Immediate Effect of Sensory Level Stimulation on Spasticity in Patients with Post-stroke Hemiplegia

Document Type : Original Article (s)

Authors

1 MSc Student, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

2 Assistant Professor, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

3 Associate Professor, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

Abstract

Background: Spasticity is one of the impairments in patients with stroke which cause more disability and secondary problems. Now, there are some ways to reduce spasticity such as drugs, exercise, heat, massage, and sensory level electrical stimulation. This study assessed the immediate effect of sensory level stimulation on spasticity in plantar flexor muscles in patients with post-stroke hemiplegia.Methods: In this study, 10 patients received 10 sessions of treatment. Protocol was 30 minutes electrical stimulation and 30 minutes proprioceptive neuromuscular facilitation techniques to improve initiation and controlling of movement. Level of the spasticity was measured carefully before and after the stimulation using Modified Ashworth scale.Findings: Electrical stimulation reduced the spasticity in two women and one man. Stimulation had not effect on seven patients. Electrical stimulation had not effect on grades one and three spasticity; it had effect on grades one-plus and two but not in all of the patients. The stimulation had effect on patients with good cognition who did their exercises carefully.Conclusion: Sensory level electrical stimulation has temporary effect only on middle-grade spasticity in middle exercise sessions. There is not any effect in next session and efficacy of stimulation reduces and stops. This electrical stimulation cannot disappear the spasticity and does not have any effect on high-grade spasticity.

Keywords

References

  1. Umphred DA. Neurological rehabilitation. 5th ed. Philadelphia, PA: Mosby; 2006. p. 1257.
  2. O'Sullivan SB, Schmitz TJ, Fulk G. Physical rehabilitation. 6th ed. Philadelphia, PA: F. A. Davis; 2014.p. 1505.
  3. Chen D, Yan T, Li G, Li F, Liang Q. Functional electrical stimulation based on a working pattern influences function of lower extremity in subjects with early stroke and effects on diffusion tensor imaging: a randomized controlled trial. Zhonghua Yi Xue Za Zhi 2014; 94(37): 2886-92. [In Chinese].
  4. Goulet C, Arsenault AB, Bourbonnais D, Laramee MT, Lepage Y. Effects of transcutaneous electrical nerve stimulation on H-reflex and spinal spasticity. Scand J Rehabil Med 1996; 28(3): 169-76.
  5. Gregson JM, Leathley M, Moore AP, Sharma AK, Smith TL, Watkins CL. Reliability of the Tone Assessment Scale and the modified Ashworth scale as clinical tools for assessing poststroke spasticity. Arch Phys Med Rehabil 1999; 80(9): 1013-6.
  6. Ping Ho CB, Kam Kwan CB. Immediate effect of transcutaneous electrical nerve stimulation on spasticity in patients with spinal cord injury. Clin Rehabil 2010; 24(3): 202-10.
  7. Aydin G, Tomruk S, Keles I, Demir SO, Orkun S. Transcutaneous electrical nerve stimulation versus baclofen in spasticity: clinical and electrophysiologic comparison. Am J Phys Med Rehabil 2005; 84(8): 584-92.
  8. Ng SS, Hui-Chan CW. Transcutaneous electrical nerve stimulation combined with task-related training improves lower limb functions in subjects with chronic stroke. Stroke 2007; 38(11): 2953-9.
  9. Cho HY, In TS, Cho KH, Song CH. A single trial of transcutaneous electrical nerve stimulation (TENS) improves spasticity and balance in patients with chronic stroke. Tohoku J Exp Med 2013; 229(3): 187-93.
  10. Park J, Seo D, Choi W, Lee S. The effects of exercise with TENS on spasticity, balance, and gait in patients with chronic stroke: a randomized controlled trial. Med Sci Monit 2014; 20: 1890-6.
  11. Karakoyun A, Boyraz I, Gunduz R, Karamercan A, Ozgirgin N. Electrophysiological and clinical evaluation of the effects of transcutaneous electrical nerve stimulation on the spasticity in the hemiplegic stroke patients. J Phys Ther Sci 2015; 27(11): 3407-11.
  12. Vodovnik L, Bowman BR, Hufford P. Effects of electrical stimulation on spinal spasticity. Scand J Rehabil Med 1984; 16(1): 29-34.
Journal of Isfahan Medical School
Volume 35, Issue 419 - Serial Number 419
January and February 2017
Pages 124-127

Files

History

  • Receive Date: 16 December 2016
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics