Cryotherapy reduces muscle hypertonia, but does not affect lower limb strength or gait kinematics post-stroke: a randomized controlled crossover study

Alcântara, Carolina Carmona; Blanco, Julián García; Oliveira, Lucilene Maria De; Ribeiro, Paula Fernanda Sávio; Herrera, Esperanza; Nakagawa, Theresa Helissa; Reisman, Darcy S.; Michaelsen, Stella Maris; Garcia, Luccas Cavalcanti; Russo, Thiago Luiz

doi:10.1080/10749357.2019.1593613

Cited by 12 publications

(5 citation statements)

References 62 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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“…Gait data were collected with seven cameras with the ProReflex Motion Capture System (Qualisys Inc., Gothenburg, Sweden) at a sampling frequency of 120 Hz. Reflexive passive markers were positioned as outlined in a previous study [18]. Afterward, a task habituation trial was carried out, and then, participants were instructed to walk at a self-selected speed along a 10 m walkway 10 times.…”

Section: Methodsmentioning

confidence: 99%

“…Reflexive passive markers were positioned as outlined in a previous study [18]. Afterward, a task habituation trial was carried out, and then, participants were instructed to walk at a self-selected speed along a 10 m walkway 10 times.…”

Section: Spatiotemporal Gait Parametersmentioning

confidence: 99%

Constraint-induced movement therapy for lower extremity use in activities of daily living in people with chronic hemiparesis: multiple case study

Pereira

Ilha

Anjos

et al. 2022

International Journal of Rehabilitation Research

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Lower extremity constraint-induced movement therapy (LE-CIMT) is an intensive intervention protocol recently reported to improve lower extremity use in individuals with chronic hemiparesis. To test if the LE-CIMT that uses essential CIMT components, including the transfer package and intensive task-oriented training, is a feasible and potentially effective intervention to improve the lower extremity real-world use and functional ability in a group of individuals with chronic hemiparesis. A quasi-experimental pre- and post-test design study with 12 individuals with chronic stroke and impaired ambulation skills engaged in a 10-weekday LE-CIMT. Intervention feasibility was assessed, examining the training adherence, acceptability, and safety. The lower extremity motor activity log (LE-MAL), lower extremity motor function test (LE-MFT), timed up and go (TUG) and spatiotemporal gait parameters were used as clinical outcomes. Clinical data were collected at baseline, 3-day post-CIMT protocol and 30-day follow-up assessment. At baseline, LE-MAL and LE-MFT outcomes were tested over 2-week apart to ensure a stable measurement and determine the smallest real difference (SRD) in the study sample. The LE-CIMT showed excellent adherence, acceptability and safety. Ten out of 12 participants showed improvements over SRD in LE-MAL composite score (1.2 point) and eight participants in LE-MFT adjusted scores (0.8 point) in post-CIMT and 30-day follow-ups. LE-CIMT is a feasible intervention that has the potential to promote improvements in real-world use and functional ability of the paretic lower extremity in individuals with chronic stroke.

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“…Rehabilitation plans should not employ intense physical efforts, which can aggravate spasticity, and instead should prioritize the use of physical agents ahead of exercise training, for enhancing the efficiency of the latter [ 124 ]. Cryotherapy is one of the procedures that can be used prior to exercise initiation, and is utilized either systemically through whole-body cryotherapy and ice baths, or locally through cryo cuffs, cooling garments and ice massage [ 152 , 153 ]. Its purpose is to induce local anesthesia and reduce the reaction to active stretching.…”

Section: Present Therapeutic Approachesmentioning

confidence: 99%

Neurorehabilitation in Multiple Sclerosis—A Review of Present Approaches and Future Considerations

Sîrbu¹,

Thompson

Pleşa

et al. 2022

JCM

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Multiple sclerosis is an increasingly prevalent disease, representing the leading cause of non-traumatic neurological disease in Europe and North America. The most common symptoms include gait deficits, balance and coordination impairments, fatigue, spasticity, dysphagia and an overactive bladder. Neurorehabilitation therapeutic approaches aim to alleviate symptoms and improve the quality of life through promoting positive immunological transformations and neuroplasticity. The purpose of this study is to evaluate the current treatments for the most debilitating symptoms in multiple sclerosis, identify areas for future improvement, and provide a reference guide for practitioners in the field. It analyzes the most cited procedures currently in use for the management of a number of symptoms affecting the majority of patients with multiple sclerosis, from different training routines to cognitive rehabilitation and therapies using physical agents, such as electrostimulation, hydrotherapy, cryotherapy and electromagnetic fields. Furthermore, it investigates the quality of evidence for the aforementioned therapies and the different tests applied in practice to assess their utility. Lastly, the study looks at potential future candidates for the treatment and evaluation of patients with multiple sclerosis and the supposed benefits they could bring in clinical settings.

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Cryotherapy reduces muscle hypertonia, but does not affect lower limb strength or gait kinematics post-stroke: a randomized controlled crossover study

Cited by 12 publications

References 62 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

Constraint-induced movement therapy for lower extremity use in activities of daily living in people with chronic hemiparesis: multiple case study

Neurorehabilitation in Multiple Sclerosis—A Review of Present Approaches and Future Considerations

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