Radial shock wave therapy: effect on pain and motor performance in a paralympic athlete

BACKGROUND: Recent studies demonstrated the usefulness of radial shock waves therapy (RSWT) in treating hypertonia in patients affected by cerebral palsy (CP), stroke, and dystonia. RSWT have never been used to treat spasticity in disabled athletes. CASE REPORT: An athlete affected by tetraparesis due to CP underwent three RSWT sessions in a week. We assessed muscular tone using the Modified Ashworth Scale (MAS), pain and fatigue experienced during athletic performance with Visual Analogic Scale (VAS) and Borg scale Category-Ratio anchored at number 10 (Borg CR10). We also performed an electrophysiological study recording the stretch reflex on the quadriceps femori muscle and assessing the soleus H-reflex to calculate post-activation depression (PAD). After 3 RSWT sessions, we found a reduction in all clinical parameters. Although MAS was unchanged, stretch reflex was significantly reduced and PAD increased, suggesting a role in contrasting non-reflex components of hypertonia. CLINICAL REHABILITATION IMPACT: The use of RSWT may improve the disabled athletes' performance.