Discussion
spasticity, shock, stroke, hemorrhagic, chronic post-stroke hemiplegia
STROKE, STILL, SHOCK
This current study is the first of its kind to compare the effectiveness of radial extracorporeal shock wave therapy (rESWT) and transcutaneous electrical nerve stimulation (TENS) in treating the upper limb spasticity of patients with chronic post-stroke hemiplegia that analyzed the effectiveness among the stroke type, gender and affected side. The rESWT group has shown superior effects on spasticity reduction, voluntary control and hand functions over the TENS group, and hemorrhagic patients have better results compared to ischemic patients. No significant differences were identified according to gender and affected side.Both groups have shown immediate after-effects at the end of the modality’s first application in spasticity reduction and improving voluntary control of the upper limb but the rESWT group has shown larger improvement compared with TENS. Statistical analysis has shown that the mean differences in T0 & T1 pair in both the groups are significant (Hand functions were improved in both the groups immediately after the first application of the modality, with statistical significance of the mean difference in FMA-UL and ARAT scales. But, comparatively, a higher percentage of mean difference was identified in the rESWT group than the TENS group. It was further clarified that a single application of both the rESWT and TENS modalities acted on improving the upper limb’s motricity. Leng et al. (2021) [At the end of the four-week treatment session (T2), both groups were presented with decreased spasticity grades, increased voluntary control grades, and improved hand function scores compared to the baseline and the first application. Still, the rESWT group has shown a significant difference from the TENS group. Previous studies have shown similar results at the end of their treatment period supporting the current findings; spasticity reduction and improvement in voluntary control grading and hand functions at the end of the four-week treatment protocol. The rESWT studies; two systematic reviews conducted by Poursaeed et al. (2021) [