Effect on Passive Range of Motion and Functional Correlates After a Long‐Term Lower Limb Self‐Stretch Program in Patients With Chronic Spastic Paresis

Abstract

III.

Ultrasound Structural Changes in Triceps Surae After a 1-Year Daily Self-stretch Program: A Prospective Randomized Controlled Trial in Chronic Hemiparesis

“…30 We observed marked improvements in passive range of motion for 6 lower limb muscles, including plantar flexors, where a long-term (>1 year) prescription of daily self-stretch was utilized, compared with muscles in the same patients where this strategy was not implemented. 30 The main objective of this prospective, randomized, parallel-group trial was to compare ultrasonographic structural changes and clinical assessments in the soleus and MG muscles in patients with chronic hemiparesis following 1 year of conventional therapy (CONV) versus those also performing daily self-stretching using the GSC. The main hypothesis for this present study was that 1 year of guided self-stretch would increase fascicle length and muscle thickness in the soleus and MG more than conventional rehabilitation alone.…”

“…This technique has been described in a diary-based program called the Guided Self-rehabilitation Contract (GSC). [25][26][27][28][29][30] In a recent retrospective study, we used this strategy for at least a year in patients with very chronic spastic paresis, with an average of 8 years following an acute central nervous system lesion, including stroke. 30 We observed marked improvements in passive range of motion for 6 lower limb muscles, including plantar flexors, where a long-term (>1 year) prescription of daily self-stretch was utilized, compared with muscles in the same patients where this strategy was not implemented.…”

“…[25][26][27][28][29][30] In a recent retrospective study, we used this strategy for at least a year in patients with very chronic spastic paresis, with an average of 8 years following an acute central nervous system lesion, including stroke. 30 We observed marked improvements in passive range of motion for 6 lower limb muscles, including plantar flexors, where a long-term (>1 year) prescription of daily self-stretch was utilized, compared with muscles in the same patients where this strategy was not implemented. 30 The main objective of this prospective, randomized, parallel-group trial was to compare ultrasonographic structural changes and clinical assessments in the soleus and MG muscles in patients with chronic hemiparesis following 1 year of conventional therapy (CONV) versus those also performing daily self-stretching using the GSC.…”

Studies on Spasticity from an Interventional Perspective

“…There is still limited evidence for standard care with stretching of spastic muscles [103,104]. However, some support is now emerging that so-called self-guided rehabilitation, where the patient performs stretching exercises and motor training daily, might improve range of motion and walking speed [105,106]. However, the method is still not implemented in the general rehabilitation community [107].…”

Contralateral seventh cervical nerve transfer can affect the pennation angle of the lower limb in spastic hemiplegia patients: An observational case series study

“…For spastic hemiplegia patients, one of the main factors resulting in dysfunction of upper and lower limbs is high muscle tone (Pradines et al, 2018). Although the Modified Ashworth Scale (MAS) and the Modified Tardieu Scale (MTS) are quick and easy to perform in clinical evaluation of spasticity, they are subjective measurements and not relatively sensitive to detect unobvious changes of spasticity (Aloraini, Gaverth, Yeung, & MacKay-Lyons, 2015;Burridge et al, 2005).…”