Radinmehr Hojjat, Ansari Noureddin Nakhostin, Naghdi Soofia, Tabatabaei Azade, Moghimi Ehsan
Department of Physiotherapy, School of Rehabilitation, Hamadan University of Medical Science, Hamadan, Iran.
Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Science, Tehran, Iran; Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
J Stroke Cerebrovasc Dis. 2019 Jun;28(6):1546-1554. doi: 10.1016/j.jstrokecerebrovasdis.2019.03.008. Epub 2019 Mar 30.
This study aimed to compare the effects of therapeutic ultrasound (US) and radial extracorporeal shock wave therapy (rESWT) in the treatment of plantar flexor spasticity after stroke.
In this prospective, single-blind, randomized clinical trial, 32 patients (age range 42-78 years; male 19) with stroke were randomly divided into two groups: The US group (n = 16) received the continuous ultrasound, intensity 1.5 w/cm, frequency 1 MHz, and duration 10 minutes. The rESWT group (n = 16) was treated with rESWT, 0.340 mJ/mm, 2000 shots. Both groups received the treatments for 1 session. The H-reflex tests of H/M ratio and H-reflex latency, the Modified Modified Ashworth Scale (MMAS), active range of motion (AROM), passive range of motion (PROM), passive plantar flexor torque (PPFT), and the timed "up and go" test (TUG) were blinded assessed at baseline (T0), immediately post-treatment (T1), and one hour follow-up (T2).
The H-reflex tests did not improve across the groups. However, the MMAS spasticity scores, AROM and PROM, PPFT, and TUG improved significantly within groups. The results found no significant differences between groups for all outcome measures.
The US and rESWT had similar effects, and the rESWT was not more effective than the US in improving ankle plantar flexor spasticity after stroke.
本研究旨在比较治疗性超声（US）和径向体外冲击波疗法（rESWT）治疗中风后跖屈肌痉挛的效果。
在这项前瞻性、单盲、随机临床试验中，32例中风患者（年龄范围42 - 78岁；男性19例）被随机分为两组：超声组（n = 16）接受连续超声治疗，强度1.5 w/cm，频率1 MHz，持续时间10分钟。体外冲击波疗法组（n = 16）接受体外冲击波疗法，能量为0.340 mJ/mm，2000次冲击。两组均接受1次治疗。在基线（T0）、治疗后即刻（T1）和1小时随访（T2）时，对H/M比值和H反射潜伏期的H反射测试、改良的Ashworth量表（MMAS）、主动活动范围（AROM）、被动活动范围（PROM）、被动跖屈扭矩（PPFT）以及定时起立行走测试（TUG）进行盲法评估。
各组的H反射测试均未改善。然而，各组内MMAS痉挛评分、AROM和PROM、PPFT以及TUG均有显著改善。结果发现，所有结局指标在两组之间均无显著差异。
超声和体外冲击波疗法具有相似的效果，在改善中风后踝关节跖屈肌痉挛方面，体外冲击波疗法并不比超声更有效。
