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桡侧体外冲击波疗法对脑卒中后患者手部痉挛的影响。

Effects of radial extracorporeal shock wave therapy on hand spasticity in poststroke patient.

作者信息

Gjerakaroska Savevska C, Nikolikj Dimitrova E, Gocevska M

机构信息

Institute for Physical and Rehabilitation Medicine, Medical Faculty, "Ss Ciryl and Methodius" University, Skopje, F.Y.R. of Macedonia.

出版信息

Hippokratia. 2016 Oct-Dec;20(4):309-312.

Abstract

BACKGROUND

Hand spasticity after a stroke greatly increases the difficulties of the daily living activities and limits the effectiveness of rehabilitation. Radial extracorporeal shock wave therapy (RESWT) has been suggested as an alternative treatment for spasticity reduction. We demonstrate the effectiveness of RESWT regarding hand spasticity in a stroke patient.

CASE DESCRIPTION

We describe the case of a 42-year-old woman with right hemiparesis after ischaemic stroke. Her right arm was plegic with increased spasticity. The patient received a total of six RESWT treatments. Clinical evaluation was performed using the Modified Ashworth Scale, passive dorsal flexion of the wrist and the Disability Assessment Scale (DAS). The measurements were made before initiation, immediately after the sixth treatment, one and three months after the RESWT. Immediately after the RESWT there was a reduction of the spasticity of the hand and fingers and increased passive range of motion of the affected wrist, as well as decreased DAS score. These effects lasted for four weeks. With time, the therapeutic effect regarding spasticity decreased, but three months following termination of treatment there was a better clinical result than before initiation of treatment.

CONCLUSION

RESWT is a safe alternative treatment for hand and fingers spasticity reduction after stroke.  Hippokratia 2016, 20(4): 309-312.

摘要

背景

中风后手痉挛极大地增加了日常生活活动的难度,并限制了康复效果。桡侧体外冲击波疗法(RESWT)已被建议作为减轻痉挛的一种替代治疗方法。我们证明了RESWT对一名中风患者手部痉挛的有效性。

病例描述

我们描述了一名42岁女性缺血性中风后右侧偏瘫的病例。她的右臂瘫痪且痉挛加重。该患者总共接受了6次RESWT治疗。使用改良Ashworth量表、腕关节被动背屈和残疾评估量表(DAS)进行临床评估。测量在开始治疗前、第6次治疗后即刻、RESWT治疗后1个月和3个月进行。RESWT治疗后即刻,手部和手指的痉挛减轻,患侧腕关节的被动活动范围增加,DAS评分降低。这些效果持续了4周。随着时间的推移,痉挛的治疗效果下降,但治疗终止3个月后临床结果比治疗开始前更好。

结论

RESWT是中风后减轻手部和手指痉挛的一种安全的替代治疗方法。《希波克拉底》2016年,20(4): 309 - 312。

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