脳卒中片麻痺患者の有痛肩に対するレーザーの治療経験

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From our experience, effects of low power level laser therapy on painful shoulders in hemiplegic patients were investigated. Ten stroke patients were subjects and their mean age was 58.6 years. The subjects were divided into treatment group (8 patients) and control group (2 patients). For the treatment group, laser therapy was given for 3 weeks. Visual analog scale was assessed to identify alleviative effect by laser therapy. Range of motion measurement was also performed before and after treatment. In additions, relationships between analgesic effect and ROM, Brunnstrom's recovery stage, existence of subluxation of shoulder joint as well as sensory disturbance and muscle tones were analyzed respectively. As a result, there was no change in passive range of motion and visual analog scale in the control group after treatment. In the treatment group, 5 patients showed improvement of range of motion and 6 patients showed alleviative effect on shoulder pain. However, there was no significant effect on 2 patients after treatment. Shoulder pain in most patients whom treatment effect was available may be caused by impingement syndrome, not by pain such as thalamic syndrome. These results may indicate that the laser therapy should be prescribed according to causes of painful shoulder in hemiplegic patients.