Radial extracorporeal shock wave therapy for severe spasticity in patients with severe mental and physical disabilities

Patients with severe motor and intellectual disability (SMID) experience persistent spastic pain and severe malpositioning of the limbs, exacerbated by the lack of effective treatment for severe spasticity. This study aimed to evaluate the efficacy and safety of radial extracorporeal shock wave therapy (rESWT) for spasticity in these patients. rESWT was applied to the biceps brachii at the elbow joint with flexion pattern spasticity of Modified Ashworth Scale (MAS) grade 1 + or greater. The MAS score and elbow joint range of motion (EROM) were monitored for up to 10 weeks. Electromyography signals at rest were recorded on eight elbow joints. Adverse events were also recorded. Following a single rESWT session, the spasticity of the elbow joint immediately decreased, MAS score significantly decreased by 1.0° ± 0.1, and EROM significantly increased by 9.1° ± 2.5°. Muscle activity decreased by an average of 32 ± 5%. rESWT resulted in an immediate and clear improvement in the MAS score for approximately 8 weeks and in the EROM continuing even at 10 weeks. Our findings highlight rESWT as a non-invasive therapy for spasticity in patients with SMID.