Comparison of Electric Stimulation Methods for Reduction of Triceps Surae Spasticity in Spinal Cord Injury

Design of the study. The patients came on 3 or 4 days, and on each day another intervention was applied: agonist stimulation, antagonist stimulation, dermatome stimulation, or a placebo approach. Each day started with a baseline measurement session followed by an intervention. The first postmeasurement session took place immediately after the intervention, and the second and third postmeasurement sessions with 1-hour intervals.

Application of the stimulation electrodes for antagonist (tibialis anterior), agonist (triceps surae), and dermatome (S1) stimulation.

Effect of the stimulations and placebo approach for the (A) MAS, (B) clonus score, (C) H/M ratio, (D) EMG₁₀₀, and (E) reflex-initiating angle. Presented are baseline, and post 1, 2, and 3 measurement outcomes. Values are average with 1 SD. The SD is mainly due to intersubject variability. Significant differences were found in intervention effect (IE) of the MAS and reflex-initiating angle. For the MAS, post hoc tests indicate significant differences in intervention effect between the placebo approach and agonist stimulation (IE Pl-Ag). For the reflex-initiating angle, a significant difference in intervention effect was found between the placebo approach and antagonist stimulation (IE Pl-Ant). Abbreviation: stim, stimulation. *P<.05; ^†P<.001.