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Pain and Muscles Properties Modifications After Botulinum Toxin Type A (BTX-A) and Radial Extracorporeal Shock Wave (rESWT) Combined Treatment.
Endocr Metab Immune Disord Drug Targets. 2019; 19(8):1127-1133.EM

Abstract

BACKGROUND AND OBJECTIVE

Spasticity (most common disability in upper motor neuron syndrome or UMNS) caused an inability of patients' to perform daily activities and a decrease inquality of life. One of the promising methods nowadays, but still not widely used in everyday practice, for spasticity reduction is extracorporeal shock wave. The aim of this study was to evaluate the objective clinical effects of combined treatment botulinum toxin type A and radial Extracorporeal Shock Wave Therapy in spasticity post stroke.

METHODS

We considered 30 subjects (14 female and 16 male) with post stroke spasticity of Biceps Brachii, Superficial Flexor Digitorum, Gastrocnemius Medialis and Lateralis and we divided patients into two groups (group A received botulinum toxin injection and physiotherapy while group B received botulinum toxin injection, rESWT and physiotherapy). Assessments were performed before treatment (t0), after 1 (t1), 2 (t2) e 3 (t3) months using Modified Ahworth Scale, Visual Analogical Scale for pain and MyotonPro® device (to assessed myometric evaluation of muscles tone and stiffness).

RESULTS

Visual Analogical Scale, Modified Ahworth Scale, muscles tone and stiffness statistically decreased until t3 in the group A and in the group B, but the differences between the two groups were significant at the t1 only.

CONCLUSION

Radial Extracorporeal Shock Wave Therapy could be an effective physical treatment aimed at the reduction of upper and lower limbs spasticity and could lead to the improvement of trophic conditions of the spastic muscles in post-stroke.

Authors+Show Affiliations

Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

30843498

Citation

Megna, Marisa, et al. "Pain and Muscles Properties Modifications After Botulinum Toxin Type a (BTX-A) and Radial Extracorporeal Shock Wave (rESWT) Combined Treatment." Endocrine, Metabolic & Immune Disorders Drug Targets, vol. 19, no. 8, 2019, pp. 1127-1133.
Megna M, Marvulli R, Farì G, et al. Pain and Muscles Properties Modifications After Botulinum Toxin Type A (BTX-A) and Radial Extracorporeal Shock Wave (rESWT) Combined Treatment. Endocr Metab Immune Disord Drug Targets. 2019;19(8):1127-1133.
Megna, M., Marvulli, R., Farì, G., Gallo, G., Dicuonzo, F., Fiore, P., & Ianieri, G. (2019). Pain and Muscles Properties Modifications After Botulinum Toxin Type A (BTX-A) and Radial Extracorporeal Shock Wave (rESWT) Combined Treatment. Endocrine, Metabolic & Immune Disorders Drug Targets, 19(8), 1127-1133. https://doi.org/10.2174/1871530319666190306101322
Megna M, et al. Pain and Muscles Properties Modifications After Botulinum Toxin Type a (BTX-A) and Radial Extracorporeal Shock Wave (rESWT) Combined Treatment. Endocr Metab Immune Disord Drug Targets. 2019;19(8):1127-1133. PubMed PMID: 30843498.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pain and Muscles Properties Modifications After Botulinum Toxin Type A (BTX-A) and Radial Extracorporeal Shock Wave (rESWT) Combined Treatment. AU - Megna,Marisa, AU - Marvulli,Riccardo, AU - Farì,Giacomo, AU - Gallo,Giulia, AU - Dicuonzo,Franca, AU - Fiore,Pietro, AU - Ianieri,Giancarlo, PY - 2018/10/26/received PY - 2019/02/13/revised PY - 2019/02/25/accepted PY - 2019/3/8/pubmed PY - 2020/4/21/medline PY - 2019/3/8/entrez KW - Botulinumtoxin type A KW - myometric examination KW - pain KW - physiotherapy KW - radial extracorporeal shock waves therapy KW - spasticity. SP - 1127 EP - 1133 JF - Endocrine, metabolic & immune disorders drug targets JO - Endocr Metab Immune Disord Drug Targets VL - 19 IS - 8 N2 - BACKGROUND AND OBJECTIVE: Spasticity (most common disability in upper motor neuron syndrome or UMNS) caused an inability of patients' to perform daily activities and a decrease inquality of life. One of the promising methods nowadays, but still not widely used in everyday practice, for spasticity reduction is extracorporeal shock wave. The aim of this study was to evaluate the objective clinical effects of combined treatment botulinum toxin type A and radial Extracorporeal Shock Wave Therapy in spasticity post stroke. METHODS: We considered 30 subjects (14 female and 16 male) with post stroke spasticity of Biceps Brachii, Superficial Flexor Digitorum, Gastrocnemius Medialis and Lateralis and we divided patients into two groups (group A received botulinum toxin injection and physiotherapy while group B received botulinum toxin injection, rESWT and physiotherapy). Assessments were performed before treatment (t0), after 1 (t1), 2 (t2) e 3 (t3) months using Modified Ahworth Scale, Visual Analogical Scale for pain and MyotonPro® device (to assessed myometric evaluation of muscles tone and stiffness). RESULTS: Visual Analogical Scale, Modified Ahworth Scale, muscles tone and stiffness statistically decreased until t3 in the group A and in the group B, but the differences between the two groups were significant at the t1 only. CONCLUSION: Radial Extracorporeal Shock Wave Therapy could be an effective physical treatment aimed at the reduction of upper and lower limbs spasticity and could lead to the improvement of trophic conditions of the spastic muscles in post-stroke. SN - 2212-3873 UR - https://www.unboundmedicine.com/medline/citation/30843498/Pain_and_Muscles_Properties_Modifications_After_Botulinum_Toxin_Type_A__BTX_A__and_Radial_Extracorporeal_Shock_Wave__rESWT__Combined_Treatment_ L2 - http://www.eurekaselect.com/170457/article DB - PRIME DP - Unbound Medicine ER -