OBJECTIVES: To compare the effect of 3 methods of electric stimulation to reduce spasticity of the triceps surae in patients with complete spinal cord injury (SCI) and to investigate the carryover effect. DESIGN:Placebo-controlled study with repeated measurements after the interventions. SETTING:Research department affiliated with a rehabilitation hospital in the Netherlands. PARTICIPANTS: Ten patients with a complete SCI were recruited from the outpatient population of the rehabilitation hospital. All subjects had American Spinal Injury Association grade A impairment scores, except for one, who had grade C. The patients had no voluntary triceps surae contractibility. INTERVENTIONS: Forty-five minutes of cyclic electric stimulation of the agonist, antagonist, or dermatome of the triceps surae or a placebo approach. MAIN OUTCOME MEASURES: Outcome measures were the Modified Ashworth Scale (MAS), clonus score, and the H-reflex and M wave (H/M) ratio. The electromyographic response to a stretch of the soleus over the whole range of motion was also determined. The magnitude and ankle angle at which the electromyographic response started were calculated. RESULTS: Stimulation of the agonist provided a significant reduction in the MAS compared with the placebo approach (P<.001). There was no significant change in the H/M ratio or the electromyographic response amplitude after any of the stimulation methods, whereas stimulation of the antagonist muscle resulted in a significant reduction in the ankle angle at which the electromyographic response started, compared with the placebo approach (P<.037). CONCLUSIONS: Triceps surae stimulation reduces the MAS for that specific muscle, whereas the angle at which the reflex starts changes after antagonist stimulation.
RCT Entities:
OBJECTIVES: To compare the effect of 3 methods of electric stimulation to reduce spasticity of the triceps surae in patients with complete spinal cord injury (SCI) and to investigate the carryover effect. DESIGN: Placebo-controlled study with repeated measurements after the interventions. SETTING: Research department affiliated with a rehabilitation hospital in the Netherlands. PARTICIPANTS: Ten patients with a complete SCI were recruited from the outpatient population of the rehabilitation hospital. All subjects had American Spinal Injury Association grade A impairment scores, except for one, who had grade C. The patients had no voluntary triceps surae contractibility. INTERVENTIONS: Forty-five minutes of cyclic electric stimulation of the agonist, antagonist, or dermatome of the triceps surae or a placebo approach. MAIN OUTCOME MEASURES: Outcome measures were the Modified Ashworth Scale (MAS), clonus score, and the H-reflex and M wave (H/M) ratio. The electromyographic response to a stretch of the soleus over the whole range of motion was also determined. The magnitude and ankle angle at which the electromyographic response started were calculated. RESULTS: Stimulation of the agonist provided a significant reduction in the MAS compared with the placebo approach (P<.001). There was no significant change in the H/M ratio or the electromyographic response amplitude after any of the stimulation methods, whereas stimulation of the antagonist muscle resulted in a significant reduction in the ankle angle at which the electromyographic response started, compared with the placebo approach (P<.037). CONCLUSIONS: Triceps surae stimulation reduces the MAS for that specific muscle, whereas the angle at which the reflex starts changes after antagonist stimulation.
Authors: Jessica M D'Amico; Elizabeth G Condliffe; Karen J B Martins; David J Bennett; Monica A Gorassini Journal: Front Integr Neurosci Date: 2014-05-12
Authors: Michael Behringer; Tobias Walter Link; Johannes Caspar Konrad Montag; Molly Leigh McCourt; Joachim Mester Journal: Orthop Rev (Pavia) Date: 2015-09-28
Authors: Marco Antonio Cavalcanti Garcia; João Marcos Yamasaki Catunda; Marcio Nogueira de Souza; Ana Paula Fontana; Sandro Sperandei; Claudia D Vargas Journal: Neural Plast Date: 2016-01-06 Impact factor: 3.599