2008 年 17 巻 2 号 p. 95-99
Spasticity following cerebral vascular accidents (CVAs) is a common occurrence, but remains a problematic entity to treat and interferes with mobility and self-care activities which are critical for successful rehabilitative outcomes. Low reactive-level laser therapy (LLLT) has attracted attention in a number of areas including spasticity associated with cerebral palsy. In the case of post CVA therapy, LLLT has been reported for pain treatment, but not spasticity. The present study examined the efficacy of LLLT in attenuating triceps surae muscle spasticity in CVA patients. The study subjects comprised 15 chronic CVA patients with spasticity, treated at our university hospital between 2002 and 2006. The LLLT device we used was a near infrared (830 nm) semiconductor laser device delivering 1 W in continuous wave (irradiance, 670 mW/cm2) . The laser probe was applied with mild pressure to the skin over the tibial nerve on the affected side, 30 sec/point (dose/point 20.1 J/cm2) repeated 3 times with a 5 sec interval between irradiations. Two sessions were given per week for 1 week. At the end of the week, we recognized LLLT effects in 11 cases out of 15. The other 4 patients had little or no effect but were in their fifties, and had successive bouts of ankle clonus. LLLT is a promising medical treatment for the attenuation of CVA-related spasticity of the triceps surae muscle spasticity, and facilitate voluntary movements in such patients. Further studies are warranted to elucidate the mechanisms by which LLLT can attenuate spasticity.
