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Cerebral PalsyNCT05702606

Shock Wave Therapy for Management of Spasticity in Patients With Cerebral Palsy

A study testing Radial extracorporeal shock wave therapy (rESWT) in people with Cerebral Palsy and Spasticity, Muscle, run by Fundacio Aspace Catalunya at 1 site in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Spasticity is the most common motor disorder in cerebral palsy (CP). The objectives of his therapeutic approach include; reducing pain, ease of use of orthopedic aids, improving posture, minimizing contractures and deformity, and facilitating mobility and dexterity, with the ultimate goal of maximizing the potential… Read more about this study

Who is it for?
Ages 4 to 50 years
What is being tested?
Radial extracorporeal shock wave therapy (rESWT)
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
73 participants
Where
1 siteSpain
Study dates
10 Jun 2021to 3 Oct 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 4 to 50 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Patients with CP.
  • With a CP classified as spastic.
  • Spasticity in the Triceps Surae muscle.
  • Who have a Gross Motor Classification (GMFCS) level between l and ll
  • Having signed the informed consent by the participant or your legal guardian

Who cannot join

  • Have received treatment with shock waves in the Triceps Surae or any other muscle of the lower extremity in the 6 months before the study.
  • Have received treatment with botulinum toxin and/or treatment focal intramuscular injection with phenol or alcohol in the Triceps Surae or some other lower extremity muscle in the 6 months before the study.
  • Patients who have undergone surgery for deformities foot orthotics in the last year.
  • Fixed deformities in the ankle joint.
  • Clinical signs of myopathy and neuropathy.
  • Infection or tumor at the site of application of the therapy*.
Show all 10Show fewer
  • Severe blood dyscrasia*.
  • Blood coagulation disorders*.
  • Treatment with oral anticoagulants*
  • Contraindications of radial extracorporeal shock wave therapy.

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Fundació Aspace Catalunya

    Barcelona, 08038

Other trials in Spain

About this study

Official title: Radial Extracorporeal Shock Wave Therapy for Management of Spasticity in Patients With Cerebral Palsy

Spasticity is the most common motor disorder in cerebral palsy (CP). The objectives of his therapeutic approach include; reducing pain, ease of use of orthopedic aids, improving posture, minimizing contractures and deformity, and facilitating mobility and dexterity, with the ultimate goal of maximizing the potential of the patient and promoting their independence and quality of life. The approach to spasticity in CP is complex and presents itself as a great challenge for the rehabilitation team. Radial extracorporeal shock wave therapy (rESWT) has been established in recent years as an effective, non-invasive alternative with hardly any side effects (small bruises or discomfort during the application) for the management of spasticity in patients with CP. rESWT is a relatively new therapy in the field of neurology, in 2010 was published the first clinical trial where shock waves were applied for the management of spasticity in patients with CP. Currently, few works have studied the efficacy of rESWT in patients with CP. In all of them, the results demonstrated the treatment's effectiveness in reducing spasticity locally in people with CP up to 3 months after the application. The group most studied muscle has been the Triceps Surae, and there is a great disparity regarding the doses of treatment applied in each study, especially regarding the number of sessions and the time interval between sessions. The most widely used protocol is 3 rESWT sessions with a time interval of 1 week between session; This protocol was established as the most effective in the treatment of trauma pathology. Despite all the variability in the administration of the dose, we have been able to observe that none of them has studied the effect of rESWT by lengthening the time interval between sessions beyond one week to check whether the therapeutic effects on spasticity can be prolonged over time by applying the same dose. Most of the studies conclude that future research should be aimed at studying the most optimal dose of treatment as well as evaluating the long-term results.

Being tested
Radial extracorporeal shock wave therapy (rESWT)
Medical subject headings
Cerebral Palsy, Muscle Spasticity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Radial extracorporeal shock wave therapy (rESWT)Other

    Radial shock waves are ballistic waves generated by injection of compressed air inside an applicator that fires a projectile into the itself and impacts against the application head

Study groups in NCT05702606
Study groupRoleWhat they receive
Control GroupActive comparator3 rESWT sessions with a time interval of 1 week between each session.
Receives: Other: Radial extracorporeal shock wave therapy (rESWT)
Experimental Group AExperimental3 rESTW sessions with a time interval of 2 weeks between each session.
Receives: Other: Radial extracorporeal shock wave therapy (rESWT)
Experimental Group BExperimental3 rESTW sessions with a time interval of 4 weeks between each session.
Receives: Other: Radial extracorporeal shock wave therapy (rESWT)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in passive range of movement and the stretching reflex in ankle dorsiflexion. Tardieu Scale

    Assess the change in degrees of passive range of motion and the ankle dorsiflexion stretch reflex measured with an inclinometer

    Measured: Base line,3,5,9,12 and 24 weeks

  2. Change in goal attainment scale (GAS)

    Goal attainment scale: Definition of an individual goal at the start. Will be assess the achievement or not of an objective and evaluates the expectations of improvement in each of the goals with a numerical scale from -2 to +2:

    (-2) Result much lower than expected (-1) Lower than expected result (0) Expected result (+1) Result higher than expected (+2) Result much higher than expected

    Measured: Setting of goal(s) at start (base line), assesment al 3,5,9,12 and 24 weeks

Secondary outcomes (3)
  1. Pain secondary to spasticity assessed by the visual analog scale

    If the patient presents pain secondary to spasticity, evaluate the degree of improvement after therapy using the visual analog scale where the value 0 is no pain and 10 is the worst possible pain.

    Measured: Base line,3,5,9,12 and 24 weeks

  2. Satisfaction with the therapy assessed by the visual analog scale

    Evaluate the degree of improvement perceived by the patient in relation to the therapy using the visual analog scale where the value 0 is no perceived improvement and 10 is the maximum expected improvement

    Measured: Base line,3,5,9,12 and 24 weeks

  3. Adverse effects by Data collection notebook

    Possible adverse effects secondary to treatment such as small bruises, petechiae, or muscle fatigue will be recorded in the data collection notebook

    Measured: Base line,3,5,9,12 and 24 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Jan 2023
  2. Study start10 Jun 2021
  3. Primary completion3 Oct 2022
  4. Study completion3 Oct 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
73 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05702606
Sponsor's protocol ID
ASP_Shock_MT
Status last verified
Jan 2023
First submitted
29 Nov 2022
Last updated
27 Jan 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Oskoui M, Coutinho F, Dykeman J, Jette N, Pringsheim T. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol. 2013 Jun;55(6):509-19. doi: 10.1111/dmcn.12080. Epub 2013 Jan 24.

    PubMed 23346889
  • Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society; Delgado MR, Hirtz D, Aisen M, Ashwal S, Fehlings DL, McLaughlin J, Morrison LA, Shrader MW, Tilton A, Vargus-Adams J. Practice parameter: pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2010 Jan 26;74(4):336-43. doi: 10.1212/WNL.0b013e3181cbcd2f.

    PubMed 20101040
  • National Collaborating Centre for Women's and Children's Health (UK). Spasticity in Children and Young People with Non-Progressive Brain Disorders: Management of Spasticity and Co-Existing Motor Disorders and Their Early Musculoskeletal Complications. London: RCOG Press; 2012 Jul. Available from http://www.ncbi.nlm.nih.gov/books/NBK116583/

    PubMed 23346608
  • Ramstad K, Jahnsen R, Skjeldal OH, Diseth TH. Characteristics of recurrent musculoskeletal pain in children with cerebral palsy aged 8 to 18 years. Dev Med Child Neurol. 2011 Nov;53(11):1013-8. doi: 10.1111/j.1469-8749.2011.04070.x.

    PubMed 22014321
  • Benini R, Shevell MI. Updates in the treatment of spasticity associated with cerebral palsy. Curr Treat Options Neurol. 2012 Dec;14(6):650-9. doi: 10.1007/s11940-012-0192-7.

    PubMed 22851256
  • Ogden JA, Alvarez RG, Levitt R, Marlow M. Shock wave therapy (Orthotripsy) in musculoskeletal disorders. Clin Orthop Relat Res. 2001 Jun;(387):22-40. doi: 10.1097/00003086-200106000-00005.

    PubMed 11400888
  • Schmitz C, Csaszar NB, Milz S, Schieker M, Maffulli N, Rompe JD, Furia JP. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database. Br Med Bull. 2015;116(1):115-38. doi: 10.1093/bmb/ldv047. Epub 2015 Nov 18.

    PubMed 26585999
  • Mattyasovszky SG, Langendorf EK, Ritz U, Schmitz C, Schmidtmann I, Nowak TE, Wagner D, Hofmann A, Rommens PM, Drees P. Exposure to radial extracorporeal shock waves modulates viability and gene expression of human skeletal muscle cells: a controlled in vitro study. J Orthop Surg Res. 2018 Apr 6;13(1):75. doi: 10.1186/s13018-018-0779-0.

    PubMed 29625618
  • Manganotti P, Amelio E. Long-term effect of shock wave therapy on upper limb hypertonia in patients affected by stroke. Stroke. 2005 Sep;36(9):1967-71. doi: 10.1161/01.STR.0000177880.06663.5c. Epub 2005 Aug 18.

    PubMed 16109905
  • Amelio E, Manganotti P. Effect of shock wave stimulation on hypertonic plantar flexor muscles in patients with cerebral palsy: a placebo-controlled study. J Rehabil Med. 2010 Apr;42(4):339-43. doi: 10.2340/16501977-0522.

    PubMed 20358168
  • Vidal X, Morral A, Costa L, Tur M. Radial extracorporeal shock wave therapy (rESWT) in the treatment of spasticity in cerebral palsy: a randomized, placebo-controlled clinical trial. NeuroRehabilitation. 2011;29(4):413-9. doi: 10.3233/NRE-2011-0720.

    PubMed 22207070
  • Vidal X, Marti-Fabregas J, Canet O, Roque M, Morral A, Tur M, Schmitz C, Sitja-Rabert M. Efficacy of radial extracorporeal shock wave therapy compared with botulinum toxin type A injection in treatment of lower extremity spasticity in subjects with cerebral palsy: A randomized, controlled, cross-over study. J Rehabil Med. 2020 Jun 30;52(6):jrm00076. doi: 10.2340/16501977-2703.

    PubMed 32556354
  • Tur Segura M, Morral A, Gimeno Esteve F, Biedermann Villagra T, Mangas Hernandez A, Ancosta Diez S, Jimenez Redondo J, Garcia Rodriguez N, Mila Villarroel R. Radial extracorporeal shock wave therapy for the management of spasticity in cerebral palsy: a randomized controlled trial with different time intervals between sessions. Front Neurol. 2026 Jun 5;17:1775659. doi: 10.3389/fneur.2026.1775659. eCollection 2026.

    PubMed 42327806
  • Tur Segura M, Gimeno Esteve F, Biedermann Villagra T, Jimenez Redondo J, Garcia Rodriguez N, Mila Villarroel R. Radial extracorporeal shock wave therapy for the management of spasticity in cerebral palsy: study protocol for a randomized controlled trial. Front Neurol. 2024 Jun 13;15:1402452. doi: 10.3389/fneur.2024.1402452. eCollection 2024.

    PubMed 38957349

Questions about this trial

What is this clinical trial studying?

A study testing Radial extracorporeal shock wave therapy (rESWT) in people with Cerebral Palsy and Spasticity, Muscle, run by Fundacio Aspace Catalunya at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Jan 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in passive range of movement and the stretching reflex in ankle dorsiflexion. Tardieu Scale (time frame: Base line,3,5,9,12 and 24 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05702606, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jan 2023.

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