アブストラクト
| Title | 痙縮の評価と治療 |
|---|---|
| Subtitle | 特集 / 脳血管障害の片麻痺患者へのリハビリテーション治療マニュアル |
| Authors | 原貴敏* |
| Authors (kana) | はらたかとし |
| Organization | *国立精神・神経医療研究センター病院 / 東京慈恵会医科大学リハビリテーション医学講座, 講師 |
| Journal | MB Medical Rehabilitation |
| Volume | |
| Number | 282 |
| Page | 59-67 |
| Year/Month | 2022 / 12 |
| Article | 報告 |
| Publisher | 全日本病院出版会 |
| Abstract | 「Abstract」脳卒中後の上下肢麻痺痙縮に対しては, ボツリヌス療法(BoNT-A療法)を含めた様々な治療が存在する. 近年の痙縮に対してはBoNT-A療法が主流であるが, 多くのRCT論文から経頭蓋磁気刺激, 体外衝撃波治療などの物理的療法によるアプローチも有効である可能性が示唆されている. BoNT-A療法においては, 痙縮に対する確固たるエビデンス確立されており, 現在では機能の向上に向けたリハビリテーションの併用に関して注目が集まっている. 上下肢痙縮ともに集中的なリハビリテーションを併用すると機能の向上が期待でき, 特にNeurorehabilitationの併用は「痙縮に隠された随意性運動機能」を引き出す可能性が示唆される. また機能予後から介入前の筋の性状や運動機能が, 機能の改善度に影響することがわかってきている. |
| Practice | 医療技術 |
| Keywords | A型ボツリヌス毒素(botulinum toxin A), エラストグラフィー(elastography), バクロフェン髄注療法(intrathecal baclofen therapy; ITB), 経頭蓋磁気刺激(transcranial magnetic stimulation; TMS), 電気刺激(electrical stimulation; ES), 体外衝撃波治療(extracorporeal shock wave therapy; ESWT) |
- 全文ダウンロード： 従量制、基本料金制の方共に968円(税込) です。
参考文献
- 1) Lance JW, et al : Spasticity : Disordered Motor Control. Year Book Medical Publishers, 485-494, 1980.
- 2) Pandyan AD, et al : Spasticity : clinical percep-tions, neurological realities and meaningful mea-surement. Disabil Rehabil, 27(1-2) : 2-6, 2005.
- 3) Malhotra S, et al : Spasticity, an impairment that is poorly defined and poorly measured. Clin Rehabil, 23(7) : 651-658, 2009.
- 4) Luo Z, et al : Advanced quantitative estimation methods for spasticity : a literature review. J Int Med Res, 48(3) : 300060519888425, 2020.
- 5) Hara T, et al : Botulinum Toxin Therapy Com-bined with Rehabilitation for Stroke : A System-atic Review of Effect on Motor Function. Toxins(Basel), 11(12) : 707, 2019.
残りの36件を表示する
- 6) Balci BP : Spasticity Measurement. Noro Psiki-yatr Ars, 55(Suppl 1) : S49-S53, 2018.
- 7) Fleuren JF, et al : Stop using the Ashworth Scale for the assessment of spasticity. J Neurol Neuro-surg Psychiatry, 81(1) : 46-52, 2010.
- 8) Boyd RN, et al : Objective measurement of clini-cal findings in the use of botulinum toxin type A for the management of children with cerebral palsy. Eur J Neurol, 6 : s23-s35, 1999.
- 9) Shu X, et al : Validity and reliability of the Modified Tardieu Scale as a spasticity outcome measure of the upper limbs in adults with neu-rological conditions : a systematic review and narrative analysis. BMJ Open, 11(12) : e050711, 2021.
- 10) Hara T, et al : Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on lower limb spasticity classified by spastic mus-cle echo intensity in post-stroke patients. Int J Neurosci, 128(5) : 412-420, 2018.
- 11) Lehoux MC, et al : Shear wave elastography potential to characterize spastic muscles in stroke survivors : Literature review. Clin Bio-mech(Bristol, Avon), 72 : 84-93, 2020.
- 12) Gao J, et al : Ultrasound Elastography to Assess Botulinum Toxin A Treatment for Post-stroke Spasticity : A Feasibility Study. Ultrasound Med Biol, 45(5) : 1094-1102, 2019.
- 13) Askin A, et al : Strain sonoelastographic evalua-tion of biceps muscle intrinsic stiffness after botulinum toxin-A injection. Top Stroke Rehabil, 24(1) : 12-17, 2017.
- 14) Simpson DM, et al : Practice guideline update summary : Botulinum neurotoxin for the treat-ment of blepharospasm, cervical dystonia, adults pasticity, and headache : Report of the Guide-line Development Subcommittee of the Ameri-can Academy of Neurology. Neurology, 86(19) : 1818-1826, 2016.
- 15) Schiess MC, et al : Prospective 12-month study of intrathecal baclofen therapy for poststroke spastic upper and lower extremity motor con-trol and functional improvement. Neuromodula-tion, 14(1) : 38-45, 2011.
- 16) Creamer M, et al : Effect of Intrathecal Baclofen on Pain and Quality of Life in Poststroke Spas-ticity. Stroke, 49(9) : 2129-2137, 2018.
- 17) McIntyre A, et al : A Systematic Review and Meta-Analysis on the Use of Repetitive Tran-scranial Magnetic Stimulation for Spasticity Poststroke. PM R, 10(3) : 293-302, 2018.
- 18) Liu Y, et al : A Meta-Analysis : Whether Repeti-tive Transcranial Magnetic Stimulation Improves Dysfunction Caused by Stroke with Lower Limb Spasticity. Evid Based Complement Alternat Med, 2021 : 7219293, 2021.
- 19) Xu P, et al : Repetitive transcranial magnetic stimulation as an alternative therapy for stroke with spasticity : a systematic review and meta-analysis. J Neurol, 268(11) : 4013-4022, 2021.
- 20) Avvantaggiato C, et al : Localized muscle vibra-tion in the treatment of motor impairment and spasticity in post-stroke patients : a systematic review. Eur J Phys Rehabil Med, 57(1) : 44-60, 2021.
- 21) Mahmood A, et al : Effect of Transcutaneous Electrical Nerve Stimulation on Spasticity in Adults With Stroke : A Systematic Review and Meta-analysis. Arch Phys Med Rehabil, 100(4) : 751-768, 2019.
- 22) Lin S, et al : Influence of transcutaneous electri-cal nerve stimulation on spasticity, balance, and walking speed in stroke patients : A systematic review and meta-analysis. J Rehabil Med, 50(1) : 3-7, 2018.
- 23) Opara J, et al : The Current State of Knowledge on the Clinical and Methodological Aspects of Extracorporeal Shock Waves Therapy in the Management of Post-Stroke Spasticity-Over-view of 20 Years of Experiences. J Clin Med, 10(2) : 261, 2021.
- 24) Cabanas-Valdes R, et al : The effectiveness of extracorporeal shock wave therapy for improv-ing upper limb spasticity and functionality in stroke patients : a systematic review and meta-analysis. Clin Rehabil, 34(9) : 1141-1156, 2020.
- 25) Hsu PC, et al : Comparative Effectiveness of Botulinum Toxin Injections and Extracorporeal Shockwave Therapy for Post-Stroke Spastic-ity : A Systematic Review and Network Meta-Analysis. EClinicalMedicine, 43 : 101222, 2021.
- 26) Dos Santos RBC, et al : Cortical and spinal excit-ability changes after repetitive transcranial magnetic stimulation combined to physiother-apy in stroke spastic patients. Neurol Sci, 40(6) : 1199-1207, 2019.
- 27) De Gail P, et al : Differential effects on tonic and phasic reflex mechanisms produced by vibration of muscles in man. J Neurol Neurosurg Psychia-try, 29(1) : 1-11, 196.
- 28) Eklund G, et al : Normal variability of tonic vibration reflexes in man. Exp Neurol, 16 : 80-92, 1966.
- 29) Rocchi L, et al : Plasticity Induced in the Human Spinal Cord by Focal Muscle Vibration. Front Neurol, 9 : 935, 2018.
- 30) Martins FL, et al : Immediate effects of TENS and cryotherapy in the reflex excitability and voluntary activity in hemiparetic subjects : a randomized crossover trial. Rev Bras Fisioter, 16(4) : 337-344, 2012.
- 31) Kim TH, et al : Task-related training combined with transcutaneous electrical nerve stimulation promotes upper limb functions in patients with chronic stroke. Tohoku J Exp Med, 231(2) : 93-100, 2013.
- 32) Tinazzi M, et al : Long-lasting modulation of human motor cortex following prolonged trans-cutaneous electrical nerve stimulation(TENS)of forearm muscles : evidence of reciprocal inhibi-tion and facilitation. Exp Brain Res, 161(4) : 457-464, 2005.
- 33) Manganotti P, et al : Long-term effect of shock wave therapy on upper limb hypertonia in patients affected by stroke. Stroke, 36(9) : 1967-1971, 2005.
- 34) Yoon SH, et al : Effective Site for the Application of Extracorporeal Shock-Wave Therapy on Spasticity in Chronic Stroke : Muscle Belly or Myotendinous Junction. Ann Rehabil Med, 41(4) : 547-555, 2017.
- 35) Hara T, et al : Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on upper and lower limb spasticity in post-stroke patients. Int J Neurosci, 127(6) : 469-478, 2017.
- 36) Wallace AC, et al : Exploratory Randomized Double-Blind Placebo-Controlled Trial of Botuli-num Therapy on Grasp Release After Stroke(PrOMBiS). Neurorehabil Neural Repair, 34(1) : 51-60, 2020.
- 37) Hara T, et al : Prognosis prediction of the effect of botulinum toxin therapy and intensive reha-bilitation on the upper arm function in post-stroke patients using hierarchical cluster analy-sis. Disabil Rehabil, 44(22) : 6815-6823, 2022.
- 38) Foley N, et al : Does the treatment of spastic equinovarus deformity following stroke with botulinum toxin increase gait velocity? A sys-tematic review and meta-analysis. Eur J Neurol, 17(12) : 1419-1427, 2010.
- 39) Varvarousis DN, et al : The effectiveness of botulinum toxin on spasticity and gait of hemi-plegic patients after stroke : A systematic review and meta-analysis. Toxicon, 203 : 74-84, 2021.
- 40) Hara T, et al : The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients. Toxins(Basel), 10(9) : 349, 2018.
- 41) Cofre Lizama LE, et al : Beyond speed : Gait changes after botulinum toxin injections in chronic stroke survivors(a systematic review). Gait Posture, 70 : 389-396, 2019.
