EFFECTS OF RADIAL EXTRACORPOREAL SHOCK WAVE THERAPY ON POST-STROKE HAND SPASTICITY
Cvetanka Gjerakaroska Savevska1, Erieta Nikolikj Dimitrova1, Biljana Mitrevska1, Marija Gocevska1, Valentina Koevska1, Biljana Kalcovska Ivanovska1, Maja Manoleva1
1Institute for Physical and Rehabilitation Medicine, Medical Faculty, “Ss Ciryl and Methodius” University, Skopje, Macedonia  

Introduction: Hand spasticity after stroke greatly increases the difficulties of daily living activities and limit the effectiveness of rehabilitation. Radial extracorporeal shock wave therapy(RESWT) has been suggested as alternative treatment in spasticity reduction. 
Purpose: To evaluate the effectiveness of RESWT on hand spasticity in stroke patients. 
Method: This was an open, controlled, prospecitive study in which 24 eligible patients with spastic hand post stroke were assigned to two groups. RESWT group received RESWT(6 treatments in total at a time distance of two to three days) at the start of the rehabilitation along with classic rehabilitation program. The control group received only classic rehabilitation program. Clinical evaluations were performed using the Modified Ashworth Scale (MAS), passive dorsal flexion in the wrist and the subscore for motor recovery of the Fugl–Meyer assessment for the upper extremity at baseline, immediately after the second, 6th and 14th week from the start of the rehabilitation for both groups. Results: Mean MAS score was significantly decreased, whereas mean wrist passive dorsal flexion was significantly increased, in RESWT group after the RESWT. These results lasted 12 weeks after the treatment. There were no changes in the subscore for motor recovery of the Fugl–Meyer assessment before and after the RESWT in the RESWT group. There was no significant difference between the groups in the individual comparison of the clinical parametars in the four measurement time points. Conclusion: Although there was no statistically significant difference in the measured parameters between the groups, RESWT reduced the hand spasticity and increased the passive range of motion in the wrist. Thus, studies with a larger sample of patients are warranted in order to verify the positive effect of RESWT on spasticity.