Case study in Scoliosis and shockwave
Shockwave and scoliosis
Scoliosis is a frequent problem for wheelchair users with cerebral palsy (CP), and has a direct impact on their quality of life. It also has an impact on how long they can sit upright in their wheelchair. Therefore I did 2 shockwave treatments in the clinic on 2 young (17 and 23 years) wheelchair users with scoliosis. The aim was to see how the treatment affected their quality of life with 3 treatments using a standard protocol, inspired by a studie made ofMirea A1, Onose G2, Padure L1 and Rosulescu E3. It looked at how to improve function and reduce pain in affected muscles. Their conclusion was as follows:
ESWT, applied in 3 sessions, with 0.15 mJ/ mm2, using 500 shocks/ min and 10 Hz as frequency may decrease children spasticity level and pain caused by it and improve the gross motor function.
Test setup
The trial I set up was with 3 treatments with a protocol that focused on the muscles that affected the curvature of the back, that is, the muscles with the greatest degree of hypertonus. Her blev brugt en protokol på 2000 skud med fokuseret shockwave med en intensitet på 0.20 mJ/mm. Work was done around the long straight back stretcher and adjacent muscles that affected each patient. Then 500 shots of focused shockwave with an intensity of 0.20 mJ/mm were fired into the illacus (the muscle that attaches to the hip socket) of the most affected side. Finally, 2000 shots of radiating shockwave were fired into the psoas major (deep hip flexor) at an intensity of 2.0 bar. We did this 3 times, one week apart. Follow-up was then carried out 1 and 2 months after the end of treatment.
I have previously done a more intensive case study within the same group, which showed a positive improvement. Here, however, the course was with 8 treatments over 4 weeks.
The equipment for the treatment has been a Storz Duolith SD1 T-Top Ultra and a Storz Masterpuls MP50 Ultra.
Result
Both participants are in the category of severe scoliosis, and thus have impaired digestion and breathing. This means that there are still different pain symptoms, which can be difficult to distinguish. However, the parents of the 2 patients noticed less muscle tone and more flexibility in everyday life. This increased the sitting time in the wheelchair. Motivation to exercise/sit is controlled by the level of pain, and the course of illness after the treatments related to digestion and flu in the participants, has made it difficult to assess 100% on the set parameters related to motivation and sitting time.
The patient group with CP is often affected by disease, which can make it difficult to make a 100% clinical assessment based on established criteria. As in other studies done on CP and Shockwave, it is seen to have a positive impact on pain and functional level in particular.
The same dose and intensity are used for all treatments. This should be varied from person to person, as well as in response to the respective pain level, in future courses of treatment. This will be to ensure maximum impact of the programme.
Conclusion
3 treatments, one week apart, provide a reduction in pain level and muscle tone for up to 2 months after completion of treatment, for wheelchair users with scoliosis and CP