뇌졸중 환자에서 체외충격파치료가 하지 기능 및 경직에 미치는 효과에 대한 연구

다국어 초록 (Multilingual Abstract)

Objective
To evaluate the effect of extracorporeal shock wave therapy(ESWT) on lower limb spasticity in chronic stroke patient.

Method
We studied thirty hemiplegic chronic stroke patients with ankle plantar flexor spasticity. ESWT was applied 1 session/week, total 3 sessions at musculotendinous junction of medial and lateral gastrocnemius muscles. Patients were evaluated both clinically and biomechanically at baseline, after sham stimulation, and at immediately, 1 week, and 4 weeks after ESWT. For clinical assessment, modified Ashworth scale(MAS), clonus score(CS), passive range of motion of ankle(PROM), and Fugl-Myer assessment(FMA) for the lower extremity were used. Biomechanical assessment of spasticity was done by isokinetic dynamometer. Two parameters, peak eccentric torque(PET) and torque threshold angle(TTA) were analyzed at the velocities of 60°/sec, 180°/sec, and 240°/sec.

Result
After sham stimulation, there were no significant changes between each assessment. MAS, PET(180°/sec and 240°/sec) were significantly improved immediately and 1 week after ESWT, but were not significantly changed at 4 weeks after ESWT. PET(60°/sec) and TTA(60°/sec, 180°/sec, and 240°/sec) were significantly improved immediately after ESWT, but were not significantly changed at 1 week and 4 weeks after ESWT.

Conclusion
Lower limb spasticity in chronic stroke patients was significantly improved immediately after ESWT. Although therapeutic effect of ESWT reduced with time so was not significant at 4 weeks after ESWT, the degree of spasticity was lower than the baseline. Future studies with a larger sample of patients to verify protocols that can optimize the effect of ESWT on spasticity are warranted.

목차 (Table of Contents)

• I. 서론 1
• II. 연구 대상 및 방법 2
• III. 결과 5
• IV. 고찰 7
• V. 결론 12
• 참고 문헌 20