Volume 87, Issue 2 , Pages 222-228, February 2006
Comparison of Electric Stimulation Methods for Reduction of Triceps Surae Spasticity in Spinal Cord Injury
Abstract
van der Salm A, Veltink PH, IJzerman MJ, Groothuis-Oudshoorn KC, Nene AV, Hermens HJ. Comparison of electric stimulation methods for reduction of triceps surae spasticity in spinal cord injury.
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.
Key Words: Electric stimulation , Muscle spasticity , Neurophysiology , Rehabilitation , Spinal cord injuries
Supported by the Functional Strain, Work Capacity and Mechanisms of Restoration of Mobility in the Rehabilitation of Persons With Spinal Cord Injury, ZONMW-Rehabilitation (grant no. 1435.0010).No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
PII: S0003-9993(05)01288-8
doi:10.1016/j.apmr.2005.09.024
© 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Volume 87, Issue 2 , Pages 222-228, February 2006
