Table 7.
Characteristics of studies using ultrasounds for the treatment of triceps spasticity after stroke.
| Author | Sample | Intervention and dosage | Comparator | Outcomes |
Follow-up (months) |
Within groups difference (over the time) |
Between group difference after treatment |
|---|---|---|---|---|---|---|---|
| Radinmehr et al. (28) (RCT) | 32 (16/16 IG1/IG2) patients with chronic spasticity (MMAS > 1) | IG1: 10-min continuous ultrasounds (1 MHz, 1.5 W/cm2) on the gastrocnemius One single session |
IG2: Radial shock-wave therapy | MMAS aROM, pROM, TUG, H-reflex latency, PPFT |
n.a. | IG1: MMAS, TUG, PPFT ↓
aROM, pROM, H-reflex latency ↑ IG2: MMAS, TUG, PPFT ↓ aROM, pROM, H-reflex latency ↑ |
No statistical difference |
| Picelli et al. (50) (RCT) | 30 (10/10/10 IG1/IG2/IG3) patients with spasticity for at least 6 months (MAS>1) | IG1: 10-min continuous ultrasounds (1 MHz, 1.5 W/cm2) on the triceps Five days a week, for 2 weeks |
IG2: 15-min TENS (100 Hz, 0.3 ms) on the tibial nerve, 5 days a week for 2 weeks IG3: BoNT-A injections in the gastrocnemius |
MAS pROM |
3 | IG1: MAS, pROM ↔
IG2: MAS, pROM ↔ IG3: MAS ↓ pROM ↑ |
MAS, pROM§ (IG3) |
| Sahin et al. (61) (RCT) | 41 (20/21 IG/CG) patients with spasticity for at least 1 year (MAS > 1) | Stretching + 10-min continuous ultrasounds (1.5 W/cm2) Five days a week, for 1 month |
CG: Stretching 5 days a week, for 1 month | MAS aROM, pROM, H/M ratio, BMRS, FIM |
n.a. | IG: MAS ↓
aROM, pROM ↑ H/M ratio, BMRS, FIM ↔ CG: MAS ↓ aROM, pROM ↑ H/M ratio, BMRS, FIM ↔ |
No statistical difference |
| Ansari et al. (62) (RCT) | 21 (11/10 IG1/IG2) patients with spasticity (85% due to stroke) | IG1: 10-min continuous ultrasounds (1 MHz, 1.5 W/cm2) on the triceps One single session |
IG2: 20-min infrared (500 W), one single session | MAS H/M ratio, aROM, pROM |
n.a. | IG1: MAS, H/M ratio, aROM, pROM ↔
IG2: MAS, H/M ratio, aROM, pROM ↔ |
No statistical difference |
| Ansari et al. (63) (RCT) | 12 (6/6 IG/CG) patients with spasticity for at least 6 months | 10-min continuous ultrasounds (1 MHz, 1.5 W/cm2) on the triceps Three days a week, for 5 weeks |
CG: Sham ultrasounds on the triceps, three days a week for 5 weeks | MAS H/M ratio, aROM, pROM |
n.a. | IG: MAS, H/M ratio ↓
aROM, pROM ↔ CG: MAS, H/M ratio, aROM, pROM ↔ |
H/M ratio† |
↑
Statistically significant increase.
↓
Statistically significant decrease.
↔
No statistical difference.
†
IG overcomes comparator.
§
Comparator overcomes IG (listed in brackets when multiple).
IG, Intervention Group; CG, Control Group; n.a, not available; RCT Randomized Controlled Trial; MMAS, Modified Modified Ashworth Scale; aROM, active Range of Motion; pROM, passive Range of Motion; TUG, Timed Up and Go; PPFT, Passive Plantarflexor Torque; MAS, Modified Ashworth Scale; BoNT-A, Botulinum Neurotoxin Type-A; BMRS, Brunnstrom Motor Recovery Stage; FIM, Functional Independence Measurement.