None listed
Conditions
Brief summary
Objectives. Investigate the hyperreflexia of patients with cerebrovascular accident (CVA) and identify the immediate effects of transcutaneous electrical nerve stimulation (TENS) and cryotherapy on the spasticity and electromyographic activity of hemiparetic subjects. Design: Nonrandomized Controlled Trial: Setting: The experiment were conducted in the Laboratory of Analysis of the Human Movement of Physiology Laboratory of the Federal University of Rio Grande do Norte. Subjects: 16 subjects with CVA-related sequel Intervention: application of TENS in the conventional manner (100Hz and 60µs) and cryotherapy in the form of ice compress over the soleus muscle Assessment measurements: H-reflex, M response, Hmax/Max, H-reflex latency and RMS value of surface EMG. Results: The Hmax/Mmax was significantly higher in the affected limb (P=0.0245). H-reflex latency was significantly lower in the affected limb (P=0.0375). The EMG amplitude of the muscle antagonist of the spastic muscle was decreased in the compromised limb (P< 0.0001). After TENS there was a reduction in the Hmax/Mmax ratio (P=0.0006) and therefore in hyperreflexia. However, soon after ice application there was an increase in the Hmax/Mmax ratio (P=0.0007) and an increase in the latency (P=0.0001). EMG amplitude was not significantly altered by any of the resources. Statistically significant differences were found when the Hmax/Mmax ratio (P<0.0001) and H reflex latency (P<0.0001) were compared between post-TENS, post-cryotherapy and control. Conclusion: We conclude that TENS can be used for the immediate reduction of spasticity and that cryotherapy may increase hyperreflexia in spastic patients. However, the decrease or increase in spasticity after intervention did not alter electromyographic activity in the antagonist of the spastic muscle.
Interventions
Application of Transcutaneous Electrical Nerve Stimulation (TENS) in the conventional manner (100Hertz and 60 microseconds) and cryotherapy in the form of ice compress over the soleus muscle. Both Transcutaneous Electrical Nerve Stimulation and cryotherapy were used for 30 minutes in single session. All the subjects underwent three days of assessment after the following procedures were randomly applied: TENS, cryotherapy or control. The application interval among the resources was of at least 2
Application of Transcutaneous Electrical Nerve Stimulation (TENS) in the conventional manner (100Hertz and 60 microseconds) and cryotherapy in the form of ice compress over the soleus muscle. Both Transcutaneous Electrical Nerve Stimulation and cryotherapy were used for 30 minutes in single session. All the subjects underwent three days of assessment after the following procedures were randomly applied: TENS, cryotherapy or control. The application interval among the resources was of at least 24 hours
Sponsors
Federal University of Rio Grande do Norte
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
30 Years to 69 Years
Healthy volunteers
No
Inclusion criteria
Clinical diagnosis of Cerebrovascular accident (CVA), minimum lesion duration of 6 months, degree of spasticity between 1 and 3 on the modified Ashworth scale, capacity to obey simple verbal commands and absence of degenerative diseases or orthopedic-traumatic lesions in ankle articulation.
Exclusion criteria
Hypersensitivity to ice or to electric current, inability to withstand the intensity of the electric current used to record H-reflex and M response and non-attendance at the three assessment days were established as exclusion criteria.
Outcome results
None listed