Radial extracorporeal shock wave therapy in the rehabilitation of incomplete traumatic flaccid paraplegia: case report
DOI:
https://doi.org/10.11606/issn.2317-0190.v32i2a233919Keywords:
Spinal Cord Injuries, Paraplegia, Extracorporeal Shockwave Therapy, Neurological RehabilitationAbstract
The rehabilitation of patients with paraplegia resulting from spinal cord injury presents a significant challenge in healthcare. There is an ongoing search for innovative methods to stimulate neuroplasticity and restore motor function in the lower limbs. In this context, extracorporeal shock wave therapy (ESWT) emerges as a promising approach, potentially capable of complementing conventional rehabilitation techniques. Recent studies have investigated the potential of ESWT in modulating neural circuits, although evidence remains limited. In scenarios where scientific literature is scarce, case reports become valuable sources of information. Objective: This study aims to evaluate the efficacy of radial ESWT in the rehabilitation of patients with incomplete traumatic flaccid paraplegia, offering perspectives on a treatment modality that is still largely unexplored in this specific context. Case Report: We present the effect of radial ESWT on strength and functionality in a patient with incomplete flaccid paraplegia due to a paragliding accident. After one year of treatment, the patient showed partial motor recovery with a gain of 27 points between initial and final assessments, totaling a 325% improvement in lower limb muscle strength, as measured by the Medical Research Council muscle strength scale. The patient achieved independent community ambulation without the use of assistive devices, improving daily functionality with gains of 62 points, a 214.81% variation, on the Functional Independence Measure. Conclusion: Radial ESWT demonstrated potential as a complementary intervention in motor rehabilitation of incomplete spinal cord injuries.
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References
Maas F, Moser GAS, Goettens DA, Lima JF, Souza SS, Aguiar DCM. Characterization of traumatic spinal cord injuries: an integrative review of the literature. Sci Elec Arch. 2020;13(5):90-5. Doi: https://doi.org/10.36560/1352020936
Ding W, Hu S, Wang P, Kang H, Peng R, Dong Y, et al. Spinal Cord Injury: The Global Incidence, Prevalence, and Disability From the Global Burden of Disease Study 2019. Spine (Phila Pa 1976). 2022;47(21):1532-1540. Doi: https://doi.org/10.1097/BRS.0000000000004417
GBD 2021 Nervous System Disorders Collaborators. Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol. 2024;23(4):344-381. Doi: https://doi.org/10.1016/S1474-4422(24)00038-3
Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2021;396(10267):2006-2017. Doi: https://doi.org/10.1016/S0140-6736(20)32340-0
Utiyama DMO, Alfieri FM, Ramos VD, Battistella LR. Results from the International Spinal Cord Injury Community Survey: The Lived Experience of People with Spinal Cord Injury in South-Eastern Brazil. J Rehabil Med. 2022;54:jrm00342. Doi: https://doi.org/10.2340/jrm.v54.2157
Kirshblum S, Snider B, Eren F, Guest J. Characterizing Natural Recovery after Traumatic Spinal Cord Injury. J Neurotrauma. 2021;38(9):1267-1284. Doi: https://doi.org/10.1089/neu.2020.7473
Leister I, Mittermayr R, Mattiassich G, Aigner L, Haider T, Machegger L, et al. The effect of extracorporeal shock wave therapy in acute traumatic spinal cord injury on motor and sensory function within 6 months post-injury: a study protocol for a two-arm three-stage adaptive, prospective, multi-center, randomized, blinded, placebo-controlled clinical trial. Trials. 2022;23(1):245. Doi: https://doi.org/10.1186/s13063-022-06161-8
Medical Research Council. Aids to examination of the peripheral nervous system. London: Her Majesty’s Stationery Office; 1976. [Memorandum nº 45].
Keith RA, Granger CV, Hamilton BB, Sherwin FS. The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil. 1987;1:6-18
Rupp R, Biering-Sørensen F, Burns SP, Graves DE, Guest J, Jones L, et al. International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019. Top Spinal Cord Inj Rehabil. 2021;27(2):1-22. Doi: https://doi.org/10.46292/sci2702-1
Hausner T, Nógrádi A. The use of shock waves in peripheral nerve regeneration: new perspectives? Int Rev Neurobiol. 2013;109:85-98. Doi: https://doi.org/10.1016/B978-0-12-420045-6.00003-1
Iskratsch T, Wolfenson H, Sheetz MP. Appreciating force and shape—the rise of mechanotransduction in cell biology. Nat Rev Mol Cell Biol. 2014;15(12):825-33. Doi: https://doi.org/10.1038/nrm3903
Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2016;47(6):e98-e169. Doi: https://doi.org/10.1161/STR.0000000000000098
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