Reznik, Jacqueline E., Gordon, Susan J., Barker, Ruth N., Keren, Ofer, Arama, Yuval, and Galea, Mary P. (2013) Extracorporeal shock wave therapy (ESWT) as a treatment for recurrent neurogenic heterotopic ossification (NHO). Brain Injury, 27 (2). pp. 242-247.

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Abstract

Primary objective: To describe the effects of extracorporeal shock wave therapy (ESWT) on neurogenic heterotopic ossification (NHO).

Research design: A single case study was considered the most appropriate methodology in this situation.

Methods and procedures: The subject was a 43 year old female 10 years post-traumatic brain injury with recurring NHO around the hip joint. Baseline assessments of pain using a 10-point VAS, range of motion of the hip using a goniometer and walking ability (number of steps over a standard distance) were conducted. Four applications of ESWT using a Minispec™ Extracorporeal Shock Wave Lithotripsy machine (Medispec Int. USA) administered over 6 weeks to the anterolateral aspect of the right hip. Follow-up assessments were conducted weekly over the period of intervention and then monthly for 5 months.

Main outcomes and results: Immediately following treatment, pain was reduced to 0 on the VAS scale; hip range of motion increased and the number of steps over a standard distance reduced, indicating increased step length. At 5-month follow-up, without further ESWT intervention, these results were maintained.

Conclusion: This case study suggests that ESWT may be a non-invasive, low risk intervention for the management of NHO.

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