| 저자 |
Sang Ho Yoon1*, Min Kyung Shin1, Hyo Jung Kang 1†, Hee Seung Yang1, Won Jae Lee1, Hea Eun Yang1, Dae Hyun Kim1, Hyo Jung Kang1† |
OBJECTIVE
Spasticity is defined as a velocity-dependent resistance against passive range of joint motion, which frequently appeared in patients with stroke. Treatments of spasticity include therapeutic exercise, motor point block and medications. Excessive spasticity interferes with rehabilitation. Recently, there have been some reports that extracorporeal shock wave therapy (ESWT) could be effective for treating spasticity. Previous studies have focused on the effect of ESWT in spasticity. However, few studies have assessed the precise site in muscles of the upper and lower extremities. The aim of this study was to investigate and compare the effect of ESWT in stroke patients with elbow and knee flexor spasticity by applying at muscle belly or myotendinous junction.
MATERIALS AND METHOD
This study was a prospective, single-blind, controlled study. Of 80 stroke patients with elbow flexor spasticity, 26 patients were enrolled into sham group (G1), 26 into muscle belly group (G2), and 28 into myotendinous junction group (G3). Of 44 stroke patients with knee flexor spasticity, 18 patients were enrolled into sham group (G1), 13 into muscle belly group (G2), and 13 into myotendinous junction group (G3). All patients were assessed for the site of ESWT application by using ultrasonography, and then completed a total of 3 ESWTs at each site once every week. Modified Ashworth scale (MAS) and the angle in which a catch or clonus was found during a quick stretch were used to evaluate elbow and knee flexor spasticity before intervention and after each session.
RESULTS
After 3 sessions, there were significant effects of ESWT on spasticity in G2 and G3 compared with G1 in both elbow and knee flexor groups (Table 1). However, there was no significant difference between G2 and G3 in both elbow and knee flexor groups (p=0.919 in elbow flexor, p=0.082 in knee flexor). Furthermore, the effect progressively increase in G2 and G3 through 3 sessions, which was significant until 2nd session of ESWT in elbow flexor (Fig.1).
CONCLUSION
These results showed that ESWT significantly decreased the stroke induced spasticity in the elbow and knee flexors applying on both muscle belly and myotendinous junction. Furthermore, the effect of ESWT was significant until 2nd sessions in elbow flexor spasticity. This study suggested that the ESWT could be a good treatment for stroke induced spasticity
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