Does the addition of Extracorporeal Shockwave Therapy dramatically improve the effect of botulinum toxin for reducing upper and lower extremity spasticity?

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K11245
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 59010:Rehabilitation science-related
• Research Institution: Jikei University School of Medicine
• Principal Investigator: Takekawa Toru 東京慈恵会医科大学, 医学部, 准教授 (80384981)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 体外衝撃波療法 / 脳卒中 / 筋痙縮 / 頭痛-緊張性 / 関節可動域

Outline of Final Research Achievements

Patients with moderate to severe paralysis in particular often experience spasticity in the muscles of the affected side as a result of inadequate transmission of signals from the cerebrum to the muscles to inhibit overactivity.
Spasticity is felt as a "resistance" when the limb is moved in another direction. If left untreated, spasticity can lead to deformity and contracture, which can have a negative impact on appearance and interfere with daily activities.
In this study, low-power extracorporeal shock wave therapy: ESWT (radial pressure wave: RPW) treatment was found to be effective in reducing spasticity immediately and for some period of time.

Free Research Field

脳卒中後の麻痺、痙縮、筋緊張、疼痛、リハビリテーション療法、ボツリヌス毒素治療

Academic Significance and Societal Importance of the Research Achievements

脳卒中後の麻痺に対してはリハビリテーション療法が実施されるが、麻痺に伴う痙縮（つっぱり）はリハビリテーション療法の効果を阻害する。それゆえ、痙縮に対する治療は麻痺の改善に欠かせないが、今回、拡散型圧力波治療が即時的にはもちろん、ある一定の期間であれば痙縮軽減効果を有する可能性が高いことが示された。
加えて、肩甲帯の筋緊張の持続が難治性の頭痛を誘発するとされる難治性緊張型頭痛に対して拡散型圧力波を適用したが、筋緊張の部分への拡散型圧力波の照射がこのタイプの頭痛に有効である可能性が示唆された。