Tragically, many who suffer from and then survive a stroke, the third leading cause of death among Americans, often experience post-stroke spasticity of upper limbs. Experiencing a stroke, also known as a Cerebrovascular Accident (CVA), is a medical emergency. Strokes occur when blood flow to the brain is blocked or a blood vessel ruptures.
Post-stroke spasticity accompanies movement restrictions that significantly impact a patient's ability to perform daily activities and enjoy a quality of life. Traditionally, doctors treating stroke patients with spasticity have relied upon pharmaceuticals, physical therapy, exercise therapy, and more. Because of the limitations and shortfalls of those regimens, medical professionals are turning more and more to Extracorporeal Shockwave Therapy (ESWT) for post-stroke treatment of spasticity.
Researchers from the Department of Rehabilitation Medicine, First Hospital of Jilin University, Changchun, China, engaged in a study to research advancements and evaluate ESWT in the treatment of post stroke spasticity. This important article was published in Frontiers of Neurology. Take a research deep dive by reading the complete study, "Research Progress in Extracorporeal Shockwave Therapy for Upper Limb Spasticity After Stroke."
What Causes Upper Limb Spasticity After Stroke?
When your brain is impacted by a stroke, the ability to send and receive messages is disrupted and can lead to spasticity. Because the brain is the control center that influences how muscles move and feel − when damaged by stroke, it profoundly impacts and scrambles signals to your muscles. Additionally, there may be abnormal processing of inputs that occur in the spinal cord. Spasticity is intrinsically linked to upper motor neuron syndrome.
Spasticity tends to arrive during the recovery period, often appearing after three months post stroke occurrence. Spasticity after stroke is marked by hyperexcitability of the stretch reflex. Post stroke patients may experience the following:
- Muscle rigidity
- Painful muscle spasms
- Curled wrist and clenched fingers
- Decreased elbow functionality
- Challenges in stretching muscles
- Hyperactive reflexes
A spastic arm after a stroke will affect a patient's ability to open their hand to reach something or open a jar. Additionally, upper limb spasticity impacts daily life in many ways, from eating and dressing, to bathing and basic hygiene care.
Patients with spasticity must receive post-stroke care to improve outcomes. In this study, scientists split the exploration into two categories: hypertonia due to stretch reflex and hypertonia due to soft tissue change.
Mechanisms of ESWT in Treating Post-Stroke Spasticity
Researchers identified four mechanisms of action of ESWT for spasticity after stroke.
- ESWT influences Nitric Oxide Synthesis.
Nitric oxide (NO) acts as a messenger molecule and influences neuromuscular junction formation and physiological and nervous system functionality. Shockwave regulates NO synthesis and impacts enzyme activity, relieving limb spasticity after stroke. - ESWT reduces motor neuron overactivity.
Stroke triggers abnormal excitability of motor neurons after cerebral cortex damage. ESWT quiets this excitability by reducing tendon tension. - Shockwave regenerates nerve conduction.
ESWT can produce a nerve block at accessible nerve endings, thus regenerating nerve conductions. Shockwaves positively influence innervation and nerve conduction in the muscles. - ESWT impact on muscle and soft tissue.
Researchers believe multiple mechanisms of action occur in patients being treated for spasticity and cannot be isolated. ESWT improves muscle and soft tissue functionality.
Conclusions on ESWT for Post-Stroke Spasticity of Upper Limbs
In conclusion, Extracorporeal Shockwave Therapy is favorable for patients, effectively relieves upper limb spasticity after a stroke, and has a lasting impact. It is equally effective at treating flexor spasms and agonists and antagonists. Treatment intensity for upper limbs after stroke is generally low energy. And treatment methods exist for the use of focused shockwave and radial pressure wave – with no notable difference in the therapeutic outcomes.
Recent studies confirm shockwave's efficacy in treating upper limb post stroke spasticity. Shockwave is safe, non-invasive, and backed by clinical evidence. Using ESWT lessens or reduces the need for antispasmodic drugs for patients with upper limb spasticity.
Regenerative Technologies to Accelerate Healing and Practice Growth
In addition to being a game-changer in the treatment of post-stroke spasticity, EPAT and ESWT are recognized medical disruptors known for delivering impressive clinical outcomes in several musculoskeletal disorders, tendinopathies, and associated pain. Integrating EPAT, ESWT, and EMTT into your practice can revolutionize patient outcomes contributing to practice growth.
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Learn More and Connect:
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