{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:54:13Z","timestamp":1781646853497,"version":"3.54.5"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":42,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012151","name":"Sanming Project of Medicine in Shenzhen","doi-asserted-by":"crossref","award":["No.SZSM202111010"],"award-info":[{"award-number":["No.SZSM202111010"]}],"id":[{"id":"10.13039\/501100012151","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Shenzhen Portion of Shenzhen-Hong Kong Science and Technology Innovation Cooperation Zone","award":["No. HTHZQSWS-KCCYB-2023060"],"award-info":[{"award-number":["No. HTHZQSWS-KCCYB-2023060"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J NeuroEngineering Rehabil"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Extracorporeal shockwave therapy (ESWT) can effectively relieve post-stroke spasticity; however, research comparing the impact of different ESWT frequencies is limited. In this study, we investigated the therapeutic efficacy of different ESWT frequencies for post-stroke ankle plantar flexor spasticity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective, single-blind, randomized controlled trial, we recruited patients treated in the Rehabilitation Department of Shenzhen Second People\u2019s Hospital for post-stroke ankle plantar flexor spasticity between January 2024 and September 2024. The participants were randomly assigned to the control (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915), 4\u00a0Hz ESWT (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915), and 10\u00a0Hz ESWT (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915) groups. All groups received conventional rehabilitation therapy; the 4\u00a0Hz and 10\u00a0Hz ESWT groups received additional ESWT. The ESWT intervention lasted for 3 weeks, with two interventions per week. ESWT was administered at 2\u00a0bar, 4\u00a0Hz, and 2000 pulses for the 4\u00a0Hz group and 2\u00a0bar, 10\u00a0Hz, and 2000 pulses for the 10\u00a0Hz group. Assessments were conducted before treatment, after the first treatment, and at the end of intervention using the modified Ashworth scale (MAS), passive joint range of motion (PROM), ankle clonus score, medial gastrocnemius muscle oscillation frequency (MGF), lateral gastrocnemius muscle oscillation frequency (LGF), medial gastrocnemius muscle dynamic stiffness (MGS), lateral gastrocnemius muscle dynamic stiffness (LGS), and the Fugl-Meyer assessment of the lower extremity (FMA-LE). Visual analog scale (VAS) tool was used before and after each ESWT session.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 4\u00a0Hz and 10\u00a0Hz ESWT groups showed significant difference in LGS after a single treatment (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). Following 3 weeks of treatment, both ESWT groups exhibited significant improvements in MAS, PROM, MGF, and LGS compared with the control group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). The 4\u00a0Hz ESWT group also demonstrated a significant improvement in MGS compared with the control group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05), and the 4\u00a0Hz and 10\u00a0Hz ESWT groups differed significantly in LGS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). We found that only five patients reported mild pain, which resolved rapidly after treatment and rest.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both single and 3-week ESWT treatments safely reduced the severity of ankle plantar flexor spasticity. The results showed the possibility of superiority of 4\u00a0Hz intervention to 10\u00a0Hz intervention.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Trial registration:<\/jats:italic>\n                      This study was registered in the Chinese Clinical Trial Registry on 10 January 2024 (registration Number: ChiCTR2400079721),\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.chictr.org.cn\/bin\/project\/edit?pid=217074\" ext-link-type=\"uri\">https:\/\/www.chictr.org.cn\/bin\/project\/edit?pid=217074<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12984-026-01901-2","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:36:10Z","timestamp":1774877770000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of different frequencies of extracorporeal shockwave on plantar flexor spasticity of the ankle in patients with stroke: a single-center, prospective, single-blind, randomized controlled trial"],"prefix":"10.1186","volume":"23","clinical-trial-number":[{"clinical-trial-number":"chictr2400079721","registry":"10.18810\/chictr"}],"author":[{"given":"Meihua","family":"Ke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peike","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongxia","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiji","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Congbai","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongbo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjun","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"issue":"10","key":"1901_CR1","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1016\/S1474-4422(24)00369-7","volume":"23","author":"Global","year":"2024","unstructured":"Global. Regional, and National burden of stroke and its risk factors, 1990\u20132021: a systematic analysis for the global burden of disease study 2021. Lancet Neurol. 2024;23(10):973\u20131003.","journal-title":"Lancet Neurol"},{"issue":"4","key":"1901_CR2","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/S1474-4422(18)30500-3","volume":"18","author":"S Wu","year":"2019","unstructured":"Wu S, Wu B, Liu M, Chen Z, Wang W, Anderson CS, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol. 2019;18(4):394\u2013405.","journal-title":"Lancet Neurol"},{"issue":"6","key":"1901_CR3","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1016\/j.rehab.2018.04.004","volume":"62","author":"KS Sunnerhagen","year":"2019","unstructured":"Sunnerhagen KS, Opheim A, Alt Murphy M. Onset, time course and prediction of spasticity after stroke or traumatic brain injury. Annals Phys Rehabilitation Med. 2019;62(6):431\u20134.","journal-title":"Annals Phys Rehabilitation Med"},{"issue":"2","key":"1901_CR4","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s40265-018-1042-z","volume":"79","author":"A Santamato","year":"2019","unstructured":"Santamato A, Cinone N, Panza F, Letizia S, Santoro L, Lozupone M, et al. Botulinum toxin type A for the treatment of lower limb spasticity after stroke. Drugs. 2019;79(2):143\u201360.","journal-title":"Drugs"},{"key":"1901_CR5","doi-asserted-by":"crossref","unstructured":"Filippetti M, Tamburin S, Di Censo R, Adamo M, Manera E, Ingr\u00e0 J et al. Role of diagnostic nerve blocks in the Goal-Oriented treatment of spasticity with botulinum toxin type A: A Case-Control study. Toxins. 2024; 16(6).","DOI":"10.3390\/toxins16060258"},{"key":"1901_CR6","doi-asserted-by":"publisher","first-page":"1342545","DOI":"10.3389\/fneur.2024.1342545","volume":"15","author":"YN Du","year":"2024","unstructured":"Du YN, Li Y, Zhang TY, Jiang N, Wei Y, Cheng SH, et al. Efficacy of botulinum toxin A combined with extracorporeal shockwave therapy in post-stroke spasticity: a systematic review. Front Neurol. 2024;15:1342545.","journal-title":"Front Neurol"},{"key":"1901_CR7","doi-asserted-by":"publisher","first-page":"101222","DOI":"10.1016\/j.eclinm.2021.101222","volume":"43","author":"PC Hsu","year":"2022","unstructured":"Hsu PC, Chang KV, Chiu YH, Wu WT, \u00d6z\u00e7akar L. Comparative effectiveness of botulinum toxin injections and extracorporeal shockwave therapy for Post-Stroke spasticity: A systematic review and network Meta-Analysis. EClinicalMedicine. 2022;43:101222.","journal-title":"EClinicalMedicine"},{"key":"1901_CR8","doi-asserted-by":"publisher","first-page":"9","DOI":"10.2147\/CIA.S221032","volume":"15","author":"R Dymarek","year":"2020","unstructured":"Dymarek R, Ptaszkowski K, Ptaszkowska L, Kowal M, Sopel M, Taradaj J, et al. Shock waves as a treatment modality for spasticity reduction and recovery improvement in Post-Stroke Adults - Current evidence and qualitative systematic review. Clin Interv Aging. 2020;15:9\u201328.","journal-title":"Clin Interv Aging"},{"key":"1901_CR9","doi-asserted-by":"crossref","unstructured":"Lee JH, Kim EJ. The effects of shock wave therapy on spasticity and walking ability in people with stroke: A comparative study of different application sites. Brain Sci. 2023; 13(4).","DOI":"10.3390\/brainsci13040687"},{"issue":"1","key":"1901_CR10","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1097\/PHM.0000000000002019","volume":"102","author":"LJ Ou-Yang","year":"2023","unstructured":"Ou-Yang LJ, Chen PH, Lee CH, Li TY, Wu YT, Jhou HJ, et al. Effect and optimal timing of extracorporeal Shock-Wave intervention to patients with spasticity after stroke: A systematic review and Meta-analysis. Am J Phys Med Rehabil. 2023;102(1):43\u201351.","journal-title":"Am J Phys Med Rehabil"},{"issue":"2","key":"1901_CR11","doi-asserted-by":"publisher","first-page":"163","DOI":"10.5535\/arm.2019.43.2.163","volume":"43","author":"JH Oh","year":"2019","unstructured":"Oh JH, Park HD, Han SH, Shim GY, Choi KY. Duration of treatment effect of extracorporeal shock wave on spasticity and subgroup-analysis according to number of shocks and application site: a meta-analysis. Annals Rehabilitation Med. 2019;43(2):163\u201377.","journal-title":"Annals Rehabilitation Med"},{"issue":"1","key":"1901_CR12","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/s13018-018-0779-0","volume":"13","author":"SG Mattyasovszky","year":"2018","unstructured":"Mattyasovszky SG, Langendorf EK, Ritz U, Schmitz C, Schmidtmann I, Nowak TE, et al. Exposure to radial extracorporeal shock waves modulates viability and gene expression of human skeletal muscle cells: a controlled in vitro study. J Orthop Surg Res. 2018;13(1):75.","journal-title":"J Orthop Surg Res"},{"issue":"7","key":"1901_CR13","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1097\/PHM.0000000000002694","volume":"104","author":"W Liu","year":"2025","unstructured":"Liu W, Zhang S. Extracorporeal shock wave therapy for limb dysfunction after stroke: a systematic review and Meta-analysis. Am J Phys Med Rehabil. 2025;104(7):654\u201362.","journal-title":"Am J Phys Med Rehabil"},{"issue":"4","key":"1901_CR14","doi-asserted-by":"publisher","first-page":"518","DOI":"10.23736\/S1973-9087.17.04801-8","volume":"54","author":"YT Wu","year":"2018","unstructured":"Wu YT, Chang CN, Chen YM, Hu GC. Comparison of the effect of focused and radial extracorporeal shock waves on spastic equinus in patients with stroke: a randomized controlled trial. Eur J Phys Rehabil Med. 2018;54(4):518\u201325.","journal-title":"Eur J Phys Rehabil Med"},{"issue":"6","key":"1901_CR15","doi-asserted-by":"publisher","first-page":"1546","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.03.008","volume":"28","author":"H Radinmehr","year":"2019","unstructured":"Radinmehr H, Ansari NN, Naghdi S, Tabatabaei A, Moghimi E. Comparison of therapeutic ultrasound and radial shock wave therapy in the treatment of plantar flexor spasticity after stroke: a prospective, single-blind, randomized clinical trial. J Stroke Cerebrovasc Diseases: Official J Natl Stroke Association. 2019;28(6):1546\u201354.","journal-title":"J Stroke Cerebrovasc Diseases: Official J Natl Stroke Association"},{"issue":"Suppl 1","key":"1901_CR16","doi-asserted-by":"publisher","first-page":"S17","DOI":"10.1310\/tsr21S1-S17","volume":"21","author":"A Santamato","year":"2014","unstructured":"Santamato A, Micello MF, Panza F, Fortunato F, Logroscino G, Picelli A, et al. Extracorporeal shock wave therapy for the treatment of poststroke plantar-flexor muscles spasticity: a prospective open-label study. Top Stroke Rehabil. 2014;21(Suppl 1):S17\u201324.","journal-title":"Top Stroke Rehabil"},{"issue":"1","key":"1901_CR17","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1186\/s12984-024-01473-z","volume":"21","author":"SM Yang","year":"2024","unstructured":"Yang SM, Chen YH, Lu YL, Wu CH, Chen WS, Lin MT. The dose effectiveness of extracorporeal shockwave on plantar flexor spasticity of ankle in stroke patients: a randomized controlled trial. J Neuroeng Rehabil. 2024;21(1):176.","journal-title":"J Neuroeng Rehabil"},{"key":"1901_CR18","doi-asserted-by":"crossref","unstructured":"Lee JH, Kim EJ. A comprehensive review of the effects of extracorporeal shock wave therapy on stroke patients: Balance, Pain, Spasticity. Medicina (Kaunas, Lithuania). 2023; 59(5).","DOI":"10.3390\/medicina59050857"},{"issue":"32","key":"1901_CR19","doi-asserted-by":"publisher","first-page":"e29664","DOI":"10.1097\/MD.0000000000029664","volume":"101","author":"AB de Menezes","year":"2022","unstructured":"de Menezes AB, Back CGN, Driusso P, Liebano RE. How to report parameters and procedures for shockwave therapy in musculoskeletal disorders: A narrative review. Medicine. 2022;101(32):e29664.","journal-title":"Medicine"},{"issue":"5","key":"1901_CR20","doi-asserted-by":"publisher","first-page":"832","DOI":"10.23736\/S1973-9087.24.08136-X","volume":"60","author":"L Lippi","year":"2024","unstructured":"Lippi L, Folli A, Moalli S, Turco A, Ammendolia A, de Sire A, et al. Efficacy and tolerability of extracorporeal shock wave therapy in patients with plantar fasciopathy: a systematic review with meta-analysis and meta-regression. Eur J Phys Rehabil Med. 2024;60(5):832\u201346.","journal-title":"Eur J Phys Rehabil Med"},{"key":"1901_CR21","doi-asserted-by":"publisher","first-page":"1063159","DOI":"10.3389\/fsurg.2023.1063159","volume":"10","author":"K Xiao","year":"2023","unstructured":"Xiao K, Zhou L, Zhu S, Lin L, Di X, Li H. Which frequency is better for pediatric shock wave lithotripsy? Low intermediate or high: a systematic review and meta-analysis. Front Surg. 2023;10:1063159.","journal-title":"Front Surg"},{"issue":"2","key":"1901_CR22","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1080\/10749357.2019.1654242","volume":"27","author":"R Cabanas-Vald\u00e9s","year":"2020","unstructured":"Cabanas-Vald\u00e9s R, Calvo-Sanz J, Urr\u00f9tia G, Serra-Llobet P, P\u00e9rez-Bellmunt A, Germ\u00e1n-Romero A. The effectiveness of extracorporeal shock wave therapy to reduce lower limb spasticity in stroke patients: a systematic review and meta-analysis. Top Stroke Rehabil. 2020;27(2):137\u201357.","journal-title":"Top Stroke Rehabil"},{"issue":"6","key":"1901_CR23","first-page":"754","volume":"55","author":"CL Chen","year":"2019","unstructured":"Chen CL, Chen CY, Chen HC, Wu CY, Lin KC, Hsieh YW, et al. Responsiveness and minimal clinically important difference of modified Ashworth scale in patients with stroke. Eur J Phys Rehabil Med. 2019;55(6):754\u201360.","journal-title":"Eur J Phys Rehabil Med"},{"issue":"2","key":"1901_CR24","doi-asserted-by":"publisher","first-page":"e002096","DOI":"10.1136\/bmjsem-2024-002096","volume":"10","author":"F Aliasgharpour","year":"2024","unstructured":"Aliasgharpour F, Honarpishe R, Hosseini-Asl SH, Khonji MS, Abbaschian F, Nakhostin Ansari N, et al. Effects of dry needling on spasticity and motor function in paralympic athletes: a study protocol for a randomised controlled trial. BMJ Open Sport Exerc Med. 2024;10(2):e002096.","journal-title":"BMJ Open Sport Exerc Med"},{"key":"1901_CR25","doi-asserted-by":"crossref","unstructured":"Lee CH, Lee SH, Yoo JI, Lee SU. Ultrasonographic evaluation for the effect of extracorporeal shock wave therapy on gastrocnemius muscle spasticity in patients with chronic Stroke. PM & R: the journal of injury, function, and rehabilitation. 2019; 11(4):363\u201371.","DOI":"10.1016\/j.pmrj.2018.08.379"},{"key":"1901_CR26","doi-asserted-by":"crossref","unstructured":"Mihai EE, Papathanasiou J, Panayotov K, Kashilska Y, Rosulescu E, Foti C et al. Conventional physical therapy combined with extracorporeal shock wave leads to positive effects on spasticity in stroke survivors: a prospective observational study. Eur J Transl Myol. 2023; 33(3).","DOI":"10.4081\/ejtm.2023.11607"},{"issue":"3","key":"1901_CR27","doi-asserted-by":"publisher","first-page":"101670","DOI":"10.1016\/j.rehab.2022.101670","volume":"66","author":"YL Chen","year":"2023","unstructured":"Chen YL, Jiang LJ, Cheng YY, Chen C, Hu J, Zhang AJ, et al. Focal vibration of the plantarflexor and dorsiflexor muscles improves poststroke spasticity: a randomized single-blind controlled trial. Annals Phys Rehabilitation Med. 2023;66(3):101670.","journal-title":"Annals Phys Rehabilitation Med"},{"issue":"1","key":"1901_CR28","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1186\/s12891-025-08791-w","volume":"26","author":"F Varol","year":"2025","unstructured":"Varol F, Ilez A, Aslan Y. Mechanical properties of extrinsic foot muscles, Achilles tendon, and plantar fascia in patients with a history of diabetic foot ulcers. BMC Musculoskelet Disord. 2025;26(1):531.","journal-title":"BMC Musculoskelet Disord"},{"issue":"1","key":"1901_CR29","doi-asserted-by":"publisher","first-page":"5062","DOI":"10.1038\/s41598-021-84656-1","volume":"11","author":"MI Garcia-Bernal","year":"2021","unstructured":"Garcia-Bernal MI, Heredia-Rizo AM, Gonzalez-Garcia P, Cort\u00e9s-Vega MD, Casuso-Holgado MJ. Validity and reliability of myotonometry for assessing muscle viscoelastic properties in patients with stroke: a systematic review and meta-analysis. Sci Rep. 2021;11(1):5062.","journal-title":"Sci Rep"},{"issue":"3","key":"1901_CR30","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1016\/j.apmr.2011.09.014","volume":"93","author":"LL Chuang","year":"2012","unstructured":"Chuang LL, Wu CY, Lin KC. Reliability, validity, and responsiveness of myotonometric measurement of muscle tone, elasticity, and stiffness in patients with stroke. Arch Phys Med Rehabil. 2012;93(3):532\u201340.","journal-title":"Arch Phys Med Rehabil"},{"key":"1901_CR31","doi-asserted-by":"crossref","unstructured":"Moskiewicz D, Mraz M, Chamela-Bili\u0144ska D. Botulinum toxin and dynamic splint restore grasping function after stroke: A case report. Int J Environ Res Public Health. 2023; 20(6).","DOI":"10.3390\/ijerph20064873"},{"key":"1901_CR32","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.clinbiomech.2019.12.026","volume":"73","author":"S Ilahi","year":"2020","unstructured":"Ilahi S, White ATM, Devos A, Henderson A, Nair J. Quantified Biomechanical properties of lower lumbar myofascia in younger adults with chronic idiopathic low back pain and matched healthy controls. Clin Biomech (Bristol Avon). 2020;73:78\u201385.","journal-title":"Clin Biomech (Bristol Avon)"},{"issue":"1","key":"1901_CR33","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/s00421-011-1959-3","volume":"112","author":"M Murayama","year":"2012","unstructured":"Murayama M, Watanabe K, Kato R, Uchiyama T, Yoneda T. Association of muscle hardness with muscle tension dynamics: a physiological property. Eur J Appl Physiol. 2012;112(1):105\u201312.","journal-title":"Eur J Appl Physiol"},{"issue":"5","key":"1901_CR34","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1016\/j.jelekin.2014.06.007","volume":"24","author":"AK Fr\u00f6hlich-Zwahlen","year":"2014","unstructured":"Fr\u00f6hlich-Zwahlen AK, Casartelli NC, Item-Glatthorn JF, Maffiuletti NA. Validity of resting myotonometric assessment of lower extremity muscles in chronic stroke patients with limited hypertonia: a preliminary study. J Electromyogr Kinesiology: Official J Int Soc Electrophysiological Kinesiol. 2014;24(5):762\u20139.","journal-title":"J Electromyogr Kinesiology: Official J Int Soc Electrophysiological Kinesiol"},{"issue":"3","key":"1901_CR35","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1007\/s00421-017-3550-z","volume":"117","author":"K Hirata","year":"2017","unstructured":"Hirata K, Kanehisa H, Miyamoto N. Acute effect of static stretching on passive stiffness of the human gastrocnemius fascicle measured by ultrasound shear wave elastography. Eur J Appl Physiol. 2017;117(3):493\u20139.","journal-title":"Eur J Appl Physiol"},{"issue":"3","key":"1901_CR36","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/j.jelekin.2014.03.002","volume":"24","author":"T Masood","year":"2014","unstructured":"Masood T, Bojsen-M\u00f8ller J, Kalliokoski KK, Kirjavainen A, \u00c1\u00e4rimaa V, Peter Magnusson S, et al. Differential contributions of ankle plantarflexors during submaximal isometric muscle action: a PET and EMG study. J Electromyogr Kinesiology: Official J Int Soc Electrophysiological Kinesiol. 2014;24(3):367\u201374.","journal-title":"J Electromyogr Kinesiology: Official J Int Soc Electrophysiological Kinesiol"},{"issue":"1","key":"1901_CR37","doi-asserted-by":"publisher","first-page":"13","DOI":"10.2340\/1650197771331","volume":"7","author":"AR Fugl-Meyer","year":"1975","unstructured":"Fugl-Meyer AR, J\u00e4\u00e4sk\u00f6 L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med. 1975;7(1):13\u201331.","journal-title":"Scand J Rehabil Med"},{"key":"1901_CR38","unstructured":"Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Lawrence Erlbaum Associates; 1988."},{"issue":"5","key":"1901_CR39","doi-asserted-by":"publisher","first-page":"483","DOI":"10.3109\/09638288.2016.1148785","volume":"39","author":"H Radinmehr","year":"2017","unstructured":"Radinmehr H, Nakhostin Ansari N, Naghdi S, Olyaei G, Tabatabaei A. Effects of one session radial extracorporeal shockwave therapy on post-stroke plantarflexor spasticity: a single-blind clinical trial. Disabil Rehabil. 2017;39(5):483\u201390.","journal-title":"Disabil Rehabil"},{"issue":"19","key":"1901_CR40","doi-asserted-by":"publisher","first-page":"4486","DOI":"10.1080\/09638288.2023.2278185","volume":"46","author":"DW Nada","year":"2024","unstructured":"Nada DW, El Sharkawy AM, Elbarky EM, Rageh ESM, Allam AES. Radial extracorporeal shock wave therapy as an additional treatment modality for spastic equinus deformity in chronic hemiplegic patients. A randomized controlled study. Disabil Rehabil. 2024;46(19):4486\u201394.","journal-title":"Disabil Rehabil"},{"issue":"4","key":"1901_CR41","doi-asserted-by":"publisher","first-page":"461","DOI":"10.5535\/arm.2013.37.4.461","volume":"37","author":"SW Moon","year":"2013","unstructured":"Moon SW, Kim JH, Jung MJ, Son S, Lee JH, Shin H, et al. The effect of extracorporeal shock wave therapy on lower limb spasticity in subacute stroke patients. Annals Rehabilitation Med. 2013;37(4):461\u201370.","journal-title":"Annals Rehabilitation Med"},{"issue":"10","key":"1901_CR42","doi-asserted-by":"publisher","first-page":"1660","DOI":"10.1002\/jor.22111","volume":"30","author":"T Kenmoku","year":"2012","unstructured":"Kenmoku T, Ochiai N, Ohtori S, Saisu T, Sasho T, Nakagawa K, et al. Degeneration and recovery of the neuromuscular junction after application of extracorporeal shock wave therapy. J Orthop Research: Official Publication Orthop Res Soc. 2012;30(10):1660\u20135.","journal-title":"J Orthop Research: Official Publication Orthop Res Soc"},{"issue":"9","key":"1901_CR43","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1177\/02692155241258740","volume":"38","author":"T Fan","year":"2024","unstructured":"Fan T, Chen R, Wei M, Zhou X, Zheng P, Zhou J, et al. Effects of radial extracorporeal shock wave therapy on flexor spasticity of the upper limb in post-stroke patients: A randomized controlled trial. Clin Rehabil. 2024;38(9):1200\u201313.","journal-title":"Clin Rehabil"},{"key":"1901_CR44","doi-asserted-by":"crossref","unstructured":"Mihai EE, Mihai IV, Berteanu M. Effectiveness of radial extracorporeal shock wave therapy and visual feedback balance training on lower limb Post-Stroke Spasticity, trunk Performance, and balance: A randomized controlled trial. J Clin Med. 2021; 11(1).","DOI":"10.3390\/jcm11010147"},{"key":"1901_CR45","doi-asserted-by":"crossref","unstructured":"Telford W, Geldard LP, Sheriff RE. Applied Geophysics: Cambridge University Press; 1990.","DOI":"10.1017\/CBO9781139167932"}],"container-title":["Journal of NeuroEngineering and Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12984-026-01901-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12984-026-01901-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12984-026-01901-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:10:21Z","timestamp":1781644221000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12984-026-01901-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,30]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1901"],"URL":"https:\/\/doi.org\/10.1186\/s12984-026-01901-2","relation":{},"ISSN":["1743-0003"],"issn-type":[{"value":"1743-0003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,30]]},"assertion":[{"value":"28 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee of Shenzhen Second People\u2019s Hospital (approval number 2023-269-02PJ). Written informed consent was obtained from all participants or their legal guardians before enrollment to ensure voluntary participation and full comprehension of the study objectives and potential risks.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"154"}}