Comparison Of Effects Of Radial Extracorporeal Shock Wave Therapy Between Subacute And Chronic Stroke Patients

Objectives:1 Explore the difference of spastic muscle composition in subacute and chronic stroke patients with similar lower limp functional level.2 Compare the effects of radial extracorporeal shock wave therapy(RSWT) between subacute and chronic stroke patients, then preliminarily explore the mechanism of RSWT on spasticity.Methods:Twenty stroke patients (8 subacute and 12 chronic) with spasticity in the hemiplegic ankle joint were recruited. Before treatment, all participants underwent a sonography evaluation of gastrocnemius to identify echo intensity (EI).Tardieu scale(TS), passive range of motion(PROM) were performed just before the ESWT and immediately after ESWT and 1 weeks and 3 weeks later. Creatine kinase (CK) was detected before and 24 hours after treatment.Results:1 EI、Dynamic range(D) were statistically significant different between subacute and chronic stroke patients (P<0.05)2 TS and PROM were no significant improved immediately and 1 week after RSWT in subacute patients (P>0.05). TS and PROM were significant improved 4 week after RSWT in subacute patients (P<0.05)3 Howere,TS and PROM were significant improved immediately and 1 week and 3weeks after RSWT in chronic patients (P<0.05).Conclusions:1 Spastic muscle composition of subacute and chronic stroke patients with similar lower limb motor function is different. There is a high level of non-contractile tissue in chronic hypertonic muscles;2 RSWT reduces hypertonia of gastrocnemius, increases passive range of motion of ankle joint in patients after stroke safely and effectively.3 The possible mechanism of RSWT is a direct effect of shock waves on fibrosis and on the rheologic components of chronic hypertonic muscles...