In a nutshell
This study compared extracorporeal shock wave therapy (ESWT) and botulinum toxin type A (BOT) for the treatment of stiff upper limbs (arms) after a stroke. Researchers suggested that ESWT is a safe and effective option for the treatment of these patients.
Some background
Stroke is one of the leading causes of adult disability in most countries. Stiffness of the arms is a very common side effect in patients with stroke. This is associated with pain, abnormal arm posture and decreased quality of life.
The treatment options for arm stiffness include physical therapy, medication, BOT injections, and surgery. However, BOT is the recommended first-line treatment. BOT injections are invasive and are associated with some side effects such as muscle weakness and formation of antibodies (cells of the immune system) that decrease the treatment effect.
ESWT consists in the application of energy pulses, through a generator to a specific area of the body. Prior studies indicated that ESWT is an effective and non-invasive method to treat muscle stiffness. However, to date, no research has compared the effect of BOT and ESWT in the treatment of muscle stiffness in patients with stroke.
Methods & findings
This study included information about 42 patients with stroke. Patients received either BOT or ESWT. The follow-up was done at the start of the treatment and at 1, 4 and 8 weeks.
No significant difference in effectiveness was seen between BOT and ESWT. However, ESWT showed greater improvement in wrist and elbow mobility.
The bottom line
This study concluded that ESWT is similar to BOT in the treatment of muscle stiffness in patients with stroke.
The fine print
The number of patients included was quite small. Larger studies are needed.
What’s next?
If you worry about BOT side effects, ask your doctor if you are eligible for treatment with ESWT.
Published By :
Archives of physical medicine and rehabilitation
Date :
Nov 01, 2018
