Effects of extracorporeal shock wave therapy on motor function in patients with cerebral palsy: a systematic review and meta-analysis.

Abstract

This study aims to evaluate extracorporeal shockwave therapy (ESWT) on spasticity, balance, gait patterns, and motor function in individuals with cerebral palsy (CP). PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov were systematically searched up to 11 April 2025. Meta-analyses were conducted using Review Manager. The primary outcomes were Modified Ashworth Scale (MAS) and gait speed. Ten randomized controlled trials (RCTs) involving 341 individuals with CP were included. Comparison between the ESWT and control groups revealed significant improvements in MAS (standardized mean difference [SMD]: -0.84, 95% confidence intervals [CIs]: -1.23 to -0.46, <i>p</i> < 0.001), gait speed (MD: 0.12, 95% CI: 0.02-0.23, <i>p</i> = 0.02), cadence (MD: -3.01, 95% CI: -6.03 to 0, <i>p</i> = 0.05), stride length (MD: 0.22, 95% CI: 0.16-0.28, <i>p</i> < 0.001), Pediatric Balance Scale (MD: 2.3, 95% CI: 0.4-4.19, <i>p</i> = 0.02), and Gross Motor Function Measure-88 (MD: 9.72, 95% CI: 7.36-12.08, <i>p</i> < 0.001). Combining ESWT with conventional physiotherapy, botulinum toxin type A (BTX-A) injection, or ankle-foot orthotics positively affects spasticity, gait, balance, and motor function. In addition, spasticity significantly decreases, particularly with focused ESWT or ESWT targeting the upper limbs.