consisted of 1) being between the ages of 6 and 12, 2) having spastic cerebral palsy, and 3) received multi-stage surgical strategy in the hospital for 6 weeks after lower extremity lysis operation, and 4) were able to participate in shock wave and routine rehabilitation. The participants were split into two groups the treatment group (n=43) and the control group (n=39).

Both groups, treatment and control, underwent regular treatment including physical therapy, speech therapy, occupational therapy, and orthotic treatment. The treatment group was also treated with rESWT throughout the course of this study. The children were placed in prone. Couplants were evenly applied to the posterior side of the triceps and hamstring muscles. The probe was placed close to the abdominal muscles to give shock, avoiding major blood vessels and nerves. Impact frequency was 10Hz, and the number of impacts was 2000 times. The probe was centered around the leg tricep hamstring and hamstring muscle belly with a radius of 2.5 cm. The treatment was performed once a week for 10 min and was performed for a total of 4 weeks.

All of the patients were evaluated before treatment, 2 weeks and 1 month after treatment. The two objective measure used in this study were the Modified Ashworth Scale (muscle spasticity) and the Gross Motor Function Measure (GMFM) which mainly assesses the function of standing, walking, and jumping of children, has 5 levels. The standing function has a total score of 39 points, and the walking and jumping function has a total score of 72 points.

The baseline measurements of the two groups showed no significant difference between the two. After treatment for 2 weeks and 1 month, the MAS scores of hamstring and triceps decreased significantly in the treatment and control groups compared with those before treatment. After 1 month of rESWT, the plantar area, plantar pressure and the GMFM scores were significantly increased compared with the control group.

Overall, I think this is a very good, informative article. It proposes an alternative treatment to cerebral palsy that is pain free and completely passive. It also could aid in the treatment and healing of the muscles and tendons post surgery. One of the limitations of this study is the fact that the outcomes were not tracked after the one month mark of treatment. However, the observable outcomes in this study show that it could be a great alternative to traditional treatments to patients with cerebral palsy.

 

One response to “Rehabilitation treatment of spastic cerebral palsy with radial extracorporeal shock wave therapy and rehabilitation therapy article summary”

  1. awilson45 says:

    Interesting article. I’ve seen shockwave therapy used for conditions such as plantar fasciitis. I see they were exposed to the shockwave treatment once a week (10 minutes) for 4 weeks. On how many days were they receiving the other therapies? Were some of them given on the same day as the shockwave therapy? I was just curious if maybe the combination of multiple therapeutic modes was a contributing factor to their decrease MAS scores?

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