Background: The tightness of ankle muscles is one of the main factors hindering in daily activities in stroke patients. Previous studies showed that extracorporeal shock wave therapy (ESWT) may decrease muscle tightness by direct action on muscle and indirect action on intramuscular connective tissue. There are few studies about this subject. The purpose of present study is to compare the effect of ESWT with that of conventional stretching exercise in ankle muscle tightness after stroke.
Methods: We enrolled hemiplegic stroke patients who had posterior ankle tightness with weak dorsiflexion, and who could ambulate with or without assist device. Subjects were randomly divided into two groups, ESWT group (EG) and conventional group (CG). In the EG, ESWT was performed for three weeks (two sessions per week). In each session, a practitioner applied 1500 shocks on affected calf muscle in prone position at energy level of 0.2mJ/mm2. Both group received stretching exercise twice a day, five days a week, for 3 weeks. In each session, 5 sets of stretching exercise for one minute with 10 seconds break. Before and after intervention, maximal passive range of motion in ankle, 6-minute walk test, functional ambulatory category (FAC) and Korean version of modified barthel index (K-MBI) were investigated to examine the functional status.
Results: Both groups had eight patients who completed the 3-week intervention. No differences were identified in any of the demographics between two groups (Table 1). After the 3-week intervention, improvement was found in all of the measurements in both groups (Table 2). There were no significant differences in change of any measurements between the two groups
(Table 3). There were no complications in either group during the study.
Conclusion: After the 3-week therapy, improvement was found in all measurement items in both groups. ESWT showed no superiority to conventional stretching exercise. We studied special group called a stroke patient. So the negative effect of hemiplegic might affect more than positive effect of ESWT. Future studies with larger number of participants should be necessary.
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