Background. Muscle spasticity causes disability in children with cerebral palsy. Extracorporeal shockwave therapy has proved to be effective in managing hypertonic muscles. Shear wave elastography can objectively assess tissue elasticity properties. The aim of the present study was to 1) evaluate the effectiveness of defocused extracorporeal shockwaves in reducing soleus muscle contracture in a group of children with cerebral palsy by using point shear wave elastography, and 2) analyse the correlation between the Modified Ashworth Scale and ultrasound elasticity index. Methods. Children with spastic cerebral palsy (n = 21) were administered extracorporeal shockwave therapy (5 sessions at weekly interval, 500 defocused shockwaves per session, 0.25 mJ/mm2, 3 Hz). The effects were measured by means of point shear wave elastography 1, 3, and 6 months after therapy. Results. Linear mixed effects modelling showed significant reduction of muscle stiffness, with the predicted greatest effect at the 13th week after completion of treatment. Analysis of covariance confirmed the correlation between the Modified Ashworth Scale and ultrasound elasticity index. Conclusions. Point shear wave elastography confirmed the effectiveness of defocused extracorporeal shockwaves in reducing muscles contracture in children with cerebral palsy. We recommend the use of this technique for the clinical assessment of spastic patients.
Usefulness of point shear wave elastography to assess the effects of extracorporeal shockwaves on spastic muscles in children with cerebral palsy: An uncontrolled experimental study
Vallone G.;
2019-01-01
Abstract
Background. Muscle spasticity causes disability in children with cerebral palsy. Extracorporeal shockwave therapy has proved to be effective in managing hypertonic muscles. Shear wave elastography can objectively assess tissue elasticity properties. The aim of the present study was to 1) evaluate the effectiveness of defocused extracorporeal shockwaves in reducing soleus muscle contracture in a group of children with cerebral palsy by using point shear wave elastography, and 2) analyse the correlation between the Modified Ashworth Scale and ultrasound elasticity index. Methods. Children with spastic cerebral palsy (n = 21) were administered extracorporeal shockwave therapy (5 sessions at weekly interval, 500 defocused shockwaves per session, 0.25 mJ/mm2, 3 Hz). The effects were measured by means of point shear wave elastography 1, 3, and 6 months after therapy. Results. Linear mixed effects modelling showed significant reduction of muscle stiffness, with the predicted greatest effect at the 13th week after completion of treatment. Analysis of covariance confirmed the correlation between the Modified Ashworth Scale and ultrasound elasticity index. Conclusions. Point shear wave elastography confirmed the effectiveness of defocused extracorporeal shockwaves in reducing muscles contracture in children with cerebral palsy. We recommend the use of this technique for the clinical assessment of spastic patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
