Could shock waves boost botox for Stroke-Related foot stiffness?

This trial investigates whether adding focused shock wave therapy to standard Botox injections can better ease foot stiffness and improve walking in people with post-stroke spastic equinovarus foot. Participants are randomly assigned to receive Botox alone, shock waves just before Botox, or shock waves two weeks after. The study measures changes in spasticity, ankle movement, muscle strength, and walking ability over a year to see if the timing of shock wave therapy makes a difference.