Published Paper Details:

Abstract: Background: Spasticity is a significant and challenging consequence of neurological conditions, often resulting in impaired mobility, discomfort, and a decline in quality of life. Conventional therapies, including pharmacological and surgical interventions, have limitations due to side effects and invasiveness. Extracorporeal shockwave therapy (ESWT) has gained attention as a novel, non-invasive therapeutic modality. Objective: This systematic review aims to evaluate and synthesize current evidence regarding the effectiveness of ESWT in reducing spasticity across various neurological disorders. Methods: A systematic literature search was conducted across four databases: PubMed, Scopus, Google Scholar, and Ovid, covering the period from January 2010 to December 2024. Search terms included "extracorporeal shockwave therapy," "ESWT," "spasticity," "stroke," "cerebral palsy," and "neurological rehabilitation." Inclusion criteria were studies involving human participants with neurologically induced spasticity treated with ESWT. Only studies employing objective measures such as the Modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA), or electromyography (EMG) were included. A total of 11 studies were included in the qualitative synthesis. Results: The majority of the included studies were conducted in stroke populations, targeting both upper and lower limb spasticity. Both radial and focused ESWT were utilized, with variations in dosage, application frequency, and treatment site. All studies reported improvements in spasticity post-treatment, with MAS scores significantly reduced in most. Improvements were observed immediately and persisted up to four weeks post-intervention. Functional improvements in mobility and limb use were noted in studies measuring secondary outcomes. The musculotendinous junction appeared to be a more effective target site compared to muscle belly. Conclusion: ESWT is a promising adjunctive treatment for reducing spasticity in neurological conditions. It demonstrates efficacy in lowering muscle tone and improving functional outcomes with minimal side effects. Further large-scale, high-quality studies are warranted to optimize treatment parameters and assess long-term efficacy.