title: A single blind, clinical trial to investigate the effects of a single session extracorporeal shock wave therapy on wrist flexor spasticity after stroke.
abstract: BACKGROUND
  Spasticity is a common, serious symptom after stroke. Extracorporeal shock wave therapy (ESWT) has been suggested for the treatment of muscle spasticity.
  
  
  OBJECTIVE
  To investigate the effects of ESWT on post stroke wrist flexor spasticity.
  
  
  METHODS
  Fifteen patients with poststroke wrist flexor spasticity (12 male and 3 female with a mean age of 54 years) were enrolled. Patients received 1 sham ESWT followed by 1 active ESWT 1 week later. The outcome measures were the Modified Modified Ashworth Scale (MMAS), the Hmax/Mmax ratio, and the Brunnstrom motor recovery stage.
  
  
  RESULTS
  The sham ESWT had not effects on the outcome measures. After active ESW, the MMAS scores of spasticity and the Hmax/Mmax ratio improved. The improvements were maintained 5 weeks after active ESWT. No significant improvements were observed for the motor recovery after sham or active ESWT.
  
  
  CONCLUSIONS
  In adult patients after stroke, a single session of active ESWT resulted in significant improvement in the wrist flexor spasticity and alpha motor neuron excitability.
authors.affiliation: Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyedeh Somayeh
authors.initials: SS
authors.lastname: Daliri
authors.affiliation: Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Bijan
authors.initials: B
authors.lastname: Forogh
authors.affiliation: Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyedeh Zahra
authors.initials: SZ
authors.lastname: Emami Razavi
authors.affiliation: Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Tannaz
authors.initials: T
authors.lastname: Ahadi
authors.affiliation: Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Faezeh
authors.initials: F
authors.lastname: Madjlesi
authors.affiliation: Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Noureddin Nakhostin
authors.initials: NN
authors.lastname: Ansari
mesh_terms: D000328:Adult; D000368:Aged; D004576:Electromyography; D005260:Female; D006181:H-Reflex / Q000502:physiology; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D009128:Muscle Spasticity / Q000209:etiology / Q000628:therapy*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D017063:Outcome Assessment, Health Care; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications / Q000628:therapy*; D014953:Wrist / Q000503:physiopathology*
keywords: H-reflex; Stroke; extracorporeal shock wave therapy; rehabilitation; spasticity; spinal excitability