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Spastic QuadriplegiaNCT07894003

Focused Versus Radial Extracorporeal Shock Wave Therapy on Gastrocnemius Spasticity in Children With Spastic Quadriplegic Cerebral Palsy

A study testing Focused Extracorporeal Shock Wave Therapy and Radial Extracorporeal Shock Wave Therapy in people with Spastic Quadriplegia and Cerebral Palsy (CP), run by Dr Cipto Mangunkusumo General Hospital at 1 site in Indonesia.

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

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. Read more about this study

Who is it for?
Ages Up to 18 years
What is being tested?
Focused Extracorporeal Shock Wave Therapy and Radial Extracorporeal Shock Wave Therapy
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
16 participants
Where
1 siteIndonesia
Study dates
12 Dec 2025to 14 Sep 2026
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 Up to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Children diagnosed with Spastic Quadriplegic Cerebral Palsy by a pediatrician or pediatric neurologist;
  • Modified Ashworth Scale (MAS) score of ≥1 at the gastrocnemius muscle
  • No fixed contracture of the affected skeletal muscles;
  • Parents or legal guardians who provided written informed consent after receiving education about the fESWT and rESWT procedures and their associated risks.

Who cannot join

  • Parents or caregivers who were unable to cooperate during clinical assessments;
  • Parents or caregivers who were unwilling to participate in the study;
  • Children who were acutely ill at the time of intervention (e.g., with cough, fever, or upper respiratory tract infection);
  • Children who had received botulinum toxin type A injection within the past 6 months;
  • Children who had undergone lower limb surgery within the past 12 months.

Trial locations and contacts

1 site in 1 country.

Indonesia1 site
  • Dr. Cipto Mangunkusumo National General Hospital (RSCM)

    Jakarta Pusat, DKI Jakarta

Other trials in Indonesia

About this study

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

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?
Read more

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.
Read the detailed description

Dosing parameter is identical in both groups: 1,500 shocks, 2 bar, 6 Hz, medium energy intensity.

Being tested
Focused Extracorporeal Shock Wave Therapy, Radial Extracorporeal Shock Wave Therapy
Keywords
spastic quadriplegic cerebral palsy, gastrocnemius muscle spasticity, focused ESWT, radial ESWT
Medical subject headings
Quadriplegia, Cerebral Palsy

What participants receive

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

  • Focused Extracorporeal Shock Wave TherapyDevice

    Also called fESWT, focused shockwave 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 TherapyDevice

    Also called rESWT, radial shockwave 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.

Study groups in NCT07894003
Study groupRoleWhat they receive
Focused Extracorporeal Shock Wave TherapyActive comparatorTotal impulses per session: 1,500 shocks. Pressure: 2 bar. Frequency: 6 Hz. Energy intensity: medium. Treatment frequency: once weekly for four consecutive weeks (Weeks 1-4). Treatment area: gastrocnemius muscle bellies, including both medial and lateral heads, applied using a sweeping technique from the gastrocnemius down to the soleus. Coupling medium: standard ultrasound gel. Patient position: prone with the knee extended and the ankle in the patient's comfortable position.
Receives: Device: Focused Extracorporeal Shock Wave Therapy
Radial Extracorporeal Shock Wave TherapyActive comparatorTotal impulses per session: 1,500 shocks. Pressure: 2 bar. Frequency: 6 Hz. Energy intensity: medium. Treatment frequency: once weekly for four consecutive weeks (Weeks 1-4). Treatment area: gastrocnemius muscle bellies, including both medial and lateral heads, applied using a sweeping technique from the gastrocnemius down to the soleus. Coupling medium: standard ultrasound gel. Patient position: prone with the knee extended and the ankle in the patient's comfortable position.
Receives: Device: Radial Extracorporeal Shock Wave Therapy

What is being measured

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

  1. The Modified Ashworth Scale (MAS) score of the gastrocnemius muscle

    The primary outcome was the Modified Ashworth Scale (MAS) score of the gastrocnemius muscle, recorded as an ordinal score on a 6-point scale (0, 1, 1.5, 2, 3, and 4), measuring resistance to passive stretch.

    Measured: The primary outcome was evaluated at baseline, post-intervention weeks 1 to 4, and follow-up at 4, 8, and 12 weeks post-final treatment by blinded outcome assessor.

Timeline

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

  1. First posted26 Oct 2026
  2. Study start12 Dec 2025
  3. Primary completion31 Aug 2026
  4. Study completion14 Sep 2026

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
16 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07894003
Sponsor's protocol ID
RKW-1672
Status last verified
Oct 2026
First submitted
16 Oct 2026
Last updated
26 Oct 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be shared publicly due to the small sample size and privacy considerations for pediatric participants.

Publications

  • Graham HK, Rosenbaum P, Paneth N, Dan B, Lin JP, Damiano DL, Becher JG, Gaebler-Spira D, Colver A, Reddihough DS, Crompton KE, Lieber RL. Cerebral palsy. Nat Rev Dis Primers. 2016 Jan 7;2:15082. doi: 10.1038/nrdp.2015.82.

    PubMed 27188686
  • Brandenburg JE, Rabatin AE, Driscoll SW. Spasticity Interventions: Decision-Making and Management. Pediatr Clin North Am. 2023 Jun;70(3):483-500. doi: 10.1016/j.pcl.2023.01.005. Epub 2023 Mar 21.

    PubMed 37121638
  • Zhang HL, Jin RJ, Guan L, Zhong DL, Li YX, Liu XB, Xiao QW, Xiao XL, Li J. Extracorporeal Shock Wave Therapy on Spasticity After Upper Motor Neuron Injury: A Systematic Review and Meta-analysis. Am J Phys Med Rehabil. 2022 Jul 1;101(7):615-623. doi: 10.1097/PHM.0000000000001977. Epub 2022 Feb 15.

    PubMed 35152251
  • Chang MC, Choo YJ, Kwak SG, Nam K, Kim SY, Lee HJ, Kwak S. Effectiveness of Extracorporeal Shockwave Therapy on Controlling Spasticity in Cerebral Palsy Patients: A Meta-Analysis of Timing of Outcome Measurement. Children (Basel). 2023 Feb 9;10(2):332. doi: 10.3390/children10020332.

    PubMed 36832460
  • Yang SM, Chen SY, Chen KY, Lai TJ, Lin MT. Efficacy of extracorporeal shock wave therapy for post-stroke spasticity and dose-response analysis: a meta-analysis of randomized controlled trials. Eur J Phys Rehabil Med. 2025 Dec;61(6):787-797. doi: 10.23736/S1973-9087.25.08796-9.

    PubMed 41677776
  • Wu YT, Chang CN, Chen YM, Hu GC. Comparison of the effect of focused and radial extracorporeal shock waves on spastic equinus in patients with stroke: a randomized controlled trial. Eur J Phys Rehabil Med. 2018 Aug;54(4):518-525. doi: 10.23736/S1973-9087.17.04801-8. Epub 2017 Oct 25.

    PubMed 29072044
  • Park DS, Kwon DR, Park GY, Lee MY. Therapeutic Effect of Extracorporeal Shock Wave Therapy According to Treatment Session on Gastrocnemius Muscle Spasticity in Children With Spastic Cerebral Palsy: A Pilot Study. Ann Rehabil Med. 2015 Dec;39(6):914-21. doi: 10.5535/arm.2015.39.6.914. Epub 2015 Dec 29.

    PubMed 26798605
  • Duan H, Lian Y, Jing Y, Xing J, Li Z. Research progress in extracorporeal shock wave therapy for upper limb spasticity after stroke. Front Neurol. 2023 Feb 9;14:1121026. doi: 10.3389/fneur.2023.1121026. eCollection 2023.

    PubMed 36846123
  • Mihai EE, Popescu MN, Iliescu AN, Berteanu M. A systematic review on extracorporeal shock wave therapy and botulinum toxin for spasticity treatment: a comparison on efficacy. Eur J Phys Rehabil Med. 2022 Aug;58(4):565-574. doi: 10.23736/S1973-9087.22.07136-2. Epub 2022 Apr 12.

    PubMed 35412036
  • Ozbek IC, Tikiz C. Effectiveness of radial extracorporeal shock wave therapy in post-stroke spasticity patients: Evaluation with shear wave elastography. Turk J Phys Med Rehabil. 2024 Dec 27;71(2):206-215. doi: 10.5606/tftrd.2025.14800. eCollection 2025 Jun.

    PubMed 40740180
  • 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
  • Wardhani RK, Wahyuni LK, Laksmitasari B, Lakmudin A. Effect of total number of pulses of radial extracorporeal shock wave therapy (rESWT) on hamstring muscle spasticity in children with spastic type cerebral palsy: A randomized clinical trial. J Pediatr Rehabil Med. 2022;15(1):159-164. doi: 10.3233/PRM-200796.

    PubMed 35275569

Questions about this trial

What is this clinical trial studying?

A study testing Focused Extracorporeal Shock Wave Therapy and Radial Extracorporeal Shock Wave Therapy in people with Spastic Quadriplegia and Cerebral Palsy (CP), run by Dr Cipto Mangunkusumo General Hospital at 1 site in Indonesia.

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 4 inclusion and 5 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 26 Oct 2026. 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 Indonesia. 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?

The Modified Ashworth Scale (MAS) score of the gastrocnemius muscle (time frame: The primary outcome was evaluated at baseline, post-intervention weeks 1 to 4, and follow-up at 4, 8, and 12 weeks post-final treatment by blinded outcome assessor.). 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 NCT07894003, which also lists 12 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 26 Oct 2026.

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