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Focused Versus Radial Extracorporeal Shock Wave Therapy on Gastrocnemius Spasticity in Children With Spastic Quadriplegic Cerebral Palsy
Sponsor: Dr Cipto Mangunkusumo General Hospital
Summary
The goal of this pilot randomized controlled trial is to compare the effectiveness of focused extracorporeal shockwave therapy (ESWT) versus radial ESWT on gastrocnemius spasticity in children with spastic quadriplegic cerebral palsy (CP). The main questions it aims to answer are: 1. Does focused ESWT (fESWT) reduce gastrocnemius spasticity more effectively than radial ESWT (rESWT)? 2. Are the antispastic effects of fESWT more durable over time compared with rESWT? Researchers will compare: * fESWT group (one session weekly, 4 weeks) * rESWT group (one session weekly, 4 weeks) to see if fESWT more effective to lower Modified Ashworth Scale (MAS) scores during all assessment time points compared with rESWT. Participants will: * Be randomly assigned to either fESWT or rESWT group. * Receive one treatment session per week for 4 consecutive weeks. * Undergo MAS score evaluations at: baseline, post-intervention weeks 1-4, and follow-up at 4, 8, and 12 weeks after the final treatment.
Official title: Comparison of Focused Versus Radial Extracorporeal Shock Wave Therapy on Gastrocnemius Spasticity in Children With Spastic Quadriplegic Cerebral Palsy: A Pilot Randomized Control
Key Details
Gender
All
Age Range
Any - 18 Years
Study Type
INTERVENTIONAL
Enrollment
16
Start Date
2025-12-12
Completion Date
2026-09-14
Last Updated
2026-10-26
Healthy Volunteers
No
Interventions
Focused Extracorporeal Shock Wave Therapy
Focused ESWT (fESWT) generates true acoustic shockwaves that converge at a defined focal point within deeper tissue. Dosing parameters: total impulses 1,500 shocks per session; 2 bar pressure; 6 Hz frequency; medium energy intensity; once weekly for four consecutive weeks. Treatment area: gastrocnemius muscle bellies, including both medial and lateral heads, applied using a sweeping technique from the gastrocnemius down to the soleus. Patient position: prone with the knee extended and the ankle in the patient's comfortable position.
Radial Extracorporeal Shock Wave Therapy
Radial ESWT (rESWT) uses pneumatic acceleration of a projectile that produces pressure waves diverging from the applicator tip, with maximal energy at the skin surface and progressively decreasing energy with depth. Dosing parameters: 1,500 shocks per session; 2 bar pressure; 6 Hz frequency; medium energy intensity; once weekly for four consecutive weeks. Treatment area: gastrocnemius muscle bellies, including both medial and lateral heads, applied using a sweeping technique from the gastrocnemius down to the soleus. Patient position: prone with the knee extended and the ankle in the patient's comfortable position.
Locations (1)
Dr. Cipto Mangunkusumo National General Hospital (RSCM)
Jakarta Pusat, DKI Jakarta, Indonesia