Shockwave Therapy or Acupoint Stimulation Combined With Physiotherapy for Spasticity and Motor Function in Post-Stroke Recovery: A Randomized Controlled Trial.

Authors

Kazi Md Azman Hossain, Meer Hossain Hero, Mahomuda Afroze, Saddam Hossain, Md Adnan Ibne Reza, Tofajjal Hossain, Ahamadullah Hil Galeb, Jannatul Ferdous Rikti, Mahdi Ul Bari, Arnob Datta

Published in

Brain and behavior. Volume 16. Issue 8. Pages e71652.

Abstract

Stroke frequently causes spasticity and motor impairment, reducing independence. Non-invasive treatments like radial extracorporeal shockwave therapy (ESWT) and acupoint-based transcutaneous electrical nerve stimulation (Acu-TENS) show potential, but direct comparisons with physiotherapy are limited.
To investigate the effectiveness of radial ESWT and Acu-TENS, combined with usual physiotherapy treatment (UPT), in spasticity and motor function during post-stroke recovery.
This trial included 120 participants, randomly allocated to three groups (n = 40 each): ESWT+UPT, Acu-TENS+UPT, or UPT alone. Interventions were administered three times weekly for 6 weeks. Primary outcomes included spasticity (Modified Ashworth Scale, MAS), spasticity control (Modified Tardieu Scale, MTS), and motor function (Fugl-Meyer Assessment, FMA). Secondary outcomes were stroke-specific quality of life (SS-QOL) and functional mobility (10-Meter Walk Test, 10MWT). Assessments were conducted at baseline, post-intervention (6 weeks), and follow-up (18 weeks).
Significant time and group effects were observed across all outcomes (p < 0.001). For MAS, ESWT and Acu-TENS showed non-significant differences in U/L (6 weeks: MD = -0.175, p = 0.620; 18 weeks: MD = -0.125, p = 1.000) and L/L (6 weeks: MD = -0.075, p = 1.000; 18 weeks: MD = -0.025, p = 1.000). MTS was significantly superior with ESWT in U/L at 6 weeks (MD = 1.584, p = 0.010) and 18 weeks (MD = 1.419, p = 0.022), whereas L/L differences were slightly greater but non-significant (6 weeks: MD = 1.500, p = 0.122; 18 weeks: MD = 1.500, p = 0.080). FMA was comparable at 6 weeks (U/L: MD = 2.461, p = 0.087; L/L: MD = 0.896, p = 0.958), with ESWT showing significant superiority in U/L at 18 weeks (MD = 3.611, p = 0.010). For SS-QOL and 10MWT, differences were non-significant at 6 weeks (SS-QOL: MD = 4.270, p = 0.714; 10MWT: MD = -1.561, p = 0.115) but slightly greater or superior with ESWT at 18 weeks (SS-QOL: MD = 4.605, p = 0.209; 10MWT: MD = -1.815, p = 0.020).
Both ESWT and Acu-TENS with physiotherapy reduced spasticity and improved motor function, mobility, and SS-QOL in post-stroke patients. ESWT showed slightly greater gains, but differences were mostly not significant, indicating both are useful additions to physiotherapy.
CTRI/2025/05/087383.

PMID:
42603267
Bibliographic data and abstract were imported from PubMed on 16 Aug 2026.

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