The effectiveness of radial extracorporeal shock wave therapy vs transcutaneous electrical nerve stimulation in the management of upper limb spasticity in chronic-post stroke hemiplegia-A randomized controlled trial
Traditionally both rESWT and TENS are used in treating post-stroke upper limb spasticity over years and their effectiveness had been assessed disjointedly. However, these methods were not yet compared for superiority. To compare rESWT vs TENS to assess their effectiveness in different parameters of...
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| Veröffentlicht in: | PloS one 2023-05, Vol.18 (5), p.e0283321-e0283321 |
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| description | Traditionally both rESWT and TENS are used in treating post-stroke upper limb spasticity over years and their effectiveness had been assessed disjointedly. However, these methods were not yet compared for superiority.
To compare rESWT vs TENS to assess their effectiveness in different parameters of stroke such as stroke type, gender, and the affected side.
The experimental group was treated with rESWT application to the middle of the muscle belly of Teres major, Brachialis, Flexor carpi ulnaris, and Flexor digitorum profundus muscles using 1500 shots per muscle, frequency of 5Hz, energy of 0.030 mJ/mm. The TENS was applied to the same muscles in the control group using 100 Hz for 15 minutes. Assessments were taken at the baseline (T0), immediately after first application (T1), and at the end of four-week protocol (T2).
Patients 106 with a mean age of 63.87±7.052 years were equally divided into rESWT (53) and TENS (53) groups including 62 males, 44 females, 74 ischemic, 32 hemorrhagic, affecting 68 right, and 38 left. Statistical analysis has revealed significant differences at T1 and T2 in both groups. But at T2 compared to T0; the rESWT group has reduced spasticity 4.8 times (95% CI 1.956 to 2.195) while TENS reduced by 2.6 times (95% CI 1.351 to 1.668), improved voluntary control by 3.9 times (95% CI 2.314 to 2.667) and it was 3.2 times (95% CI 1.829 to 2.171) in TENS group. Improvement of the hand functions of the rESWT group was 3.8 times in FMA-UL (95% CI 19.549 to 22.602) and 5.5 times in ARAT (95% CI 22.453 to 24.792) while thrice (95% CI 14.587 to 17.488) and 4.1 times (95% CI 16.019 to 18.283) in TENS group respectively.
The rESWT modality is superior compared to the TENS modality for treating chronic post-stroke spastic upper limb. |
| doi_str_mv | 10.1371/journal.pone.0283321 |
| format | Article |
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To compare rESWT vs TENS to assess their effectiveness in different parameters of stroke such as stroke type, gender, and the affected side.
The experimental group was treated with rESWT application to the middle of the muscle belly of Teres major, Brachialis, Flexor carpi ulnaris, and Flexor digitorum profundus muscles using 1500 shots per muscle, frequency of 5Hz, energy of 0.030 mJ/mm. The TENS was applied to the same muscles in the control group using 100 Hz for 15 minutes. Assessments were taken at the baseline (T0), immediately after first application (T1), and at the end of four-week protocol (T2).
Patients 106 with a mean age of 63.87±7.052 years were equally divided into rESWT (53) and TENS (53) groups including 62 males, 44 females, 74 ischemic, 32 hemorrhagic, affecting 68 right, and 38 left. Statistical analysis has revealed significant differences at T1 and T2 in both groups. But at T2 compared to T0; the rESWT group has reduced spasticity 4.8 times (95% CI 1.956 to 2.195) while TENS reduced by 2.6 times (95% CI 1.351 to 1.668), improved voluntary control by 3.9 times (95% CI 2.314 to 2.667) and it was 3.2 times (95% CI 1.829 to 2.171) in TENS group. Improvement of the hand functions of the rESWT group was 3.8 times in FMA-UL (95% CI 19.549 to 22.602) and 5.5 times in ARAT (95% CI 22.453 to 24.792) while thrice (95% CI 14.587 to 17.488) and 4.1 times (95% CI 16.019 to 18.283) in TENS group respectively.
The rESWT modality is superior compared to the TENS modality for treating chronic post-stroke spastic upper limb.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0283321</identifier><identifier>PMID: 37235581</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Analysis ; Biology and Life Sciences ; Care and treatment ; Causes of ; Clinical trials ; Comparative analysis ; Consent ; Data collection ; Effectiveness ; Extracorporeal Shockwave Therapy ; Female ; Hemiplegia ; Hemiplegia - etiology ; Hemiplegia - therapy ; Hemorrhage ; Humans ; Ischemia ; Lithotripsy ; Male ; Medicine and Health Sciences ; Middle Aged ; Muscle Spasticity - etiology ; Muscle Spasticity - therapy ; Muscles ; Paralysis ; Patient outcomes ; Patients ; Prevention ; Risk factors ; Shock waves ; Spasticity ; Statistical analysis ; Stroke ; Stroke (Disease) ; Stroke - complications ; Stroke - therapy ; Transcutaneous Electric Nerve Stimulation - methods ; Transcutaneous electrical nerve stimulation ; Transcutaneous electrical nerve stimulation-TENS ; Treatment Outcome ; Upper Extremity</subject><ispartof>PloS one, 2023-05, Vol.18 (5), p.e0283321-e0283321</ispartof><rights>Copyright: © 2023 Senarath et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Senarath et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Senarath et al 2023 Senarath et al</rights><rights>2023 Senarath et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c693t-654cee536a6691b38e651d241ff0ce9a5d7f9ecf25dbc4828e35cc911c7d026a3</citedby><cites>FETCH-LOGICAL-c693t-654cee536a6691b38e651d241ff0ce9a5d7f9ecf25dbc4828e35cc911c7d026a3</cites><orcidid>0000-0002-0481-7777</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218748/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218748/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37235581$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Pinzon, Rizaldy Taslim</contributor><creatorcontrib>Senarath, Iresha Dilhari</creatorcontrib><creatorcontrib>Thalwathte, Randika Dinesh</creatorcontrib><creatorcontrib>Pathirage, Manoji</creatorcontrib><creatorcontrib>Kularatne, Senanayake A M</creatorcontrib><title>The effectiveness of radial extracorporeal shock wave therapy vs transcutaneous electrical nerve stimulation in the management of upper limb spasticity in chronic-post stroke hemiplegia-A randomized controlled trial</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Traditionally both rESWT and TENS are used in treating post-stroke upper limb spasticity over years and their effectiveness had been assessed disjointedly. However, these methods were not yet compared for superiority.
To compare rESWT vs TENS to assess their effectiveness in different parameters of stroke such as stroke type, gender, and the affected side.
The experimental group was treated with rESWT application to the middle of the muscle belly of Teres major, Brachialis, Flexor carpi ulnaris, and Flexor digitorum profundus muscles using 1500 shots per muscle, frequency of 5Hz, energy of 0.030 mJ/mm. The TENS was applied to the same muscles in the control group using 100 Hz for 15 minutes. Assessments were taken at the baseline (T0), immediately after first application (T1), and at the end of four-week protocol (T2).
Patients 106 with a mean age of 63.87±7.052 years were equally divided into rESWT (53) and TENS (53) groups including 62 males, 44 females, 74 ischemic, 32 hemorrhagic, affecting 68 right, and 38 left. Statistical analysis has revealed significant differences at T1 and T2 in both groups. But at T2 compared to T0; the rESWT group has reduced spasticity 4.8 times (95% CI 1.956 to 2.195) while TENS reduced by 2.6 times (95% CI 1.351 to 1.668), improved voluntary control by 3.9 times (95% CI 2.314 to 2.667) and it was 3.2 times (95% CI 1.829 to 2.171) in TENS group. Improvement of the hand functions of the rESWT group was 3.8 times in FMA-UL (95% CI 19.549 to 22.602) and 5.5 times in ARAT (95% CI 22.453 to 24.792) while thrice (95% CI 14.587 to 17.488) and 4.1 times (95% CI 16.019 to 18.283) in TENS group respectively.
The rESWT modality is superior compared to the TENS modality for treating chronic post-stroke spastic upper limb.</description><subject>Aged</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Causes of</subject><subject>Clinical trials</subject><subject>Comparative analysis</subject><subject>Consent</subject><subject>Data collection</subject><subject>Effectiveness</subject><subject>Extracorporeal Shockwave Therapy</subject><subject>Female</subject><subject>Hemiplegia</subject><subject>Hemiplegia - etiology</subject><subject>Hemiplegia - therapy</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Lithotripsy</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Muscle Spasticity - etiology</subject><subject>Muscle Spasticity - therapy</subject><subject>Muscles</subject><subject>Paralysis</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Prevention</subject><subject>Risk factors</subject><subject>Shock waves</subject><subject>Spasticity</subject><subject>Statistical analysis</subject><subject>Stroke</subject><subject>Stroke (Disease)</subject><subject>Stroke - complications</subject><subject>Stroke - therapy</subject><subject>Transcutaneous Electric Nerve Stimulation - methods</subject><subject>Transcutaneous electrical nerve stimulation</subject><subject>Transcutaneous electrical nerve stimulation-TENS</subject><subject>Treatment Outcome</subject><subject>Upper Extremity</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9tu1DAQhiMEoqXwBggsISG42MWHHK_QquJQqVIlKNxajjPZuHXsYCcL5UV5HSbdbdVFvUC5iON884_H_0ySPGd0yUTB3l34KThll4N3sKS8FIKzB8khqwRf5JyKh3fWB8mTGC8ozUSZ54-TA1FwkWUlO0z-nHdAoG1Bj2YDDmIkviVBNUZZAr_GoLQPgw-An7Hz-pL8VBsgYwdBDVdkEwkiLuppVA78FAlYlApGI-8gIBpH009WjcY7YtwcSXrl1Bp6cOOcbBoGCMSaviZxUIhrM17NqO6Cd0YvBh9HlAn-EkgHvRksrI1arPCYrvG9-Q0N0d4hYC0uMbuyT5NHrbIRnu3eR8m3jx_Ojz8vTs8-nRyvThc6r8S4yLNUA2QiV3lesVqUkGes4SlrW6qhUllTtBXolmdNrdOSlyAyrSvGdNFQnitxlLzc6g7WR7nzJEpesipPWcoYEidbovHqQg7B9CpcSa-MvN7wYS1VwKItSFpmRSXaiuapThWtqyJt65TWmnNaNmmJWu932aa6h0bjDQZl90T3_zjTybXfSEY5K4trhTc7heB_TBBH2ZuowdqtfXhwTikXVVog-uof9P7ydtRaYQXGtX7umVlUroqMlkywTCC1vIfCp0E_0TtoDe7vBbzdC5j9xXZcqylGefL1y_-zZ9_32dd32A7beuyit9PcnnEfTLegDj7GAO3tLTMq5wG8uQ05D6DcDSCGvbjr0G3QzcSJv5MLMWc</recordid><startdate>20230526</startdate><enddate>20230526</enddate><creator>Senarath, Iresha Dilhari</creator><creator>Thalwathte, Randika Dinesh</creator><creator>Pathirage, Manoji</creator><creator>Kularatne, Senanayake A M</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0481-7777</orcidid></search><sort><creationdate>20230526</creationdate><title>The effectiveness of radial extracorporeal shock wave therapy vs transcutaneous electrical nerve stimulation in the management of upper limb spasticity in chronic-post stroke hemiplegia-A randomized controlled trial</title><author>Senarath, Iresha Dilhari ; Thalwathte, Randika Dinesh ; Pathirage, Manoji ; Kularatne, Senanayake A M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c693t-654cee536a6691b38e651d241ff0ce9a5d7f9ecf25dbc4828e35cc911c7d026a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aged</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Causes of</topic><topic>Clinical trials</topic><topic>Comparative analysis</topic><topic>Consent</topic><topic>Data collection</topic><topic>Effectiveness</topic><topic>Extracorporeal Shockwave Therapy</topic><topic>Female</topic><topic>Hemiplegia</topic><topic>Hemiplegia - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Senarath, Iresha Dilhari</au><au>Thalwathte, Randika Dinesh</au><au>Pathirage, Manoji</au><au>Kularatne, Senanayake A M</au><au>Pinzon, Rizaldy Taslim</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effectiveness of radial extracorporeal shock wave therapy vs transcutaneous electrical nerve stimulation in the management of upper limb spasticity in chronic-post stroke hemiplegia-A randomized controlled trial</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-05-26</date><risdate>2023</risdate><volume>18</volume><issue>5</issue><spage>e0283321</spage><epage>e0283321</epage><pages>e0283321-e0283321</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Traditionally both rESWT and TENS are used in treating post-stroke upper limb spasticity over years and their effectiveness had been assessed disjointedly. However, these methods were not yet compared for superiority.
To compare rESWT vs TENS to assess their effectiveness in different parameters of stroke such as stroke type, gender, and the affected side.
The experimental group was treated with rESWT application to the middle of the muscle belly of Teres major, Brachialis, Flexor carpi ulnaris, and Flexor digitorum profundus muscles using 1500 shots per muscle, frequency of 5Hz, energy of 0.030 mJ/mm. The TENS was applied to the same muscles in the control group using 100 Hz for 15 minutes. Assessments were taken at the baseline (T0), immediately after first application (T1), and at the end of four-week protocol (T2).
Patients 106 with a mean age of 63.87±7.052 years were equally divided into rESWT (53) and TENS (53) groups including 62 males, 44 females, 74 ischemic, 32 hemorrhagic, affecting 68 right, and 38 left. Statistical analysis has revealed significant differences at T1 and T2 in both groups. But at T2 compared to T0; the rESWT group has reduced spasticity 4.8 times (95% CI 1.956 to 2.195) while TENS reduced by 2.6 times (95% CI 1.351 to 1.668), improved voluntary control by 3.9 times (95% CI 2.314 to 2.667) and it was 3.2 times (95% CI 1.829 to 2.171) in TENS group. Improvement of the hand functions of the rESWT group was 3.8 times in FMA-UL (95% CI 19.549 to 22.602) and 5.5 times in ARAT (95% CI 22.453 to 24.792) while thrice (95% CI 14.587 to 17.488) and 4.1 times (95% CI 16.019 to 18.283) in TENS group respectively.
The rESWT modality is superior compared to the TENS modality for treating chronic post-stroke spastic upper limb.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>37235581</pmid><doi>10.1371/journal.pone.0283321</doi><tpages>e0283321</tpages><orcidid>https://orcid.org/0000-0002-0481-7777</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2023-05, Vol.18 (5), p.e0283321-e0283321 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2819641411 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Aged Analysis Biology and Life Sciences Care and treatment Causes of Clinical trials Comparative analysis Consent Data collection Effectiveness Extracorporeal Shockwave Therapy Female Hemiplegia Hemiplegia - etiology Hemiplegia - therapy Hemorrhage Humans Ischemia Lithotripsy Male Medicine and Health Sciences Middle Aged Muscle Spasticity - etiology Muscle Spasticity - therapy Muscles Paralysis Patient outcomes Patients Prevention Risk factors Shock waves Spasticity Statistical analysis Stroke Stroke (Disease) Stroke - complications Stroke - therapy Transcutaneous Electric Nerve Stimulation - methods Transcutaneous electrical nerve stimulation Transcutaneous electrical nerve stimulation-TENS Treatment Outcome Upper Extremity |
| title | The effectiveness of radial extracorporeal shock wave therapy vs transcutaneous electrical nerve stimulation in the management of upper limb spasticity in chronic-post stroke hemiplegia-A randomized controlled trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-31T11%3A48%3A52IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20effectiveness%20of%20radial%20extracorporeal%20shock%20wave%20therapy%20vs%20transcutaneous%20electrical%20nerve%20stimulation%20in%20the%20management%20of%20upper%20limb%20spasticity%20in%20chronic-post%20stroke%20hemiplegia-A%20randomized%20controlled%20trial&rft.jtitle=PloS%20one&rft.au=Senarath,%20Iresha%20Dilhari&rft.date=2023-05-26&rft.volume=18&rft.issue=5&rft.spage=e0283321&rft.epage=e0283321&rft.pages=e0283321-e0283321&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0283321&rft_dat=%3Cgale_plos_%3EA750813153%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2819641411&rft_id=info:pmid/37235581&rft_galeid=A750813153&rft_doaj_id=oai_doaj_org_article_085793f9064c4a0b974fb40bc2208d48&rfr_iscdi=true |