Spasticity in spinal cord injured patients: 2. Initial measures and long-term effects of surface electrical stimulation.

Electrical stimulation of paralyzed muscles has been shown to affect their spasticity, especially in patients with hemiplegia. But little has been reported on the long-term effects of such stimulation on individuals with spinal cord injury. This paper documents initial quadriceps spasticity in 31 spinal cord injured subjects, and the effect of four to eight weeks of reconditioning using electrical stimulation. Spasticity was quantified through the use of a normalized relaxation index (R2n) obtained from a pendulum drop test. The reconditioning protocol consisted of twice daily 20-minute exercise sessions at least four hours apart, six days per week. Spasticity and stimulated quadriceps torque were measured during one to three evaluations performed at least one day apart at the beginning of the program, and at four and eight weeks. There was no significant difference in average initial measures of spasticity between left and right legs and no effect of time since injury on average R2n values. Significant differences were seen for right leg average baseline R2n values when grouped by lesion level or completeness. Quadriplegic individuals were more spastic than paraplegic individuals, and subjects with incomplete lesions were more spastic than those with complete lesions. These findings are interrelated since most of the quadriplegic subjects (14 of 16) had incomplete lesions. Most participants had increased spasticity after four weeks of reconditioning but not after eight weeks. However, only eight subjects completed eight weeks of reconditioning. Subjects who had the greatest increases in spasticity also had the greatest gains in stimulated torque, both after four and eight weeks.(ABSTRACT TRUNCATED AT 250 WORDS)