Effects of a single session of prolonged muscle stretch on spastic muscle of stroke patients.

The control of spasticity is often a significant problem in the management of patients with spasticity. The aim of this study was to evaluate the effect of a single session of prolonged muscle stretch (PMS) on the spastic muscle. Seventeen patients with spastic hemiplegia were selected to receive treatment. Subjects underwent PMS of the triceps surae (TS) by standing with the feet dorsiflexed on a tilt-table for 30 minutes. Our test battery consisted of four measurements including the modified Ashworth scale of the TS, the passive range of motion (ROM) of ankle dorsiflexion, the H/M ratio of the TS, and the F/M ratio of the tibialis anterior (TA). The results indicated that the passive ROM of ankle dorsiflexion increased significantly (p < 0.05) compared to that before PMS treatment. Additionally, PMS reduced motor neuron excitability of the TS and significantly increased that of the TA (p < 0.05). These results suggest that 30 minutes of PMS is effective in reducing motor neuron excitability of the TS in spastic hemiplegia, thus providing a safe and economical method for treating stroke patients.

[1]  P D Neilson,et al.  Presynaptic inhibition of the monosynaptic reflex by vibration , 1969, The Journal of physiology.

[2]  C. Kukulka,et al.  Effects of tendon pressure on alpha motoneuron excitability in patients with stroke. , 1988, Physical therapy.

[3]  M. Levin,et al.  Relief of hemiparetic spasticity by TENS is associated with improvement in reflex and voluntary motor functions. , 1992, Electroencephalography and clinical neurophysiology.

[4]  P. Ashby,et al.  Neurophysiologic changes in hemiplegia , 1976, Neurology.

[5]  R. Angel,et al.  THE H REFLEX IN NORMAL, SPASTIC, AND RIGID SUBJECTS. , 1963, Archives of neurology.

[6]  J. Lehmann,et al.  Effect of cooling on H- and T-reflexes in normal subjects. , 1987, Archives of physical medicine and rehabilitation.

[7]  C. Richards,et al.  Effects of prolonged muscle stretch on reflex and voluntary muscle activations in children with spastic cerebral palsy. , 2020, Scandinavian journal of rehabilitation medicine.

[8]  P Ashby,et al.  The Evaluation of “Spasticity” , 1987, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[9]  T Bajd,et al.  Electrical stimulation in treating spasticity resulting from spinal cord injury. , 1985, Archives of physical medicine and rehabilitation.

[10]  P. Komi,et al.  Reduced reflex sensitivity persists several days after long-lasting stretch-shortening cycle exercise. , 1999, Journal of applied physiology.

[11]  D. Burke,et al.  autogenic effects of static muscle stretch in spastic man. , 1971, Archives of neurology.

[12]  A. McComas,et al.  Control of soleus motoneuron excitability during muscle stretch in man. , 1982, Journal of neurology, neurosurgery, and psychiatry.

[13]  Richard W. Bohannon,et al.  Interrater reliability of a modified Ashworth scale of muscle spasticity. , 1987, Physical therapy.

[14]  C. Richards,et al.  Effects of a single session of prolonged plantarflexor stretch on muscle activations during gait in spastic cerebral palsy. , 1991, Scandinavian journal of rehabilitation medicine.

[15]  A. Scremin,et al.  Effect of "standing" on spasticity, contracture, and osteoporosis in paralyzed males. , 1993, Archives of physical medicine and rehabilitation.

[16]  E Knutsson,et al.  Evaluation of the effects of muscle stretch and weight load in patients with spastic paraplegia. , 1981, Scandinavian journal of rehabilitation medicine.

[17]  I. Odéen,et al.  Reduction of muscular hypertonus by long-term muscle stretch. , 1981, Scandinavian journal of rehabilitation medicine.

[18]  S. J. Sullivan,et al.  Effects of massage on alpha motoneuron excitability. , 1991, Physical therapy.

[19]  G. Petroski,et al.  Inhibitory casting decreases a vibratory inhibition index of the H-reflex in the spastic upper limb. , 1999, Archives of physical medicine and rehabilitation.

[20]  J. W. Little Spasticity and associated abnormalities of muscle tone. , 1993 .