Short-Term Effects of Radial Extracorporeal Shock Wave Therapy in Addition to Physiotherapy on Spasticity, Walking Performance, and Quality of Life in Chronic Stroke: A Sham-Controlled Randomized Trial

NEUROREHABILITATION, cilt.0, sa.0, ss.1-10, 2026 (Hakemli Dergi)

Abstract

Introduction: This study evaluated the short-term effects of adding a 4-week radial extracorporeal shock wave therapy

(rESWT) program to standardized physiotherapy on spasticity, walking performance, lower-extremity motor function,

and health-related quality of life in chronic stroke patients with plantar exor spasticity.

Methods: In this prospective, single-blind, sham-controlled trial, 85 chronic stroke survivors were randomized to active

rESWT (n= 43; 0.10–0.20 mJ/mm2, 4000–6000 pulses/session, 3 sessions/week) plus physiotherapy or sham rESWT plus

physiotherapy for 4 weeks. Outcomes were assessed at baseline and Week 4. The primary outcome was the Modi ed

Ashworth Scale (MAS). Secondary outcomes included the 10-Meter Walk Test (10MWT), Timed Up and Go (TUG)

test, 6-Minute Walk Test (6MWT), Fugl-Meyer Assessment–Lower Extremity (FMA-LE), and Stroke-Speci c Quality of

Life (SS-QOL) scale. Between-group treatment effects were estimated with baseline-adjusted analysis of covariance

and are reported with 95% con dence intervals.

Results: Adjusted mean differences favored the rESWT group for MAS (−0.56; 95% CI−0.77 to−0.35), 10MWT

(−1.41 s;−1.87 to−0.96), TUG (−2.46 s;−3.19 to−1.74), FMA-LE (4.42; 3.62 to 5.23), and SS-QOL (11.73; 9.15 to

14.31), all p < 0.001. Median MAS decreased from 2 to 1 in the rESWT group versus no change in controls. The

6MWT did not differ signi cantly between groups (−6.26 m;−15.27 to 2.74). No adverse events occurred.

Conclusions: Adding rESWT to physiotherapy produced short-term improvements in spasticity, walking, functional

mobility, motor function, and quality of life. Long-term ef cacy and safety require further study.

Trial Registration: ClinicalTrials.gov Identi er: “This eld has been blinded”

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Keywords

extracorporeal shock wave therapy, spasticity, stroke rehabilitation, gait, quality of life