Extracorporeal Shock Wave Therapy in Enhancing Sensitivity and Postural Stability in Multiple Sclerosis

Plain-language summary

This randomized controlled trial aimed to investigate the efficacy of Extracorporeal Shock Wave Therapy (ESWT) on plantar somatosensory function, knee joint proprioception, and spatiotemporal gait parameters in individuals diagnosed with Multiple Sclerosis (MS). The study included participants with a spasticity level below 1+, with the intervention group receiving ESWT three times per week over a 6-week period. To evaluate sensory changes, light touch thresholds were measured at six plantar sites-the heel, medial longitudinal arch, 1st and 5th metatarsal heads, and the 1st and 5th toes-using the Semmes-Weinstein monofilament kit. Additionally, two-point discrimination was assessed at the heel, and vibration duration was measured at the metatarsal heads using a 128 Hz tuning fork. Proprioception was quantified via the active knee joint reposition test in a closed kinetic chain position, measuring the absolute angular error at a 60° target angle. Postural stability and dynamic gait were objectively analyzed using the Win-Track platform and a reliable 3-step protocol to record parameters such as gait cycle duration, step length, cadence, and maximum plantar pressure. Static balance was further evaluated by recording the percentage of body weight transferred to each foot. By targeting both mechanoreceptor sensitivity and joint position sense, this 6-week ESWT intervention seeks to enhance the overall functional mobility and stability of MS patients.

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