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About the Authors

Raikhan Tleulinova - Director of Nursing, NJSC "National Center for Children's Rehabilitation", Astana, Kazakhstan, This email address is being protected from spambots. You need JavaScript enabled to view it., https://orcid.org/0009-0001-1891-7955

Zinugul Baisova - Senior nurse of the Department of Physical Medicine and Rehabilitation, NJSC "National Center for Children's Rehabilitation", Astana, Kazakhstan, This email address is being protected from spambots. You need JavaScript enabled to view it., https://orcid.org/0009-0008-8957-7960

Zhanar Makhanbayeva - Nurse of the Department of Physical Medicine and Rehabilitation, NJSC "National Center for Children's Rehabilitation", Astana, Kazakhstan, This email address is being protected from spambots. You need JavaScript enabled to view it., https://orcid.org/0009-0003-7317-4490

Ainagul Smagulova - Nurse of the Department of Physical Medicine and Rehabilitation, NJSC "National Center for Children's Rehabilitation", Astana, Kazakhstan, This email address is being protected from spambots. You need JavaScript enabled to view it., https://orcid.org/0009-0008-3736-1746

Aigul Shagirova - Nurse of the Department of Physical Medicine and Rehabilitation, NJSC "National Center for Children's Rehabilitation", Astana, Kazakhstan, This email address is being protected from spambots. You need JavaScript enabled to view it., https://orcid.org/0009-0000-8555-8414

Aigul Khodzhabekova - Nurse of the Department of Physical Medicine and Rehabilitation, NJSC "National Center for Children's Rehabilitation", Astana, Kazakhstan, This email address is being protected from spambots. You need JavaScript enabled to view it., https://orcid.org/0009-0006-1395-4737

Abstract

Muscle hyper-resistance in spastic cerebral palsy restricts passive range of motion, impairs foot loading and limits functional training. Extracorporeal shock wave therapy is a non-invasive local intervention that may affect both neural and non-neural components of resistance to passive muscle stretch. This review analyzed the efficacy, safety, treatment parameters and duration of effect of extracorporeal shock wave therapy in children with cerebral palsy. Randomized and controlled clinical trials, systematic reviews and meta-analyses published mainly between 2010 and 2026 were considered. The most reproducible findings were reduced Modified Ashworth Scale scores, increased passive ankle dorsiflexion and improved plantar pressure distribution. Several trials also reported gains in selective motor control, balance, Gross Motor Function Measure dimensions D and E, and gait-related outcomes. However, differences in radial versus focused devices, pulse counts, number of sessions, target muscles and concomitant rehabilitation limit direct comparisons. A 2025 systematic review included 12 randomized controlled trials and 421 children, with methodological quality ranging from poor to good. No serious adverse events were reported in pediatric studies, although safety reporting was incomplete. Extracorporeal shock wave therapy should be considered an adjunct to physical therapy and other evidence-based spasticity management strategies rather than a replacement. Standardized protocols, long-term functional follow-up and multicenter studies in Kazakhstan are required.

Keywords

Cerebral palsy, muscle spasticity, extracorporeal shock wave therapy, child, rehabilitation, motor function.

References

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