Effects Of Shockwave Therapy on Reducing the Muscle Tone in A Patient with Multiple Sclerosis: A Case Report
Main Article Content
Keywords
Multiple sclerosis, Muscle tone, Shock wave
Abstract
This case study involved a young patient who was given a multiple sclerosis diagnosis. Briefly, the patient arrived at the clinic complaining of facial tingling and other electricity-related symptoms. After collapsing twice, the patient was sent to the intensive care unit.
Purpose: To evaluate the effects of shockwave on reducing the tone in a patient diagnosed with multiple sclerosis.
Method: Before the intervention, the patient's muscle power was low, and his muscle tone was high. The patient received Ocrelizumab and 30 mg of Baclofen. The patient was also instructed to do strengthening and stretching exercises at home and clinic. The shock wave was used to decrease the tone of the biceps and hamstring muscles. The goal of the treatment was to help the patient walk more safely and with better balance. The patient's symptoms subsided following treatment, and he could walk without incident.
Result: The findings of the case report suggest that extracorporeal shock wave therapy was beneficial in reducing hypertonia among a young male patient diagnosed with multiple sclerosis. However, the patient was also given oral medication. It is not clear whether shock therapy alone improved the symptoms or reduced muscle tone could also be due to oral medications and lifestyle changes such as exercise.
Conclusion: Proportion of reduction in muscle tone attributed to shock wave therapy cannot be estimated and needs to be evaluated further in future studies.
References
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32. Mauch M, Kalin X. Reliability of the Prokin Type B Line System (TechnoBody™) Balance System. Internal Project Report Praxisklinik Rennbahn: Swiss Olympic Medical Center Zürich Switzerland. 2011:1-9.
33. Etoom M, Khraiwesh Y, Lena F, Hawamdeh M, Hawamdeh Z, Centonze D, et al. Effectiveness of physiotherapy interventions on spasticity in people with multiple sclerosis: a systematic review and meta-analysis. American journal of physical medicine & rehabilitation. 2018;97(11):793-807.
34. Chen P-H, Ho C-L, Lee C-H. Extracorporeal shockwave therapy on spasticity after central nervous system injury: A systemic review and meta-analysis. 2023.
35. Troncati F, Paci M, Myftari T, Lombardi B. Extracorporeal shock wave therapy reduces upper limb spasticity and improves motricity in patients with chronic hemiplegia: a case series. NeuroRehabilitation. 2013;33(3):399-405.
36. Vetrano M, d'Alessandro F, Torrisi MR, Ferretti A, Vulpiani MC, Visco V. Extracorporeal shock wave therapy promotes cell proliferation and collagen synthesis of primary cultured human tenocytes. Knee Surg Sports Traumatol Arthrosc. 2011;19(12):2159-68.
37. Notarnicola A, Moretti B. The biological effects of extracorporeal shock wave therapy (eswt) on tendon tissue. Muscles Ligaments Tendons J. 2012;2(1):33-7.
38. Ward M, Goldman MD. Epidemiology and Pathophysiology of Multiple Sclerosis. CONTINUUM: Lifelong Learning in Neurology. 2022;28(4):988-1005.
39. Walton C, King R, Rechtman L, Kaye W, Leray E, Marrie RA, et al. Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS. Multiple Sclerosis Journal. 2020;26(14):1816-21.
2. Orton SM, Herrera BM, Yee IM, Valdar W, Ramagopalan SV, Sadovnick AD, et al. Sex ratio of multiple sclerosis in Canada: a longitudinal study. Lancet Neurol. 2006;5(11):932-6.
3. Browne P, Chandraratna D, Angood C, Tremlett H, Baker C, Taylor BV, et al. Atlas of Multiple Sclerosis 2013: A growing global problem with widespread inequity. Neurology. 2014;83(11):1022-4.
4. Marinelli L, Mori L, Solaro C, Uccelli A, Pelosin E, Currà A, et al. Effect of radial shock wave therapy on pain and muscle hypertonia: a double-blind study in patients with multiple sclerosis. Multiple Sclerosis Journal. 2015;21(5):622-9.
5. Karussis D. The diagnosis of multiple sclerosis and the various related demyelinating
syndromes: a critical review. J Autoimmun. 2014;48-49:134-42.
6. Trapp BD, Peterson J, Ransohoff RM, Rudick R, Mörk S, Bö L. Axonal transection in the lesions of multiple sclerosis. N Engl J Med. 1998;338(5):278-85.
7. Hauser SL, Cree BAC. Treatment of Multiple Sclerosis: A Review. Am J Med. 2020;133(12):1380-90.e2.
8. Greenfield AL, Hauser SL. B-cell Therapy for Multiple Sclerosis: Entering an era. Ann Neurol. 2018;83(1):13-26.
9. Coles AJ, Cox A, Le Page E, Jones J, Trip SA, Deans J, et al. The window of therapeutic opportunity in multiple sclerosis: evidence from monoclonal antibody therapy. J Neurol. 2006;253(1):98-108.
10. Ramagopalan SV, Dobson R, Meier UC, Giovannoni G. Multiple sclerosis: risk factors, prodromes, and potential causal pathways. Lancet Neurol. 2010;9(7):727-39.
11. Kurtzke JF. Epidemiology in multiple sclerosis: a pilgrim's progress. Brain. 2013;136(Pt 9):2904-17.
12. Dobson R, Giovannoni G. Multiple sclerosis – a review. European Journal of Neurology. 2019;26(1):27-40.
13. Hauser SL, Cree BAC. Treatment of Multiple Sclerosis: A Review. The American Journal of Medicine. 2020;133(12):1380-90.e2.
14. Nicholas R, Young C, Friede T. Bladder symptoms in multiple sclerosis: a review of pathophysiology and management. Expert opinion on drug safety. 2010;9(6):905-15.
15. Puce L, Currà A, Marinelli L, Mori L, Capello E, Di Giovanni R, et al. Spasticity, spastic dystonia, and static stretch reflex in hypertonic muscles of patients with multiple sclerosis. Clin Neurophysiol Pract. 2021;6:194-202.
16. Truini A, Barbanti P, Pozzilli C, Cruccu G. A mechanism-based classification of pain in multiple sclerosis. Journal of neurology. 2013;260:351-67.
17. Henze T. Managing specific symptoms in people with multiple sclerosis. Int MS J. 2005;12(2):60-8.
18. Joy JE, Johnston Jr RB. Characteristics and management of major symptoms. Multiple sclerosis: current status and strategies for the future: National Academies Press (US); 2001.
19. Coyle PK. Symptom management and lifestyle modifications in multiple sclerosis. Continuum: Lifelong Learning in Neurology. 2016;22(3):815-36.
20. Sammaraiee Y, Yardley M, Keenan L, Buchanan K, Stevenson V, Farrell R. Intrathecal baclofen for multiple sclerosis related spasticity: a twenty year experience. Multiple sclerosis and related disorders. 2019;27:95-100.
21. Ghanavatian S, Derian A. Tizanidine. StatPearls [Internet]: StatPearls Publishing; 2022.
22. Paisley S, Beard S, Hunn A, Wight J. Clinical effectiveness of oral treatments for spasticity in multiple sclerosis: a systematic review. Multiple Sclerosis Journal. 2002;8(4):319-29.
23. Shakespeare D, Boggild M, Young CA, Sclerosis CM, Group RDotC. Anti‐spasticity agents for multiple sclerosis. Cochrane Database of Systematic Reviews. 1996;2010(1).
24. Manganotti P, Amelio E. Long-term effect of shock wave therapy on upper limb hypertonia in patients affected by stroke. Stroke. 2005;36(9):1967-71.
25. Santamato A, Notarnicola A, Panza F, Ranieri M, Micello MF, Manganotti P, et al. SBOTE study: extracorporeal shock wave therapy versus electrical stimulation after botulinum toxin type a injection for post-stroke spasticity-a prospective randomized trial. Ultrasound Med Biol. 2013;39(2):283-91.
26. Cleveland RO, Chitnis PV, McClure SR. Acoustic field of a ballistic shock wave therapy device. Ultrasound Med Biol. 2007;33(8):1327-35.
27. Schmitz C, Császár NB, Rompe JD, Chaves H, Furia JP. Treatment of chronic plantar fasciopathy with extracorporeal shock waves (review). J Orthop Surg Res. 2013;8:31.
28. Wang CJ. Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res. 2012;7:11.
29. Forsberg A, Andreasson M, Nilsagård Y. The Functional Gait Assessment in People with Multiple Sclerosis: Validity and Sensitivity to Change. Int J MS Care. 2017;19(2):66-72.
30. Nilsagård Y, Carling A, Forsberg A. Activities-specific balance confidence in people with multiple sclerosis. Multiple sclerosis international. 2012;2012.
31. Shah G, Oates AR, Arora T, Lanovaz JL, Musselman KE. Measuring balance confidence after spinal cord injury: the reliability and
validity of the Activities-specific Balance Confidence Scale. The journal of spinal cord medicine. 2017;40(6):768-76.
32. Mauch M, Kalin X. Reliability of the Prokin Type B Line System (TechnoBody™) Balance System. Internal Project Report Praxisklinik Rennbahn: Swiss Olympic Medical Center Zürich Switzerland. 2011:1-9.
33. Etoom M, Khraiwesh Y, Lena F, Hawamdeh M, Hawamdeh Z, Centonze D, et al. Effectiveness of physiotherapy interventions on spasticity in people with multiple sclerosis: a systematic review and meta-analysis. American journal of physical medicine & rehabilitation. 2018;97(11):793-807.
34. Chen P-H, Ho C-L, Lee C-H. Extracorporeal shockwave therapy on spasticity after central nervous system injury: A systemic review and meta-analysis. 2023.
35. Troncati F, Paci M, Myftari T, Lombardi B. Extracorporeal shock wave therapy reduces upper limb spasticity and improves motricity in patients with chronic hemiplegia: a case series. NeuroRehabilitation. 2013;33(3):399-405.
36. Vetrano M, d'Alessandro F, Torrisi MR, Ferretti A, Vulpiani MC, Visco V. Extracorporeal shock wave therapy promotes cell proliferation and collagen synthesis of primary cultured human tenocytes. Knee Surg Sports Traumatol Arthrosc. 2011;19(12):2159-68.
37. Notarnicola A, Moretti B. The biological effects of extracorporeal shock wave therapy (eswt) on tendon tissue. Muscles Ligaments Tendons J. 2012;2(1):33-7.
38. Ward M, Goldman MD. Epidemiology and Pathophysiology of Multiple Sclerosis. CONTINUUM: Lifelong Learning in Neurology. 2022;28(4):988-1005.
39. Walton C, King R, Rechtman L, Kaye W, Leray E, Marrie RA, et al. Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS. Multiple Sclerosis Journal. 2020;26(14):1816-21.
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Published
Jun 9, 2023
Article Details
How to Cite
Danah M. Alyahya. (2023). Effects Of Shockwave Therapy on Reducing the Muscle Tone in A Patient with Multiple Sclerosis: A Case Report. Journal of Population Therapeutics and Clinical Pharmacology, 30(14), 297-303. https://doi.org/10.47750/jptcp.2023.30.14.039
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Danah M. Alyahya. (2023). Effects Of Shockwave Therapy on Reducing the Muscle Tone in A Patient with Multiple Sclerosis: A Case Report. Journal of Population Therapeutics and Clinical Pharmacology, 30(14), 297-303. https://doi.org/10.47750/jptcp.2023.30.14.039