Physical treatment interventions for managing spasticity after stroke

Monaghan, Kenneth; Horgan, Frances; Blake, Catherine; Cornall, Catherine; Hickey, P; Lyons, Bernadette E; Langhorne, Peter

doi:10.1002/14651858.cd009188

Cited by 17 publications

(11 citation statements)

References 72 publications

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“…We can include such rehabilitation exercise methods, such as constraint-induced movement therapy (CIMT), sensorimotor movement training (SMT), task-related training (TRT), robot-assisted training (RAT), whole body vibration training (WBVT), mirror visual feedback training (MVFT), electromyographic biofeedback training (EMG-BTF), and virtual reality-based training (VRBT). Moreover, there physical therapy agents can be also used, such as neuromuscular electrical stimulation (NMES), electromyography neuromuscular electrical stimulation (EMG-NMES), transcutaneous electrical nerve stimulation (TENS), functional electrical stimulation (FES), therapeutic ultrasound (TU), as well as cryotherapy (cold water, ice packs, and evaporative sprays), thermotherapy (hot water, sauna, and infrared heat), hydrotherapy, and acupuncture [ 15 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

The Current State of Knowledge on the Clinical and Methodological Aspects of Extracorporeal Shock Waves Therapy in the Management of Post-Stroke Spasticity—Overview of 20 Years of Experiences

Opara

Taradaj

Walewicz

et al. 2021

JCM

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In many patients after stroke, spasticity develops over time, resulting in a decrease in the patient’s independence, pain, worsening mood, and, consequently, lower quality of life. In the last ten years, a rich arsenal of physical agents to reduce muscle tone such as extracorporeal shock therapy (ESWT) wave has come through. The aim of this narrative review article is to present the current state of knowledge on the use of ESWT as a supplement to the comprehensive rehabilitation of people after stroke suffering from spasticity. The PubMed and PEDro databases were searched for papers published in English from January 2000 to December 2020, 22 of which met inclusion criteria for clinical studies related to post-stroke spasticity management with ESWT. A total of 22 studies including 468 post-stroke patients—11 reports with the upper limb (267 patients) and 10 reports within the lower limb (201 patients), as well as one report including both upper and lower limb. We focused our attention on clinical and methodological aspects. Therefore, we performed the assessment of enrolled studies in terms of methodological quality using the PEDro and level of evidence using the National Institute for Health and Clinical Excellence (NICE) guidelines. Furthermore, we indicated implications for clinical practice in using ESWT for post-stroke spasticity management. Moreover, we discussed a suggestion for future research directions. In conclusion, an ESWT effectively reduces muscle tone in people with spastic limb after stroke. Further, ESWT is safe and free of undesirable side effects. The mechanism of action of ESWT on muscles affected by spasticity is still unknown. To date, no standard parameters of ESWT in post-stroke spasticity regarding intensity, frequency, location, and the number of sessions has been established. Further research, meeting the highest standards, is needed to establish uniform muscle stimulation parameters using ESWT.

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Section: Introductionmentioning

confidence: 99%

The Current State of Knowledge on the Clinical and Methodological Aspects of Extracorporeal Shock Waves Therapy in the Management of Post-Stroke Spasticity—Overview of 20 Years of Experiences

Opara

Taradaj

Walewicz

et al. 2021

JCM

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“…Informal caregivers are defined as those who provide unpaid assistance to others, usually a family member or friend, following onset of chronic illness or disability (1). According to the Irish National Audit of Stroke Care (INASC), there are approximately 30,000 stroke survivors in Ireland, many of whom required the support of informal caregivers to carry out their daily activities (2).The support required can be extensive and demanding as stroke often leads to physical, cognitive, and psychological deficits in survivors (3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Implications of Stroke for Caregiver Outcomes: Findings from the ASPIRE-S Study

Atteih

Mellon

Hall

et al. 2015

International Journal of Stroke

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on behalf of the ASPIRE-S study group Background Informal caregivers are vital to the long-term care and rehabilitation of stroke survivors worldwide. However, caregiving has been associated with negative psychological outcomes such as anxiety and depression, which leads to concerns about caregiver as well as stroke survivor well-being. Furthermore, caregivers may not receive the support and service provision they require from the hospitals and community. Aims This study examines caregiver psychological well-being and satisfaction with service provision in the context of stroke. Methods Caregiver data were collected as part of the ASPIRE-S study, a prospective study of secondary prevention and rehabilitation which assessed stroke patients and their carers at six-months post stroke. Carer assessment included measurement of demographics, satisfaction with care (UK Healthcare Commission National Patient Survey of Stroke Care), psychological distress (Hospital Anxiety and Depression Scale), and vulnerability (Vulnerable Elders Scale). Logistic regression analyses and chi-squared tests were performed using STATA version 12. Results Analyses from 162 carers showed substantial levels of dissatisfaction (37·9%) with community and hospital services, as well as notable levels of anxiety (31·3%) and depressive symptoms (18·8%) among caregivers. Caregiver anxiety was predicted by stroke survivor anxiety (OR = 3·47, 95% CI 1·35-8·93), depression (OR = 5·17, 95% CI 1·83-14·58), and stroke survivor cognitive impairment (OR 2·35, 95% CI 1·00-5·31). Caregiver depression was predicted by stroke survivor anxiety (OR = 4·41, 95% CI 1·53-12·72) and stroke survivor depression (OR = 6·91, 95% CI 2·26-21·17). Conclusion Findings indicate that caregiver and stroke survivor well-being are interdependent. Thus, early interventions, including increased training and support programs that include caregivers, are likely to reduce the risk of negative emotional outcomes.

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“…Also, the patient received the stretching exercises for the ankle plantar flexors and the ankle supinators. The stretching exercise is known to effectively reduce spasticity 13 , 14 ) by increasing tissue extensibility 15 ) . It was thought that the reduced spasticity in the patient was attributed, at least in part, to the stretching exercises.…”

Section: Discussionmentioning

confidence: 99%

Reduced foot pain after spasticity control with alcohol block in a patient with chronic hemiparetic stroke: a case report

Lee

2017

J Phys Ther Sci

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[Purpose] This study report a case of a patient with hemiparetic stroke who showed significantly reduced foot pain when ankle spasticity was reduced using nerve and motor point blocks with 20% ethyl alcohol. [Subject and Methods] A 58-year-old woman with left hemiparesis following intracranial hemorrhage five years previously presented with pain in the left fifth metatarsal head for two years (numeric rating scale[NRS]: 8). Erythema and edema were observed on the lateral aspect of the head of the fifth metatarsal bone. She was diagnosed with a Tailor’s bunion. Spasticity was observed in the left ankle plantar flexor and ankle supinator (Modified Ashworth Scale: 1+). Using 20% ethyl alcohol, a block in the medial and lateral motor branches to the gastrocnemius muscle of the left tibial nerve and the motor point of the left posterior tibialis muscle was performed. [Results] After the alcohol block, spasticity had almost disappeared and foot pain was significantly reduced (NRS: 1). Results from the foot pressure measurement system test showed foot contact pressure was highly distributed to the lateral forefoot pre-block. After the block, the distribution of foot contract pressure was similar to normal distribution. [Conclusion] Clinicians should consider the possibility that spasticity can contribute to foot pain.

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Physical treatment interventions for managing spasticity after stroke

Cited by 17 publications

References 72 publications

The Current State of Knowledge on the Clinical and Methodological Aspects of Extracorporeal Shock Waves Therapy in the Management of Post-Stroke Spasticity—Overview of 20 Years of Experiences

The Current State of Knowledge on the Clinical and Methodological Aspects of Extracorporeal Shock Waves Therapy in the Management of Post-Stroke Spasticity—Overview of 20 Years of Experiences

Implications of Stroke for Caregiver Outcomes: Findings from the ASPIRE-S Study

Reduced foot pain after spasticity control with alcohol block in a patient with chronic hemiparetic stroke: a case report

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