The Effects of Extracorporeal Shock Wave Therapy on Spasticity in Chronic Stroke Patients
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Objective To evaluate the immediate and short term effects of extracorporeal shock wave therapy (ESWT) on elbow flexor spasticity after stroke, to compare the treatment effects according to the ESWT applied site (muscle group and musculotendinous junction group) and to assess the factors affecting the treatment effect. Method A total of 32 stroke patients were enrolled, 23 of them were ESWT group and 9 were control group. ESWT was applied 1 session/week, total 3 sessions and 12 patients were applied at biceps muscle belly and 11 patients were applied at biceps musculotendinosus junction. Patients were evaluated using modified Ashworth scale (MAS), modified Tardieu scale (MTS), Korean-modified Barthel index (K-MBI) at baseline, immediately, 1 week and 4 weeks after ESWT. Results MAS and MTS were significantly improved immediately after ESWT, but were not significantly changed at 1 week, 4 weeks in ESWT group. The scores of K-MBI improved but were not different between ESWT group and control group. The treatment effect was greater in musculotendinous junction group than muscle belly group in MTS and MAS immediately after ESWT. We could not find out any significant factors affecting the effects of ESWT. Conclusion Spasticity after chronic stroke improved immediately after ESWT, but was not changed significantly at 1 week and 4 weeks after ESWT. Further studies about ESWT parameters for spasticity and factors affecting treatment effect are needed.
Abstract
Objective To evaluate the immediate and short term effects of extracorporeal shock wave therapy (ESWT) on elbow flexor spasticity after stroke, to compare the treatment effects according to the ESWT applied site (muscle group and musculotendinous junction group) and to assess the factors affecting the treatment effect. Method A total of 32 stroke patients were enrolled, 23 of them were ESWT group and 9 were control group. ESWT was applied 1 session/week, total 3 sessions and 12 patients were applied at biceps muscle belly and 11 patients were applied at biceps musculotendinosus junction. Patients were evaluated using modified Ashworth scale (MAS), modified Tardieu scale (MTS), Korean-modified Barthel index (K-MBI) at baseline, immediately, 1 week and 4 weeks after ESWT. Results MAS and MTS were significantly improved immediately after ESWT, but were not significantly changed at 1 week, 4 weeks in ESWT group. The scores of K-MBI improved but were not different between ESWT group and control group. The treatment effect was greater in musculotendinous junction group than muscle belly group in MTS and MAS immediately after ESWT. We could not find out any significant factors affecting the effects of ESWT. Conclusion Spasticity after chronic stroke improved immediately after ESWT, but was not changed significantly at 1 week and 4 weeks after ESWT. Further studies about ESWT parameters for spasticity and factors affecting treatment effect are needed.
참고문헌 (27)
- Lance JW, "The control of muscle tone, reflexes, and movement: Robert Wartenberg Lecture", Neurology, 30, pp.1303~1313 (1980)
- Barker WH, "Stroke in a defined elderly population, 1967-1985. A lesser lethal and disabling but no less common disease", Stroke, 28, pp.284~290 (1997)
- Warkins CL, "Prevalence of spasticity post stroke", Clin Rehabil, 16, pp.515~522 (2002)
- Welmer AK, "Spasticity and its association with functioning and health-related quality of life 18 months after stroke", Cerebrovasc Dis, 21, pp.247~253 (2006)
- Bhakta BB, "Management of spasticity in stroke", Br Med Bull, 56, pp.476~485 (2000)
- Lundstrom E, "Four-fold increase in direct costs of stroke survivors with spasticity compared with stroke survivors without spasticity: the first year after the event", Stroke, 41, pp.319~324 (2010)
- Satkunam LE, "Rehabilitation medicine: 3. Management of adult spasticity", CMAJ, 169, pp.1173~1179 (2003)
- Nielsen JB, "The spinal pathophysiology of spasticity-from a basic science point of view", Aceta Physiol, 189, pp.171~180 (2007)
- Foran JR, "Structural and mechanical alterations in spastic skeletal muscle", Dev Med Child Neurol, 47, pp.713~717 (2005)
- Mirbagheri MM, "Intrinsic and reflex stiffness in normal and spastic, spinal cord injured subjects", Exp Brain Res, 141, pp.446~459 (2001)
- 유승돈, "뇌졸중 환자에서 체외충격파 치료기의 상지 경직에 대한 효과", Annals of Rehabilitation Medicine, 32(4), pp.406~410 (2008), 대한재활의학회
- Manganotti P, "Long-term effect of shock wave therapy on upper limb hypertonia in patients affected by stroke", Stroke, 36, pp.1967~1971 (2005)
- Boyd RN, "Management of upper limb dysfunction in children with cerebral palsy: a systemic review", Eur J Nuerol, 8(Suppl.5), pp.150~166 (2001)
- Hansson GA, "Measurements of wrist and forearm positions and movements: effect of, and compensation for, goniometer crosstalk", J Electromyogr Kinesiol, 14, pp.355~367 (2004)
- Auge BK, "Update on shock wave lithotripsy technology", Curr Opin Urol, 12, pp.287~290 (2002)
- Preminger GM, "Sonographic piezoelectric lithotripsy: more bang for your buck", J Endourol, 3, pp.321~327 (1989)
- Folberth W, "Pressure distribution and energy flow in the focal region of two different electromagnetic shock wave sources", J Stone Dis, 4, pp.1~7 (1992)
- Loew M, "Shock-wave therapy is effective for chronic calcifying tendinitis of the shoulder", J Bone Joint Surg Br, 81, pp.863~867 (1999)
- Mouzopoulos G, "Extracorporeal shock wave treatment for shoulder calcific tendinitis: a systematic review", Skeletal Radiol, 36, pp.803~811 (2007)
- Leone JA, "Effects of tendon pressure on alpha motoneuron excitability in patients with stroke", Phys Ther, 68, pp.475~480 (1988)
- Bobath K, "Spastic paralysis treatment of by the use of reflex inhibition", Br J Phys Med, 13, pp.121~127 (1950)
- Mirbagheri MM, "Time course of changes in neuromuscular properties following stroke", Conf Proc IEEE Eng Med Biol Soc, 2008, pp.5097~5100 (2008)
- Fellow SJ, "The limitations of the tendon jerk as a marker of pathological stretch reflex activity in human spasticity", J Neurol Neurosurg Psychiatry, 56, pp.531~537 (1993)
- Given JD, "Joint dependent passive stiffness in paretic and contralateral limbs of spastic patients with hemiparetic stroke", J Neurol Neuosurg Psychiatry, 59, pp.271~279 (1995)
- Biering-Sorensen F, "Spasticity-assessment: a review", Spinal cord, 44, pp.708~722 (2006)
- Voerman GE, "Neurophysiological methods for the assessment of spasticity: the Hoffmann reflex, the tendon reflex, and the stretch reflex", Disabil Rehabil, 27, pp.33~68 (2005)
- Carmeli E, "The physiology and biochemistry of skeletal muscle atrophy as a function of age", Proc Soc Exp Biol Med, 206, pp.103~113 (1994)