Shock wave therapy helps some stroke sufferers

NEW YORK — After a stroke, some patients develop muscle spasm in their hand and wrist. A small study now indicates that the condition can be relieved with focused shock wave therapy, and the benefits may persist for at least 12 weeks after treatment.

Shock wave therapy is commonly used to break up kidney stones, and it has also proven useful in the treatment of various bone and tendon diseases, but there’s not much known about its use for abnormal muscle tension, or “hypertonia,” Italian researchers note.

Dr. P. Manganotti and Dr. E. Amelio, from the University of Verona assessed the outcomes of 20 patients with stroke-related hypertonia in the upper limbs who were first treated with sham stimulation and then, 1 week later, with shock wave therapy.

The treatment consisted of pressure pulses from a “lithotripter” device aimed at hypertonic muscles in the forearm and hand. Much lower energies were used than is customary for dealing with kidney stones, so the procedure was painless and patients didn’t need anesthesia.

Compared with placebo stimulation, shock wave treatment was associated with significantly greater improvements in muscle tone of the wrist and fingers, the researchers report in the American Heart Association’s journal Stroke.

After 4 weeks, shock wave therapy was tied to significant reductions in passive muscle tension in all the patients. At 12 weeks, half of the patients still showed a reduction in muscle tone.

None of the patients experienced any adverse effects from shock wave therapy, the report indicates.

The investigators say the results “could open new areas of research in the treatment of hypertonicity.”

SOURCE: Stroke, September 2005.

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