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Effect of myofascial trigger points release with shockwave therapy on shoulder hand syndrome in stroke patients

Introduction. To investigate the influence of Myofascial Trigger Points (MTrPs) release combined with shockwave therapy on pain and functions of the upper extremity with shoulder hand syndrome (SHS) in stroke patients with diabetic neuropathy. Methods. Two groups of thirty stroke patients, divided equally into, the study group: which received MTrPs release with shockwave therapy and conventional physical therapy program, while the control group: received the conventional physical therapy program. All the patients were evaluated pre-and post-intervention by the severity score of the Complex Regional Pain Syndrome (CRPS), Motor Evaluation Scale Upper Extremity Stroke Patients (MESUPES), the figure of eight test for hand swelling, and the Visual Analogue Scale for pain (VAS-P). Results. highly significant improvement of affected upper extremity functions, with a significant reduction of SHS symptoms, swelling, and pain of the study group compared to the control group (p < 0.05), also there was a negative significant correlation between MESUPES- all-out score and VAS-P. Conclusions. The combination of both MTrPs release with shockwave therapy had a significant improvement effect on upper extremity function and a significant reduction of both SHS symptoms and pain in stroke patients with diabetic neuropathy, which leads to improvement in stroke patients' functional rehabilitation.