Effects of Extracorporeal Shockwave Therapy Combined with Neuroplasticity-Based Training Protocol on Lower Limb Spasticity in Stroke Patients: A Randomized Controlled Trial with Ultrasonography Evaluation.

This article focuses on a randomized controlled trial investigating the combined effects of extracorporeal shockwave therapy (ESWT) and a neuroplasticity-based training protocol (NBTP) on lower limb spasticity, muscle architecture, and motor function in stroke patients with post-stroke spasticity (PSS). Fifty-four patients were assigned to receive either ESWT plus NBTP or sham ESWT plus NBTP over 12 weeks, with assessments including the Modified Ashworth Scale (MAS), passive range of motion (PROM), Fugl-Meyer Assessment–Lower Extremity (FMA-LE), and ultrasonographic muscle measurements. Results showed that the combined ESWT and NBTP intervention led to significantly greater reductions in spasticity, improvements in joint mobility, motor recovery, and favorable muscle architectural changes (muscle thickness, fascicle length, and pennation angle) compared to NBTP alone. The study concludes that integrating ESWT with neuroplasticity-based rehabilitation may offer enhanced functional and structural benefits for managing post-stroke spasticity, though further research with larger samples and longer follow-up is recommended.