Effect of Extracorporeal Shock Wave and Peripheral Magnetic Stimulation on Spastic CP Children

Hypotheses:There will be an effect of radial extracorporeal shock wave therapy and peripheral magnetic stimulation on the following parameters, in children with spastic hemiplegia:Wrist flexors spasticity.Wrist joint range of motion.Hand grip muscles strength.Sensorimotor function of wrist and hand.

Inclusion Criteria:• Spastic hemiplegic children will be included in this study.The children ages will be ranged from 6-10 years chronologically.Children will have wrist flexors degree of spasticity ranged from +1 to 2 on Modified Ashworth Scale.The children will have Level III to Level IV according to the Manual Ability Classification System.All children will be medically stable.Children take their anti-spasticity medications.All children will be able to follow instructions.Exclusion Criteria:• History of recent nonunion fracture of the upper extremities.Neurological or orthopedic surgery in the upper extremities in the last 12 months before the study.Received Botulinum toxin A injections in the last six months.Fixed contractures and deformities.Patients with a self-contained medical implant such as: a metal plate along the spastic limbs, pacemaker, cochlear implant, and so on.Children with cognitive dysfunction.Poor skin integrity.