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Clinical Rehabilitation
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What's this?

Does electrical stimulation reduce spasticity after stroke? A randomized controlled study

Amir H Bakhtiary

Physiotherapy Department, Rehabilitation Faculty, Semnan University of Medical Sciences, Semnan, Iran, amir822{at}yahoo.com

Elham Fatemy

Physiotherapy Department, Rehabilitation Faculty, Semnan University of Medical Sciences, Semnan, Iran

Objective: To investigate the therapeutic effect of electrical stimulation on plantarflexor spasticity in stroke patients.

Design: A randomized controlled clinical trial study.

Setting: Rehabilitation clinic of Semnan University of Medical Sciences.

Subjects: Forty stroke patients (aged from 42 to 65 years) with ankle plantarflexor spasticity.

Intervention: Fifteen minutes of inhibitory Bobath techniques were applied to one experimental group and a combination of 9 minutes of electrical stimulation on the dorsiflexor muscles and inhibitory Bobath techniques was applied to another group for 20 sessions daily.

Main measures: Passive ankle joint dorsiflexion range of motion, dorsiflexion strength test, plantarflexor muscle tone by Modified Ashworth Scale and soleus muscle H-reflex.

Results: The mean change of passive ankle joint dorsiflexion in the combination therapy group was 11.4 (SD 4.79) degrees versus 6.1 (SD 3.09) degrees, which was significantly higher (P = 0.001). The mean change of plantarflexor muscle tonicity measured by the Modified Ashworth Scale in the combination therapy group was -1.6 (SD 0.5) versus -1.1 (SD 0.31) in the Bobath group (P = 0.001). Dorsiflexor muscle strength was also increased significantly (P = 0.04) in the combination therapy group (0.7 ± 0.37) compared with the Bobath group (0.4 ± 0.23). However, no significant change in the amplitude of H-reflex was found between combination therapy (-0.41 ± 0.29) and Bobath (-0.3 ± 0.28) groups.

Conclusion: Therapy combining Bobath inhibitory technique and electrical stimulation may help to reduce spasticity effectively in stroke patients.

Clinical Rehabilitation, Vol. 22, No. 5, 418-425 (2008)
DOI: 10.1177/0269215507084008
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