Effect of extracorporeal shock wave therapy (ESWT) on gastrocnemius muscle spasticity among cerebral palsy children: A randomised controlled trial with sonographic evidence
In brief
Shock wave therapy improves motor function and reduces calf tone in CP children
In a randomized trial of 36 kids with spastic cerebral palsy, adding extracorporeal shock wave therapy to standard rehab for 12 weeks raised Gross Motor Function Measure scores and lowered Modified Ashworth Scale ratings compared with therapy alone. Ultrasound showed thicker, longer calf muscle fibers and smaller pennation angles, though it remains unclear whether these gains persist long term or translate into everyday walking improvements.
- Journal
- European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society (Q1)
- Published
- 3 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Lijie Zhu, Guangfu Chen, Qing Liu, Guojun Yun, Jianguo Cao
- PMID
- 42556181
- DOI
- 10.1016/j.ejpn.2026.08.001
Why clinicians should know about it
- Picked for Critical Care and Intensive Care Medicine (top studies of the week, 9 August 2026): High-quality evidence in a top journal
Abstract
BACKGROUND: Cerebral palsy (CP) is a group of permanent central motor and postural development disorders caused by non-progressive damage to the developing brain. Spastic cerebral palsy, the most common type, often results in increased gastrocnemius muscle tone, limiting gait and activity. This study investigates the impact of extracorporeal shock wave therapy (ESWT) on gross motor capacity assessed by the Gross Motor Function Measure (GMFM), muscle tone, and muscle properties in children with spastic cerebral palsy. METHODS: Thirty-six patients (mean age 3.58 ± 0.96) years with spastic cerebral palsy were recruited and randomly assigned to an ESWT group (N = 18) or a control group (N = 18). The ESWT group received ESWT three times per week in addition to standard daily physical and occupational therapy for 12 weeks, while the control group received only conventional treatment. Baseline and post-intervention measurements included Gross Motor Function Measure (GMFM), Modified Ashworth Scale (MAS), muscle thickness (MT), pinnate angle (PA), fascicle length (FL), and shear wave velocity (SWV). RESULTS: The ESWT group showed significant improvements in GMFM scores, reduced MAS ratings, increased MT and FL, and decreased PA compared to the control group. SWV was significantly correlated with MAS ratings in both groups. However, no significant correlations were found between GMFM and other muscle parameters in the ESWT group. CONCLUSIONS: ESWT, combined with conventional treatment, was associated with greater short-term post-intervention GMFM scores, reduced gastrocnemius muscle tone, and improved selected sonographic muscle properties in children with spastic cerebral palsy. These findings suggest that ESWT may be a useful adjunct therapy, but longer-term follow-up is required to determine whether these changes are sustained and translate into real-world mobility benefits.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.