Abstract
Aim of the study is to analyze the effect of mechano-sound vibrations at a frequency of 120 Hz on limited areas of the spastic muscles through the searching for specific "key points," specific areas that, if properly stimulated, allow a reduction in the tone of the entire muscle. We evaluated and treated a sample group of 10 patients with spasticity; aged between 63 and 70 years. All subjects were assessed by: Ashworth Scale, passive R.O.M.; assessment of active motility, Bahkta Test, Surface EMG. Treatment with focused acoustic waves at 120 Hz was performed twice a week for 8 weeks with distal-proximal stimulation. After 8 weeks of treatment patients are underwent injection of botulinum toxin into the most dysfunctional muscles. We found a mean reduction in the level of spasticity on the Ashworth scale; increase of ROM passive extension of the wrist, knee flexion and ankle dorsiflexion; increase in muscle strength in the hemiplegic side; increase in the mean score on Bahkta The electromyographic analysis showed a significant reduction of the minimum value (uV) of the basal tone of all the treated muscles. The results show the validity of the application of focused acoustic waves in the treatment of spasticity. The "experimentally" identified key points are all situated in close proximity to fascial structures, connective tissue, tendons and ligaments. This is in line with the location of type III and IV "interstitial" mechanoreceptors, involved in the clasp-knife phenomenon. The use of focused acoustic waves, associated with specific stretching and muscle strengthening, can therefore be regarded as a good method for preparation to the next phase of treatment, such as for example preparing the tissue to inoculation of botulinum toxin, and then to prolong and potentiate the effect in the months after inoculation.
