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

Objective: Recently, extracorporeal shock wave therapy (ESWT) has emerged as a novel and noninvasive approach for alleviating spasticity and pain, improving motor dysfunction after stroke. To determine the effectiveness of ESWT and the effects of shock wave parameters in relieving spasticity, pain, and motor dysfunction following stroke.

Design: We conducted a systematic search of PubMed, EBSCOhost, Embase, Cochrane Library, and Web of Science databases for randomized controlled trials on ESWT 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.

Results: This review included nine articles and 327 patients. ESWT improved the spasticity, pain, and motor function following 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.

Conclusion: The treatment outcomes are optimal when a shock wave frequency < 8 Hz, pressure < 2 bar, and released extracorporeal shock waves are used.