1. Pain and Muscles Properties Modifications After Botulinum Toxin Type A (BTX-A) and Radial Extracorporeal Shock Wave (rESWT) Combined Treatment
- Author
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Riccardo Marvulli, Pietro Fiore, Marisa Megna, Franca Dicuonzo, Giulia Gallo, Giacomo Farì, and Giancarlo Ianieri
- Subjects
Extracorporeal Shockwave Therapy ,Male ,030506 rehabilitation ,Time Factors ,Endocrinology, Diabetes and Metabolism ,Acetylcholine Release Inhibitors ,Biceps ,03 medical and health sciences ,0302 clinical medicine ,Combined treatment ,medicine ,Spastic ,Humans ,Immunology and Allergy ,Spasticity ,Botulinum Toxins, Type A ,Muscle, Skeletal ,Lead (electronics) ,Physical Therapy Modalities ,Retrospective Studies ,business.industry ,Myalgia ,Middle Aged ,Extracorporeal shock wave ,Stroke ,Treatment Outcome ,Upper motor neuron syndrome ,Muscle Spasticity ,Anesthesia ,Female ,medicine.symptom ,0305 other medical science ,business ,030217 neurology & neurosurgery ,Muscle Contraction ,Botulinum toxin type - Abstract
Background and Objective:Spasticity (most common disability in upper motor neuron syndrome or UMNS) caused an inability of patients’ to perform daily activities and a decrease inquality of life. One of the promising methods nowadays, but still not widely used in everyday practice, for spasticity reduction is extracorporeal shock wave. The aim of this study was to evaluate the objective clinical effects of combined treatment botulinum toxin type A and radial Extracorporeal Shock Wave Therapy in spasticity post stroke.Methods:We considered 30 subjects (14 female and 16 male) with post stroke spasticity of Biceps Brachii, Superficial Flexor Digitorum, Gastrocnemius Medialis and Lateralis and we divided patients into two groups (group A received botulinum toxin injection and physiotherapy while group B received botulinum toxin injection, rESWT and physiotherapy). Assessments were performed before treatment (t0), after 1 (t1), 2 (t2) e 3 (t3) months using Modified Ahworth Scale, Visual Analogical Scale for pain and MyotonPro® device (to assessed myometric evaluation of muscles tone and stiffness).Results:Visual Analogical Scale, Modified Ahworth Scale, muscles tone and stiffness statistically decreased until t3 in the group A and in the group B, but the differences between the two groups were significant at the t1 only.Conclusion:Radial Extracorporeal Shock Wave Therapy could be an effective physical treatment aimed at the reduction of upper and lower limbs spasticity and could lead to the improvement of trophic conditions of the spastic muscles in post-stroke.
- Published
- 2019