Extracorporeal Shock Wave Therapy (eSWT) in Spinal Cord Injury-A Narrative Review

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Sep 14

PMID 39274325

Authors

Jozef Opara

Robert Dymarek

Miroslaw Sopel

Malgorzata Paprocka-Borowicz

Affiliations

Soon will be listed here.

Abstract

Background: Injury of the spinal cord causes motor and sensory dysfunction as well as pathological reflexes, leading to paraplegia or tetraplegia. The sequelae of traumatic spinal cord injury (SCI) are a significant burden and impact on healthcare systems. Despite constant progress in medicine, traumatic SCI still remains irreversible. To date, no satisfying treatment that can enable neuronal regeneration and recovery of function at the damaged level has been found. Hundreds of experiments have been conducted on various possibilities of influencing spinal regeneration; some of them have yielded promising results, but unfortunately, the successes obtained in experimental animals have not translated into humans.

Methods: This narrative review article presents the application of extracorporeal shock wave therapy (eSWT) in patients with SCI. The article has been divided into parts: 1) use of extracorporeal shock wave therapy for regeneration of the spinal cord after traumatic spinal cord injury; 2) application of extracorporeal shock wave therapy in spasticity after spinal cord injury. In both cases, the hypotheses of possible mechanisms of action will be described.

Results And Conclusions: A small number of clinical trials have demonstrated the potential of eSWT to influence the regeneration of the spine, as an innovative, safe, and cost-effective treatment option for patients with SCI. Some reports have shown that eSWT can improve spasticity, walking ability, urological function, quality of life, and independence in daily life.

References

Afzal B, Noor R, Mumtaz N, Bashir M . Effects of extracorporeal shock wave therapy on spasticity, walking and quality of life in poststroke lower limb spasticity: a systematic review and meta-analysis. Int J Neurosci. 2023; 134(12):1503-1517. DOI: 10.1080/00207454.2023.2271164. View

Shackleton C, Samejima S, Williams A, Malik R, Balthazaar S, Alrashidi A . Motor and autonomic concomitant health improvements with neuromodulation and exercise (MACHINE) training: a randomised controlled trial in individuals with spinal cord injury. BMJ Open. 2023; 13(7):e070544. PMC: 10351300. DOI: 10.1136/bmjopen-2022-070544. View

JUSIC A, Fronjek N . [Treatment of spasticity with low-frequency rhythmic electric stimulation of the muscle by Hufschmidt's method (our experiences and modifications)]. Neuropsihijatrija. 1970; 18(4):387-96. View

Yamaya S, Ozawa H, Kanno H, Kishimoto K, Sekiguchi A, Tateda S . Low-energy extracorporeal shock wave therapy promotes vascular endothelial growth factor expression and improves locomotor recovery after spinal cord injury. J Neurosurg. 2014; 121(6):1514-25. DOI: 10.3171/2014.8.JNS132562. View

Yousefifard M, Ramezani F, Vaccaro A, Hosseini M, Rahimi-Movaghar V . The Role of Intraspinal Administration of Self-Assembled Peptide on Locomotion Recovery After Spinal Cord Injury: A Systematic Review and Meta-Analysis Study. Neuromodulation. 2022; 26(6):1171-1178. DOI: 10.1016/j.neurom.2022.01.011. View

Massey S, Vanhoestenberghe A, Duffell L . Neurophysiological and clinical outcome measures of the impact of electrical stimulation on spasticity in spinal cord injury: Systematic review and meta-analysis. Front Rehabil Sci. 2023; 3:1058663. PMC: 9801305. DOI: 10.3389/fresc.2022.1058663. View

Yahata K, Kanno H, Ozawa H, Yamaya S, Tateda S, Ito K . Low-energy extracorporeal shock wave therapy for promotion of vascular endothelial growth factor expression and angiogenesis and improvement of locomotor and sensory functions after spinal cord injury. J Neurosurg Spine. 2016; 25(6):745-755. DOI: 10.3171/2016.4.SPINE15923. View

Gomara-Toldra N, Sliwinski M, Dijkers M . Physical therapy after spinal cord injury: a systematic review of treatments focused on participation. J Spinal Cord Med. 2014; 37(4):371-9. PMC: 4116720. DOI: 10.1179/2045772314Y.0000000194. View

Dymarek R, Ptaszkowski K, Slupska L, Halski T, Taradaj J, Rosinczuk J . Effects of extracorporeal shock wave on upper and lower limb spasticity in post-stroke patients: A narrative review. Top Stroke Rehabil. 2016; 23(4):293-303. DOI: 10.1080/10749357.2016.1141492. View

10.

Bonosi L, Poullay Silven M, Alessandro Biancardino A, Sciortino A, Giammalva G, Scerrati A . Stem Cell Strategies in Promoting Neuronal Regeneration after Spinal Cord Injury: A Systematic Review. Int J Mol Sci. 2022; 23(21). PMC: 9657320. DOI: 10.3390/ijms232112996. View

11.

Wang R, Bai J . Pharmacological interventions targeting the microcirculation following traumatic spinal cord injury. Neural Regen Res. 2023; 19(1):35-42. PMC: 10479866. DOI: 10.4103/1673-5374.375304. View

12.

Tarnacka B, Korczynski B, Frasunska J . Impact of Robotic-Assisted Gait Training in Subacute Spinal Cord Injury Patients on Outcome Measure. Diagnostics (Basel). 2023; 13(11). PMC: 10252491. DOI: 10.3390/diagnostics13111966. View

13.

Szymoniuk M, Mazurek M, Dryla A, Kamieniak P . The application of 3D-bioprinted scaffolds for neuronal regeneration after traumatic spinal cord injury - A systematic review of preclinical in vivo studies. Exp Neurol. 2023; 363:114366. DOI: 10.1016/j.expneurol.2023.114366. View

14.

Opara J, Taradaj J, Walewicz K, Rosinczuk J, Dymarek R . The Current State of Knowledge on the Clinical and Methodological Aspects of Extracorporeal Shock Waves Therapy in the Management of Post-Stroke Spasticity-Overview of 20 Years of Experiences. J Clin Med. 2021; 10(2). PMC: 7826726. DOI: 10.3390/jcm10020261. View

15.

Chen H, Feng Z, Min L, Tan M, Zhang D, Gong Q . Vagus Nerve Stimulation Prevents Endothelial Necroptosis to Alleviate Blood-Spinal Cord Barrier Disruption After Spinal Cord Injury. Mol Neurobiol. 2023; 60(11):6466-6475. DOI: 10.1007/s12035-023-03477-7. View

16.

Auersperg V, Trieb K . Extracorporeal shock wave therapy: an update. EFORT Open Rev. 2020; 5(10):584-592. PMC: 7608508. DOI: 10.1302/2058-5241.5.190067. View

17.

Lee J, Ha K, Kim J, Seo J, Kim Y . Does extracorporeal shock wave introduce alteration of microenvironment in cell therapy for chronic spinal cord injury?. Spine (Phila Pa 1976). 2014; 39(26):E1553-9. DOI: 10.1097/BRS.0000000000000626. View

18.

Chamberlain G, Colborne G . A review of the cellular and molecular effects of extracorporeal shockwave therapy. Vet Comp Orthop Traumatol. 2016; 29(2):99-107. DOI: 10.3415/VCOT-15-04-0057. View

19.

Matsuda M, Kanno H, Sugaya T, Yamaya S, Yahata K, Handa K . Low-energy extracorporeal shock wave therapy promotes BDNF expression and improves functional recovery after spinal cord injury in rats. Exp Neurol. 2020; 328:113251. DOI: 10.1016/j.expneurol.2020.113251. View

20.

Wang C . Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res. 2012; 7:11. PMC: 3342893. DOI: 10.1186/1749-799X-7-11. View