Efficacy of radial shock wave therapy for ankle spasticity in patients with stroke within 3 months of onset: a prospective quasi-experimental study

So, still a failure; no cure for spasticity. The goal is to cure spasticity, not just reduce it.

When you are the 1 in 4 per WHO that has a stroke with spasticity, you'll want your spasticity cured. You better start solving that now.

Since you are using a subjective measurement scale(Modified Ashworth Scale) nothing here inspires any sort of confidence. In fact I would assume that the participants are using the Hawthorne effect to please the researchers. 

Efficacy of radial shock wave therapy for ankle spasticity in patients with stroke within 3 months of onset: a prospective quasi-experimental study

• Yuichi Hiramatsu,
• Hajime Yagura,
• Hiroaki Fujimoto,
• Megumi Hatakenaka,
• Teiji Kawano,
• Shota Segawa,
• Makiko Rai,
• Ryutaro Hayashi,
• Akihiko Nakae,
• Haruka Asano,
• Takuya Ogawa &
• Ichiro Miyai 

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Background

Extracorporeal shock wave therapy (ESWT) is widely used to reduce poststroke spasticity (PSS). However, limited evidence exists regarding its efficacy in patients with stroke within 3 months of onset. Therefore, this study aimed to investigate the association between ESWT administered 1 to 3 months after stroke and changes in spasticity and joint mobility in patients with PSS.

Methods

Prospective quasi-experimental study. Fifty-two patients with PSS affecting the ankle joint were enrolled from March 2023 to March 2025, and allocated into three groups based on the time elapsed from stroke onset: 1, 2, or 3 months. All patients underwent radial ESWT to the gastrocnemius and soleus muscles once weekly for 3 consecutive weeks. Spasticity and joint mobility were evaluated using the Modified Ashworth Scale (MAS) and passive range of motion (PROM) measurements before and after each session, and at 1 and 5 weeks post-treatment.

Results

Except for the MAS score obtained after the first session, significant immediate reductions in the MAS scores and PROM measurements were observed after all shock wave therapy sessions. Compared to baseline, cumulative changes were greatest after the third session, with a mean reduction of 0.6 points in the MAS score and a 6.4° increase in the PROM. These changes were maintained for 5 weeks. No serious adverse events related to shock wave therapy were reported.

Conclusions

ESWT during the early subacute stage was associated with improvements(NOT GOOD ENOUGH!) in spasticity and joint mobility in patients with PSS. Repeated sessions showed greater cumulative changes compared with a single session.

Trial registration UMIN-CTR000050477.