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KMID : 0361420160400050862
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Journal of Korean Academy of Rehabilitation Medicine
2016 Volume.40 No. 5 p.862 ~ p.870
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Effects of Extracorporeal Shockwave Therapy in Chronic Stroke Patients With Knee Osteoarthritis: A Pilot Study
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Cho Sung-Jun
Yang Ja-Ryung
Yang Hee-Seung
Yang Hea-Eun
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Abstract
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Objective: To evaluate the effects of extracorporeal shockwave therapy (ESWT) on pain, function, and ultrasonographic features of chronic stroke patients with knee osteoarthritis (OA).
Methods: A total of 18 chronic stroke patients (33 knee joints) with unilateral or bilateral knee OA (Kellgren-Lawrence grade ≥1) were enrolled in this study. The patients were randomly allocated to an experimental group receiving ESWT (n=9) or a control group receiving sham ESWT (n=9). For the ESWT group, patients received 1,000 pulses weekly for 3 weeks, totaling to an energy dose of 0.05 mJ/mm2 on the proximal medial tibia of the affected knee. The assessments were performed before the treatment, immediately after the first treatment, and 1 week after the last treatment using the following: the visual analog scale (VAS) for pain; patient perception of the clinical severity of OA; the Korean version of Modified Barthel Index (ambulation and chair/bed transfer); the Functional Independence Measure scale (FIM; bed/chair/wheelchair transfer, toilet transfer, walking, and stairs); and ultrasonographic features (articular cartilage thickness, Doppler activity, and joint effusion height).
Results: The experimental group showed a significant improvement in VAS score (4.50±1.87 to 2.71±1.38) and patient perception of the clinical severity of OA (1.87±0.83 to 2.75±0.46). The bed/chair/wheelchair transfer components of the FIM score also improved significantly (4.12±1.55 to 4.62±1.30). In terms of the ultrasonographic features, increased Doppler activity was observed in the medial knee in the experimental group immediately following ESWT.
Conclusion: It is suggested that ESWT may reduce pain and improve function in chronic stroke patients with OA, and may increase vascular activity at the target site.
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KEYWORD
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High-energy shock waves, Knee osteoarthritis, Stroke, Ultrasonography, Pain
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