Stötvågsterapi och dess effekt på spasticitet hos patienter med långvarig stroke: en systematisk litteraturstudie

Sammanfattning: Background: Spasticity is a common symptom post-stroke which causes vast complications regarding important daily functions among patients. This manifests as a resistance in the muscle during a velocity-dependent passive motion and is commonly evaluated by using the Modified Ashworth Scale (MAS). Extra corporeal shock wave therapy (ESWT) is a relatively novel way to treat spasticity, with promising results. Purpose: The aim of the current study was to investigate the scientific evidence of ESWT as treatment regarding spasticity and function among patients with prolonged stroke. Methods: The purpose was tackled by conducting a literature review of randomized controlled trials with MAS as outcome measurement. PubMed was searched for relevant studies followed by a quality assessment through the PEDro Scale. The reliability of the evidence was assessed with the use of GRADEstud.  Results: The quality of the included articles was mainly deemed as good with eight of nine articles receiving a PEDro Score of 6 or higher. This review found generally positive effects from ESWT regarding spasticity with MAS as the outcome measurement. The results regarding function were equivocal. The reliability of the results was graded as very low due to the methodological heterogeneity of the included studies. Conclusion: ESWT showed positive results regarding spasticity and function, although the reliability of the evidence was considered very low. More research is inquired to further explore the potential effects of ESWT on spasticity and function among post-stroke patients. This could potentially increase the reliability of the evidence regarding ESWT as a treatment option.