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실시간 탄성초음파를 이용한 만성 뇌졸중 후 편마비 환자의 상지 강직에 대한 사암침 효과 연구

Study of the Effects of Sa-am Acupuncture on Upper Limb Spasticity in Patients with Chronic Post-stroke Hemiparesis using Real-time Sonoelastography

박기영|권동락|백경민
대한한방내과학회 (The Society Of Korean Oriental Internal Medicine)|2014.03|대한한방내과학회지 (The Journal of Korean Oriental Internal Medicine)|제35권 제1호|pp. 1-11|DOI .

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참고문헌

키워드

strokeSa-am acupunctureSonoelastographyspasticityGanseunggyeok
주제분류한의학

초록

Objectives : To investigate the effects of Sa-am acupuncture on muscle architecture and elastic properties of the spastic elbow flexor and to evaluate the correlation between clinical findings and parameters of real-time sonoelastography (RTS) in patients with chronic post-stroke hemiparesis. Materials and Methods : Seven patients (five males, two females) with chronic post-stroke hemiparesis were included. Sa-am acupuncture of Ganseunggyeok (肝勝格: LU8 LR4 補, HT8 LR2 瀉) was applied to the unaffected side 3 times a week for 4 weeks. During each acupuncture treatment period, patients were requested to exercise their affected arm, and spasticity and functional recovery outcomes of the affected arm were evaluated before and after Sa-am acupuncture treatment. Clinical outcomes were assessed using motricity index (MI), modified Ashworth scale (MAS), Fugl-Meyer assessment scale (FMA) and modified Barthel index (MBI) for elbow flexor spasticity. RTS images indicate the relative hardness of the examined muscles ranged from red (hard) to purple (soft) for color-scale, and from black (hard) to white (soft) for hue scale. Color and hue histograms of the biceps brachii and brachialis were analyzed using Image J software, and median red, blue, and hue pixel intensity were obtained. Results : MI and FMA score significantly increased and MAS score significantly decreased (p<0.05). F-wave maximal amplitude of affected abductor pollicis brevis significantly decreased (p<0.05). Muscle thickness of affected brachialis significantly increased (p<0.05). Red and green pixel intensity of affected brachialis significantly decreased (p<0.05). Conclusions : Our study revealed that Sa-am acupuncture is effective as a useful and safe treatment for spasticity in chronic post-stroke hemiparesis.

Abstract

Objectives : To investigate the effects of Sa-am acupuncture on muscle architecture and elastic properties of the spastic elbow flexor and to evaluate the correlation between clinical findings and parameters of real-time sonoelastography (RTS) in patients with chronic post-stroke hemiparesis. Materials and Methods : Seven patients (five males, two females) with chronic post-stroke hemiparesis were included. Sa-am acupuncture of Ganseunggyeok (肝勝格: LU8 LR4 補, HT8 LR2 瀉) was applied to the unaffected side 3 times a week for 4 weeks. During each acupuncture treatment period, patients were requested to exercise their affected arm, and spasticity and functional recovery outcomes of the affected arm were evaluated before and after Sa-am acupuncture treatment. Clinical outcomes were assessed using motricity index (MI), modified Ashworth scale (MAS), Fugl-Meyer assessment scale (FMA) and modified Barthel index (MBI) for elbow flexor spasticity. RTS images indicate the relative hardness of the examined muscles ranged from red (hard) to purple (soft) for color-scale, and from black (hard) to white (soft) for hue scale. Color and hue histograms of the biceps brachii and brachialis were analyzed using Image J software, and median red, blue, and hue pixel intensity were obtained. Results : MI and FMA score significantly increased and MAS score significantly decreased (p<0.05). F-wave maximal amplitude of affected abductor pollicis brevis significantly decreased (p<0.05). Muscle thickness of affected brachialis significantly increased (p<0.05). Red and green pixel intensity of affected brachialis significantly decreased (p<0.05). Conclusions : Our study revealed that Sa-am acupuncture is effective as a useful and safe treatment for spasticity in chronic post-stroke hemiparesis.

참고문헌 (36)

  1. McGuire JR, "The prevention and management of complications after stroke", Phys Med Rehabil Clin North Am, 10, pp.857~874 (1999)
  2. 김진호, "재활의학", pp.263~288 (2003), 군자출판사
  3. 한태륜, "편마비 환자에서의 경직의 평가", 대한재활의학회지, 17(1), pp.18~25 (1993)
  4. 김연희, "뇌졸중 재활치료를 위한 한국형 표준 진료 지침", Brain & Neuro Rehabilitation, 2, pp.1~38 (2009)
  5. 대한뇌졸중학회, "뇌졸중", pp.424~ (2009), 이퍼블릭
  6. 김용석, "중풍경직에 전침, TENS 및 신경근 자극기의 효과에 대한 연구", 대한침구학회지, 17(2), pp.209~220 (2000)
  7. Fink M, "Needle acupuncture in chronic post-stroke leg spasticity", Arch Phys Med Rehabil, 85(4), pp.667~672 (2004)
  8. Wayne PM, "Acupuncture for upper-extremity rehabilitation in chronic stroke: a randomized sham-controlled study", Arch Phys Med Rehabil, 86(12), pp.2248~2255 (2005)
  9. Moon SK, "Antispastic Effet of Electroacupuncture and Moxibusion in Stroke Patients", Am J Chin Med, 31(3), pp.467~474 (2003)
  10. 노주환, "중풍 환자의 상지 경직에 대한 봉약침의 효과", 대한침구의학회지, 27(4), pp.115~124 (2010), 대한침구의학회
  11. 유진호, "전침자극이 중풍환자의 경직에 미치는 효과", 대한침구학회지, 16(2), pp.1~12 (1999)
  12. Kang SK, "Effectiveness of Electroacupuncture on Sapsticity in Stroke Patients", Journal of Oriental Medicine, 2(1), pp.25~32 (1997)
  13. 심우진, "중풍 주관절 경직에 대한 음경과 양경 전침 효과의 비교", 한방재활의학과학회지, 13(1), pp.95~111 (2003)
  14. 이선우, "뇌졸중 환자의 상지 경직에 대한 전침의 치료 효과", 대한한방내과학회지, 28(3), pp.492~501 (2007), 대한한방내과학회
  15. 주현욱, "사암침법", pp.73~74 (2005), 대성의학사
  16. Bipin BB, "Management of Spasticity in Stroke", Br Med Bull, 56(2), pp.476~485 (2000)
  17. Lalith E, "Sarkunam. Rehabilitation medicine: 3. Management of adult spasticity", CMAJ, 169(11), pp.1173~1179 (2003)
  18. 張伯景, "中醫內科學", pp.469~470 (1988), 人民衛生出版社
  19. 김영석, "임상중풍학", pp.350~454 (1997), 서원당
  20. 홍원식, "校勘直譯 황제내경소문", pp.500~ (1996), 전통문화연구회
  21. 張介賓, "景岳全書", pp.203~215 (1988), 대성문화사
  22. 박영희, "테이핑이 편마비 환자의 주관절 경직에 미치는 영향", 한방재활의학과학회지, 11(1), pp.159~171 (2001)
  23. 노주환, "중풍 환자의 하지 경직에 대한 자하거 약침의 효과 연구", Journal of Pharmacopuncture, 12(4), pp.97~110 (2009), 대한약침학회
  24. 임종국, "침구치료학", pp.647~ (1983), 집문당
  25. 전국한의과대학 침구경혈학교실, "침구학(하)", pp.1132~1136 (1993), 집문
  26. 사암도인, "사암오행침해설", pp.17~18 (1983), 음양맥진출판사
  27. 박영수, "뇌졸중 환자에서 사암침의 혈압강하에 대한 고찰", 대한침구의학회지, 21(4), pp.217~224 (2004), 대한침구의학회
  28. 송민식, "중풍후 언어장애 환자 20례에 대한 체침과 사암침 치료의 임상적 비교 고찰", 대한침구의학회지, 20(6), pp.16~ (2003), 대한침구의학회
  29. 홍권의, "만성 긴장성 두통 환자에 대한 사암침 치료효과의 Pilot 임상연구", 대한침구의학회지, 24(1), pp.13~28 (2007), 대한침구의학회
  30. 김경조, "월오사암오행침요법", pp.436~ (2007), 월오사암
  31. Bohannon RW, "Motricity index scores are valid indicators of paretic upper extremity strength following stroke", J Phys Ther Sci, 11(2), pp.59~62 (1999)
  32. Gladstone DJ, "The Fugl-Meyer assessement of motor recovery after stroke: a critical review of its measurement properties", Neurorehabil Neural Repair, 16(3), pp.232~240 (2002)
  33. Kaya T, "Inter-rater reliability of the modified Ashworth scale and modified modified ashworth scale in assessing poststroke elbow flexor spasticity", Int J Rehabil Res, 34(1), pp.59~64 (2011)
  34. Milanov IG, "F-wave for assessment of segmental mononeurone excitability", Electromyogr Clin Neurophysiol, 32(1), pp.11~15 (1992)
  35. Fisher MA, "F", M ratios in polyneuropathy and spastic hyperreflexia, 1988, pp.11, 217~222
  36. Kwo DR, "Diagnostic value of real-time sonoelastography in congenital muscular torticollis", J Ultrasound Med, 31, pp.721~727 (2012)

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