Does Shortwave Diathermy Reduce the Intractable Spasticity of Patients with Spinal Cord Injury?

痙孿(spasticity)，廣義來說是肌肉張力過強的現象，與肢體移動的速度有關(velocity-dependent)；上運動神經元(upper motor neuron)受傷的病人，容易伴隨著痙孿的問題產生，而痙孿問題又會影響動作功能的表現，甚至造成次發性的併發症。較為普遍的短波治療儀器大部分使用27.12MHz這個頻率，臨床上短波用來止痛與消腫，促進組織癒合與神經生長以及軟化孿縮的組織。本文報告一位52歲男性，於1999年6月27日因意外摔傷導致頸椎3-4，4-5節椎間盤突出，緊急施行手術，脊椎損傷定位為SCI (C4, ASIA:D)，長期接受復健追蹤治療。軀幹及四肢長年處於痙孿狀態(spasticity, MAS:3-4)，不僅造成日常生活及照護困擾，對於復健治療亦有窒礙難行之處。曾併用多種降低張力的藥物及復健治療方法，皆無顯著之改善。2003年4月開始，嘗試以短波治療痙孿，患者張力明顯下降(MAS:3-4→2)，且患者能自行獨立操作日常生活技能，軀幹活動及轉位靈巧性亦大幅增加。因此短波也許能降低脊髓損傷患者痙孿的程度，但仍需更進一步的研究來驗證療效。

關鍵字

痙孿；短波；脊髓損傷

並列摘要

Spasticity is a hallmark of an upper motor neuron disorder and represents the most important impairments for individuals who care for patients with central nervous system disease. It may have an adverse effect on rehabilitation training. Shortwave diathermy is a modality that produces deep heat. It is usually used to relieve pain and stiffness, promote wound healing and relieve deep muscle spasm. In the present case, we show a 52-year-old male patient with spinal cord injury who has severe spastic hypertonia. He is disabling in motor and daily living. We have tried in vain with various physical therapy and medications. He has been receiving the shortwave therapy since April 2003. After treatment, the spasticity has been reduced. His motor recovery and functional performance have greatly improvement followed. We suggest that shortwave diathermy might become an adjunctive method for treating spasticity. Although shortwave diathermy reduced the spasticity of this patient, further study with more subjects is needed to establish its effect.

並列關鍵字