Title:Pain and Muscles Properties Modifications After Botulinum Toxin Type A (BTX-A) and Radial Extracorporeal Shock Wave (rESWT) Combined Treatment
Volume: 19
Issue: 8
Author(s): Megna Marisa*, Marvulli Riccardo, Farì Giacomo, Gallo Giulia, Dicuonzo Franca, Fiore Pietro and Ianieri Giancarlo
Affiliation:
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari “Aldo Moro”, Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari,Italy
Keywords:
Botulinumtoxin type A, radial extracorporeal shock waves therapy, spasticity, pain, myometric examination,
physiotherapy.
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.