Shockwave therapy in persons with a spinal cord injury and spasticity: A multiple single-case experimental design study

OBJECTIVE: To determine whether ESWT is able to safely and positively influence specific ADL activities in people with SCI and spasticity, measured by Goal Attainment Scaling (GAS).

STUDY DESIGN: Multiple single-case experimental design with a randomized baseline length.

SETTING: Rehabilitation centre.

SUBJECTS: This study included 11 participants with SCI, aged >18 years (mean (SD) 63 (12.2) years), mean (SD) duration after injury 9 (8.1) years, with hindering spasticity in the upper or lower limb.

METHODS: During the 3-week treatment phase, radial ESWT in the plantar flexors of the calf (n = 6) or in the flexors of the wrist/hand (n = 5) was applied weekly, followed by a 12-week follow-up phase. The primary outcome measure consisted of the Goal Attainment Scaling (GAS), in which three individual goals were set. Secondary outcome measures included range of joint motion, pain (0-10), 10-m walking test and Van-Lieshout-hand-function-test-for-Tetraplegia (short form).

RESULTS: At descriptive level, in total, 28 of the 33 GAS items improved after ESWT and these effects generally were maintained during the follow-up phase. The results of all secondary outcome measures varied. No serious adverse events occurred.

CONCLUSIONS: In this study, ESWT resulted in improved performance of specific ADL items in most persons with SCI. More research is needed to confirm these results in a larger cohort.