Cryotherapy Reduces Muscle Spasticity But Does Not Affect Proprioception in Ischemic Stroke

Garcia, Luccas Cavalcanti; Alcântara, Carolina Carmona; Santos, Glauber dos; Monção, João Victor Almeida; Russo, Thiago Luiz

doi:10.1097/phm.0000000000001024

Cited by 15 publications

(11 citation statements)

References 19 publications

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“…Patients included in the two studies by Alcantara and Garcia presenting chronic spasticity were treated by applying an ice pack on the calf for 20 min, while the control group was given a 1 kg, room temperature sand pack to mimic the pressure the ice pack exerts on the muscles. Immediately after one session of cryotherapy, MAS values in the intervention group reduced in both studies compared to the controls (see Table 8 ): from a median value of 1+ (range 1–2) to a median value of 1 (range 0–1+), and from a mean value (std) of 2.29 (0.49) to 1.29 (0.76) ( 64 , 65 ). In the study by Martins et al, a group was treated once by applying TENS to the tibialis nerve, and the following day the same patients received 30 min of cryotherapy.…”

Section: Resultsmentioning

confidence: 92%

Physical therapy interventions for the correction of equinus foot deformity in post-stroke patients with triceps spasticity: A scoping review

et al. 2022

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ObjectiveEquinus foot deformity (EFD) is the most common deformity following a stroke. Several approaches have been suggested for its correction, including pharmacological, surgical, and physical therapy (PT) interventions. This scoping review aims to map and synthesize the available evidence focusing on physical therapy treatments for EFD caused by triceps surae (TS) spasticity.MethodsScoping review methodological frameworks have been used. Pubmed, Cinahl, and Cochrane databases were searched for primary literature. Studies focusing on the treatment of EFD in adult stroke patients were included only when the intervention involved PT treatments and presented at least one outcome measure for the functional and/or structural condition of the TS. Data were systematically collected and reported in tables inclusive of type of intervention, sample characteristics, dosage, comparators, outcomes, follow-up timeline, and treatment efficacy. A narrative synthesis was also added.ResultsOf the 642 experimental or observational screened studies, 53 were included, focusing on stretching exercises, shock waves, electrical stimulation, dry needling, TENS, vibration therapy, ultrasounds, cryotherapy, and active physiotherapy. Patients with EFD benefited from specific physical therapy treatments. These usually resulted in Modified Ashworth Scale reduction, typically by 1 point, and an increase in ROM. Interventions consisting of shock waves, dry needling, and electrostimulation showed the best results in reducing EFD. Heterogeneous dosage and delivery mode generally limited conclusions.ConclusionsThis scoping review summarized available primary literature based on PT treatments for the correction of EFD. By highlighting the remaining gaps in knowledge, it provides a reference for future studies on this pathology. Further investigations are necessary to pinpoint the best dosage and delivery methods. Future studies should investigate whether early rehabilitation programs started during the acute phase might help prevent or limit the development of secondary deformities.

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Section: Resultsmentioning

confidence: 92%

Physical therapy interventions for the correction of equinus foot deformity in post-stroke patients with triceps spasticity: A scoping review

et al. 2022

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“…Segundo Knight, após a aplicação do frio, o potencial de ação nervosa tem maior duração que pode ser resultado do aumento dos períodos refratários que diminuem o número de fibras que poderiam disparar em determinado período, reduzindo, assim, a velocidade de condução e com isso, a informação sobre a percepção sensorial. Neste caso, provavelmente, o impulso estará chegando ao córtex de forma reduzida, o que pode ser a causa das mudanças de sensibilidade, que associado com a redução da descarga fusal, ocorre a diminuição da descarga elétrica e com isso a redução de tônus muscular, logo diminuindo a espasticidade [13].…”

Section: Discussionunclassified

Efeitos agudos da crioterapia na transferência de peso em sujeitos com hemiparesia espástica crônica

Pinheiro¹,

Oliveira²,

Barroso³

et al. 2019

Fisioter Bras

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Objetivo: Foi avaliar os efeitos agudos da crioterapia na transferência de peso de pacientes hemiparéticos crônicos. Métodos: Estudo transversal composto por 52 pacientes, sendo 24 pacientes hemiparéticos crônicos e 28 pacientes saudáveis como controles. Utilizou-se a versão brasileira do Questionário de Waterloo para avaliar a preferência podal (WFQ-Brasil) para o grupo de pacientes-controle. Foram utilizadas duas balanças calibradas nas quais foi calculada a razão de simetria (lado parético/lado não parético) em pacientes hemiparéticos crônicos. Para o grupo controle, foi calculada uma razão de simetria (lado não dominante/lado dominante). Foi realizada a imersão do membro inferior acometido dos pacientes hemiparéticos e o lado dominante dos pacientes-controle em um balde com capacidade de 60 litros, com gelo e água, a uma temperatura aproximada de até 5ºC, sendo feita a avaliação pré-intervenção e imediatamente após. Resultados: Pôde-se observar diferença significativa na transferência de peso em ambos os grupos após a crioimersão. Conclusão: Conclui-se que a crioimersão por um período de 30 segundos com temperatura de até 5ºC foi suficiente para gerar alterações na transferência de peso para o lado parético resultando em alterações na simetria de sujeitos hemiparéticos crônicos, e nos controles, o comportamento foi similar com alterações na transferência de peso para a perna não dominante.Palavras-chave: acidente vascular cerebral, paresia, crioterapia.

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“…Ankle proprioception was assessed by measuring JPS and FS errors on both sides using a commercial dynamometer (Biodex System 4 Pro TM ; Biodex Medical Systems, Inc., Shirley, NY, USA). Participants remained seated in a chair with the hip flexed at 70° and the knee flexed at 45°, and the thigh was fixed to the dynamometer chair using a band [30]. The dynamometer rotation axis was aligned with the lateral malleolus and the foot was fixed to the device with strips designed for the ankle joint (Figure 1).…”

Section: ) Ankle Proprioception Testmentioning

confidence: 99%

Age-related Differences in Ankle-joint Proprioception and Postural Balance in Women: Proprioception of Force Versus Position

Kim

Lim

et al. 2022

Physical Therapy Korea

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Background: During postural control, older adults are more dependent on proprioception than are young adults. Ankle proprioception, which plays an important role in maintaining postural balance, decreases with age. Published studies are insufficient to establish a significant age difference in postural sway resulting from the known age-related decrease in ankle proprioception and do not examine various detailed test conditions.Objects: The present study aimed to compare ankle proprioception between older and younger groups along dimensions of position vs. force proprioception and dorsiflexion vs. plantarflexion. The present study also aimed to compare postural sway between young and older women during quiet standing under two sensory conditions. Methods:We recruited seven young women aged 21-24 and seven older women aged 60-63. Ankle proprioception was assessed as the accuracy of the joint position sense (JPS) and the force sense (FS). Postural sway was assessed using center-of-pressure measurements recorded during quiet standing under two sensory positions: eyes open and eyes closed with head tilted back.Results: Older women had lower JPS in dorsiflexion and lower FS in plantarflexion than did younger women. We found no significant age differences in JPS in plantarflexion or in FS in dorsiflexion. We observed a main effect of group on postural sway in two sway parameters out of three. We observed significant differences in JPS with dorsiflexion, and in FS with plantarflexion. Conclusion:Proprioception for ankle plantar flexor decreased more significantly with aging than did that for ankle dorsiflexor, accounting for the impaired postural balance observed in older women.

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Cryotherapy Reduces Muscle Spasticity But Does Not Affect Proprioception in Ischemic Stroke

Abstract: Cryotherapy (using an ice pack) may reduce plantar flexor spasticity without influencing proprioception.

Cited by 15 publications

References 19 publications

Physical therapy interventions for the correction of equinus foot deformity in post-stroke patients with triceps spasticity: A scoping review

Physical therapy interventions for the correction of equinus foot deformity in post-stroke patients with triceps spasticity: A scoping review

Efeitos agudos da crioterapia na transferência de peso em sujeitos com hemiparesia espástica crônica

Age-related Differences in Ankle-joint Proprioception and Postural Balance in Women: Proprioception of Force Versus Position

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