Extracorporeal Shock Wave Therapy for Limb Dysfunction After Stroke: A Systematic Review and Meta-analysis.

Abstract

Recently, extracorporeal shock wave therapy has emerged as a novel and noninvasive approach for alleviating spasticity and pain, improving motor dysfunction after stroke. To determine the effectiveness of extracorporeal shock wave therapy and the effects of shock wave parameters in relieving spasticity, pain, and motor dysfunction after stroke. We conducted a systematic search of PubMed, EBSCOhost, Embase, Cochrane Library, and Web of Science databases for randomized controlled trials on extracorporeal shock wave therapy for limb dysfunction after stroke from inception until February 1, 2023. Two researchers independently searched and screened articles identified from each database, used RevMan v.5.4 analyzing data. This review included 9 articles and 327 patients. Extracorporeal shock wave therapy improved the spasticity, pain, and motor function after stroke. They also improved the passive range of motion in the lower limbs. The treatment effect was highest when the shock wave frequency was <8 Hz and pressure was <2 bar. However, the effect was not significantly affected by treatment duration. Compared to focused extracorporeal shock waves, released extracorporeal shock waves were associated with better outcomes. The treatment outcomes are optimal when a shock wave frequency <8 Hz, pressure <2 bar, and released extracorporeal shock waves are used.