title: Effect of radial shock wave therapy on pain and muscle hypertonia: a double-blind study in patients with multiple sclerosis.
abstract: BACKGROUND
  Radial shock wave therapy (RSWT) has been extensively used in rehabilitative medicine to treat pain, and more recently muscle hypertonia, in patients with cerebral palsy and stroke.
  
  
  OBJECTIVE
  To assess the long-term effects of RSWT in a cohort of subjects affected by multiple sclerosis (MS) who were suffering from painful hypertonia of ankle extensor muscles.
  
  
  METHODS
  In this randomised, double blind, placebo-controlled study, we treated 34 patients with four sessions of RSWT (once weekly) and treated 34 patients with placebo. Participants were assessed at baseline, 1 week after the first session, and 1 week and 4 weeks after the last session. We measured pain using the visual analogue scale for pain, while we assessed muscle tone using the modified Ashworth scale and evaluated spinal excitability using the H-reflex.
  
  
  RESULTS
  After RSWT, muscle tone decreased 1 week after the last session and pain decreased at all the follow-up evaluations, while spinal excitability was unaffected. No significant changes were found after the placebo treatment.
  
  
  CONCLUSIONS
  RSWT can reduce pain and muscle tone in MS patients without adverse effects. The lack of RSWT effects on spinal excitability supports the idea that RSWT is likely to act on non-reflex hypertonia, for example reducing muscle fibrosis.
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genova; Italy lucio.marinelli@unige.it.
authors.forename: L
authors.initials: L
authors.lastname: Marinelli
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genova; Italy.
authors.forename: L
authors.initials: L
authors.lastname: Mori
authors.affiliation: Department of Head and Neck, PA Micone Hospital, Genova, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Solaro
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genova; Italy.
authors.forename: A
authors.initials: A
authors.lastname: Uccelli
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genova; Italy.
authors.forename: E
authors.initials: E
authors.lastname: Pelosin
authors.affiliation: Department of Medical-Surgical Sciences and Biotechnologies, A Fiorini Hospital, Terracina, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Currà
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genova; Italy.
authors.forename: L
authors.initials: L
authors.lastname: Molfetta
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genova; Italy.
authors.forename: G
authors.initials: G
authors.lastname: Abbruzzese
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genova; Italy.
authors.forename: C
authors.initials: C
authors.lastname: Trompetto
mesh_terms: D000328:Adult; D000368:Aged; D000842:Ankle; D015331:Cohort Studies; D004311:Double-Blind Method; D004576:Electromyography; D004597:Electroshock; D005260:Female; D006181:H-Reflex; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000628:therapy*; D009122:Muscle Hypertonia / Q000209:etiology / Q000628:therapy*; D010146:Pain / Q000209:etiology; D059408:Pain Management / Q000379:methods*; D016896:Treatment Outcome
keywords: Ankle; H-reflex; ankle muscle strength; hypertonia; multiple sclerosis; muscle hypertonia; muscle tone; pain; radial shock wave therapy; rehabilitation; spasticity; spinal excitability; upper motor neuron syndrome; walking speed