The purpose of this study was to investigate effects of the long-term high-frequency transcutaneous electrical nerve stimulation(TENS) on the spasticity and the balance in chronic stroke patients. Twenty-six subjects with spasticity over lower limbs were allocated randomly into two groups under standard rehabilitation: (1) TENS group, (2) placebo-TENS group. TENS stimulation was applied on the both the gastrocnemius for 30 minutes, 5 days a week for 4 weeks(100 Hz, 0.25 ms, 2 times sensory threshold). The Modified Ashworth Scale(MAS) and Hand-held manual muscle tester were used to assess the ankle plantarflexor spasticity. Balance function under three conditions was measured by using force-plate and the amount of postural sway was assessed; in (1) the condition of standing with eyes opened, (2) with eyes closed and (3) the condition of standing on unstable surface with eyes opened. Both groups showed significant improvement in spasticity and balance function after treatment for 4 weeks(p<.05). Especially, TENS group showed a significant reduction of spasticity compared to placebo-TENS group(p<.05). These results suggested that additional stimulation of a long-term high-frequency TENS to standard rehabilitation induced an improved balance function and a spasticity reduction. The long-term application of high-frequency TENS will be an effective intervention for reducing spasticity and increasing balance ability in the chronic stroke patients.
The objective of this study was to investigate the effect of gait training using rhythmic auditory stimulation on gait symmetry of stroke patients. Forty chronic stroke patients were divided into four groups by intervention. Group A and B received auditory stimulation when they walk with comfortable gait speed. Group A received auditory stimulation to paralyzed side while group B to non-paralyzed side. Group C and D received auditory stimulation with 10% faster gait speed than their comfortable gait speed. Group C received auditory stimulation to paralyzed side while group D to non-paralyzed side. Gait training using auditory stimulation was done in each group during five minutes. Gait symmetry was evaluated by formula and temporal variables of gait were measured by gait analysis system. Step time was decreased significantly in all groups except group A (P<.05), and gait symmetry was also improved significantly in all groups except group A (P<.05). Cadence was increased significantly in all groups except group A (p<.05), but velocity was not increased in all groups. Therefore we conclude that RAS gait training is effective in improving gait symmetry and can be useful to stroke patient's gait training.
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