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Effets des ondes de choc radiales sur la spasticite du triceps sural de patients hemiplegiques en phase subaigue: un essai controle randomise (Effects of radial shock wave therapy on sural triceps spasticity in hemiplegic patients in subacute phase: a controlled randomized trial) [French; with consumer summary]
Tirbisch L
Kinesitherapie La Revue 2015 Aug-Sep;15(164-165):62-69
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To assess the effect of radial shockwave therapy on sural triceps spasticity and passive joint motion in patients with subacute hemiplegia. METHODOLOGY: A single-centre randomised controlled trial with concealed computerised allocation and intention-to-treat analysis. PARTICIPANTS: Eight subacute hemiplegic patients with sural triceps spasticity graded 1+ on the modified Ashworth Scale. INTERVENTION: All patients providing informed consent and meeting the inclusion criteria participated in a 3-week program. The experimental group received three shock wave sessions a week plus usual treatment. The control group received usual treatment only. OUTCOME MEASURES: Assessment criteria were: spasticity, and passive ankle motion on the modified Ashworth and Tardieu scales. Side effects were recorded. Assessment was performed before program initiation, immediately after the first shockwave session, and at end of program. RESULTS: The 8 patients had all three assessments. Neither spasticity nor range of motion differed significantly between groups. There were no inter-group differences for any assessment criteria (p > 0.05). Within groups, gastrocnemius spasticity decreased significantly between first and final assessment for the experimental group. CONCLUSION: Shock wave therapy did not show superiority over usual treatment in decreasing triceps sural spasticity or improving ankle range of motion in dorsiflexion. Other studies with higher power will be necessary to confirm or counter the present results. LEVEL OF EVIDENCE: 2.

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