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Comparison of electric stimulation methods for reduction of triceps surae spasticity in spinal cord injury.
Arch Phys Med Rehabil. 2006 Feb; 87(2):222-8.AP

Abstract

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.

Authors+Show Affiliations

Roessingh Research & Development, Enschede, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16442976

Citation

van der Salm, Arjan, et al. "Comparison of Electric Stimulation Methods for Reduction of Triceps Surae Spasticity in Spinal Cord Injury." Archives of Physical Medicine and Rehabilitation, vol. 87, no. 2, 2006, pp. 222-8.
van der Salm A, Veltink PH, Ijzerman MJ, et al. Comparison of electric stimulation methods for reduction of triceps surae spasticity in spinal cord injury. Arch Phys Med Rehabil. 2006;87(2):222-8.
van der Salm, A., Veltink, P. H., Ijzerman, M. J., Groothuis-Oudshoorn, K. C., Nene, A. V., & Hermens, H. J. (2006). Comparison of electric stimulation methods for reduction of triceps surae spasticity in spinal cord injury. Archives of Physical Medicine and Rehabilitation, 87(2), 222-8.
van der Salm A, et al. Comparison of Electric Stimulation Methods for Reduction of Triceps Surae Spasticity in Spinal Cord Injury. Arch Phys Med Rehabil. 2006;87(2):222-8. PubMed PMID: 16442976.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of electric stimulation methods for reduction of triceps surae spasticity in spinal cord injury. AU - van der Salm,Arjan, AU - Veltink,Peter H, AU - Ijzerman,Maarten J, AU - Groothuis-Oudshoorn,Karin C, AU - Nene,Anand V, AU - Hermens,Hermie J, PY - 2005/03/17/received PY - 2005/09/05/revised PY - 2005/09/23/accepted PY - 2006/1/31/pubmed PY - 2006/3/7/medline PY - 2006/1/31/entrez SP - 222 EP - 8 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 87 IS - 2 N2 - 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. SN - 0003-9993 UR - https://www.unboundmedicine.com/medline/citation/16442976/Comparison_of_electric_stimulation_methods_for_reduction_of_triceps_surae_spasticity_in_spinal_cord_injury_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(05)01288-8 DB - PRIME DP - Unbound Medicine ER -