Very Low and Low-energetic Extracorporeal Shock Wave Treatment of Spasticity in Children and Adults – A Systematic Review
Systematic Review | Volume 2 | Issue 1 | JRS Jan – Jun 2022 | Page 03-08 | Karsten Knobloch, Henning Lohse-Busch, Andreas Gohritz, Tomas Nedelka
Author: Karsten Knobloch , Henning Lohse-Busch , Andreas Gohritz , Tomas Nedelk [4,5]
 Department of Sports Medicine, SportPraxis Prof. Knobloch, Hannover, Germany.
 Zentrum für Bewegungsstörungen, Rheintalklinik Bad Krozingen, Germany.
 Department of Neurology, Universitätsspital Basel, Plastische, Rekonstruktive und Ästhetische Chirurgie, Handchirurgie, Suisse.
 Department of Neurology, Charles University in Prague, 2nd Faculty of Medicine, Prague, Czech Republic.
 Department of Neurology, Czech Technical University, Faculty of Biomedical Engineering, Kladno, Czech Republic.
Address of Correspondence
Prof. Dr. Karsten Knobloch,
SportPraxis Prof. Knobloch, Heiligerstr. 3, D-30159 Hannover, Germany.
Introduction: This systemic review aims to assess the modes and treatment parameters of radial and focused extracorporeal shockwave therapy (ESWT) in spasticity based on the technologies and energy levels involved.
Materials and Methods: 1086 patients from 31 randomized-controlled trials (RCT) or cohort studies are included. 300 children were studied in seven studies (3 RCTs) with two radial and four focused electromagnetic ESWT devices and 14 studies with 443 patients using focused ESWT (electrohydraulic 46 patients, electromagnetic 367 patients, and piezoelectric 30 patients).
Results: In electromagnetic focused ESWT 8 RCTs (n = 323 patients) and three cohort studies (n = 44) used either very low-energetic (0.03–0.05 mJ/mm2) with 1500–2000 shots and 4–5 Hz with 3–5 focused sessions, or low-energetic 0.07–0.12 mJ/mm2 with 1500–2000 shots with 4–5 Hz and 1–3 sessions. The 64 children in the five electromagnetic focused trials were treated with very low-energetic 0.03 mJ/mm2, 1500 shots, and three sessions. 17 studies (n = 687) were using radial technologies with 7 RCTs (n = 349) and ten cohort studies (n = 338). Among the 17 trials, four studies (1 RCT, 3 cohort studies) included 236 children treated with either very low-energetic 0.6–1 bar (two trials) or low-energetic 1.5–3 bar with 5–10 Hz. Energy-wise three radial studies were very low-energetic 0.6–1 bar and 14 studies applied low-energetic radial pressures 1.5–3 bar. Notably, the frequency was mainly 4–8 Hz in the radial studies.
Conclusion: Both, radial and focused very low- to low-energetic ESWT improve function and reduce spasticity significantly. Adverse effects were not noted with the applied very low- to low-energetic device parameters neither among children nor in adults.
Keywords: Spasticity, Extracorporeal shock wave therapy, Extracorporeal shockwave therapy, Children.
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|How to Cite this article: Knobloch K, Lohse-Busch H, Gohritz A, Nedelka T | Very Low and Low-energetic Extracorporeal Shock Wave Treatment of Spasticity in Children and Adults–A Systematic Review. | Journal of Regenerative Science | Jan – Jun 2022; 2(1): 03-08.|