Effects of extracorporeal shock wave therapy on motor function in patients with cerebral palsy: a systematic review and meta-analysis.

[PURPOSE] This study aims to evaluate extracorporeal shockwave therapy (ESWT) on spasticity, balance, gait patterns, and motor function in individuals with cerebral palsy (CP).

[MATERIALS AND METHODS] PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov were systematically searched up to 11 April 2025. Meta-analyses were conducted using Review Manager. The primary outcomes were Modified Ashworth Scale (MAS) and gait speed.

[RESULTS] Ten randomized controlled trials (RCTs) involving 341 individuals with CP were included. Comparison between the ESWT and control groups revealed significant improvements in MAS (standardized mean difference [SMD]: -0.84, 95% confidence intervals [CIs]: -1.23 to -0.46,  < 0.001), gait speed (MD: 0.12, 95% CI: 0.02-0.23,  = 0.02), cadence (MD: -3.01, 95% CI: -6.03 to 0,  = 0.05), stride length (MD: 0.22, 95% CI: 0.16-0.28,  < 0.001), Pediatric Balance Scale (MD: 2.3, 95% CI: 0.4-4.19,  = 0.02), and Gross Motor Function Measure-88 (MD: 9.72, 95% CI: 7.36-12.08,  < 0.001).

[CONCLUSIONS] Combining ESWT with conventional physiotherapy, botulinum toxin type A (BTX-A) injection, or ankle-foot orthotics positively affects spasticity, gait, balance, and motor function. In addition, spasticity significantly decreases, particularly with focused ESWT or ESWT targeting the upper limbs.