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Botulinum Toxin-A Effects on the Muscle Architecture of Hemiplegic Upper Extremity in Stroke Patients: An Ultrasonographic Study : 뇌졸중 환자의 편측마비 상지의 근육 구조에 미치는 보툴리눔 톡신-A의 효과: 초음파 연구

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Authors

임채영

Advisor
이시욱
Major
의과대학 의학과
Issue Date
2015-02
Publisher
서울대학교 대학원
Keywords
Muscle ArchitecturePennation AngleMuscle VolumeHemiplegiaStrokeBotulinum Toxin-A
Description
학위논문 (석사)-- 서울대학교 대학원 : 의학과, 2015. 2. 이시욱.
Abstract
Introduction:
Muscle architecture is main determinant of muscle function and there was no study about the change of muscle architecture in spastic upper extremity after botulinum toxin-A (BoNT-A) injection. The aim of this study was to evaluate the effects of BoNT-A injection on the hemiplegic upper extremity muscle architecture of stroke patients using ultrasonography.
Methods:
Fifteen consecutive hemiplegic patients (mean age: 60.3±8.8 years) who were injected with BoNT-A for the treatment of upper extremity spasticity in April to June 2014 were enrolled. Flexor carpi radialis muscle of hemiplegic side was evaluated using ultrasonography. Muscle length, anterior and posterior pennation angle, muscle thickness, cross-sectional area of muscle and muscle volume were measured. Ultrasonographic evaluations were performed before BoNT-A injection and repeated 1 month and 3 months after injection.
Results:
Muscle thickness at a neutral position and posterior pennation angle at maximal extension significantly decreased 3 months after injection (p=0.001, p=0.023, respectively), fascicle length increased at neutral, maximal flexion and maximal extension positions after 1 month (p=0.001, p=0.004, p=0.002, respectively) and this increase was maintained at neutral and maximal extension after 3 months (p=0.041). Proximal muscle volume around the injection site significantly decreased after 3 months (p=0.036) and distal volume from injection site increased 1month and 3 months after injection (p=0.002, p=0.027).
Conclusions:
These results confirm the change in muscle architecture in spastic upper extremity hemiplegia after BoNT-A injection, elucidating the effects of BoNT-A injection on spastic muscle of stroke patients.

Keywords: Muscle Architecture, Pennation Angle, Muscle Volume, Hemiplegia, Stroke, Botulinum Toxin-A

Student Number: 2010-21822
Language
English
URI
https://hdl.handle.net/10371/132765
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