Yoon Sang Ho, Shin Min Kyung, Choi Eun Jung, Kang Hyo Jung
Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea.
Ann Rehabil Med. 2017 Aug;41(4):547-555. doi: 10.5535/arm.2017.41.4.547. Epub 2017 Aug 31.
To compare the effect of extracorporeal shock-wave therapy (ESWT) applied at the muscle belly and myotendinous junction on spasticity in the upper and lower limbs of chronic stroke patients.
Of the 151 patients, a total of 80 patients with stroke-induced spasticity on the elbow flexor and 44 patients on the knee flexor were enrolled for a prospective, randomized clinical trial. The patients were divided into control, muscle belly, and myotendinous junction groups, and a total of three ESWT sessions (0.068-0.093 mJ/mm, 1,500 shots) were conducted at one per week. A Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS) were collected at the baseline and at 1 week after each session.
After interventions, the MAS and MTS of both the belly and the junction groups showed positive effects from the ESWT on spasticity in the elbow and knee flexors, but the control group did not. The results also tended to improve after each session until the entire intervention was completed. However, there was no significant difference between the belly and junction groups.
ESWT could be effective for treating chronic spasticity after stroke when applied to muscle belly or myotendinous junction.
比较在慢性卒中患者的上肢和下肢肌肉腹部及肌腱连接处进行体外冲击波疗法（ESWT）对痉挛的影响。
在151例患者中，共有80例肘屈肌有卒中后痉挛的患者和44例膝屈肌有卒中后痉挛的患者被纳入一项前瞻性随机临床试验。将患者分为对照组、肌肉腹部组和肌腱连接处组，共进行3次ESWT治疗（0.068 - 0.093 mJ/mm，1500次冲击），每周1次。在基线时以及每次治疗后1周收集改良Ashworth量表（MAS）和改良Tardieu量表（MTS）。
干预后，腹部组和连接处组的MAS和MTS均显示ESWT对肘屈肌和膝屈肌痉挛有积极作用，而对照组无此效果。每次治疗后结果也趋于改善，直至整个干预完成。然而，腹部组和连接处组之间无显著差异。
将ESWT应用于肌肉腹部或肌腱连接处时，对治疗卒中后的慢性痉挛可能有效。
