Immediate effect of icing versus passive stretch on spasticity
Shweta Kulkarni, Prachiti Doijad, Ujwal L Yeole, Devika Bhide
Background: Spasticity has been defined as a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks resulting from hyper excitability of the stretch reflex as one component of the upper motor neuron syndrome. Local muscle cooling has been described to temporarily decrease spasticity and clonus mainly by reducing the sensitivity of the muscle spindle to stretch and also has an antispastic effect by increasing pain threshold and consequently reducing receptor sensitivity of low threshold afferents. Stretching can increase the extensibility by a change in the excitability of motor neurons supplying the spastic muscle and involves viscous deformation and structural adaptations of a muscle and other soft tissues. Subjects: Subjects with elbow flexor spasticity with a grade 1, 1+, 2 on Modified Ashworth Scale were included. Methods: The tools and materials used were goniometer and ice packs with an outcome measure Modified Ashworth Scale and Goniometry. Out of 30 subjects, 15 subjects were treated by applying ice packs for 20 minutes and other 15 subjects with a passive sustained stretch of 45 seconds 3 times to evaluate the effectiveness for the reduction of spasticity. Results: Both passive stretch and icing help reduce spasticity. Mean values and SD of goniometry measures of icing and passive stretch were 17.1333 and 22.9333, 8.114 and 8.664 respectively. Values for Modified Ashworth Scales of passive stretch and icing were, (mean- 0.5, 0.5) respectively, (SD-0.000, 0.000) respectively. Conclusion: The study showed that both the treatments are effective to reduce spasticity and increase the range of motion, but passive stretch has shown to have greater significance considering range of motion.
Shweta Kulkarni, Prachiti Doijad, Ujwal L Yeole, Devika Bhide. Immediate effect of icing versus passive stretch on spasticity. National Journal of Multidisciplinary Research and Development, Volume 3, Issue 1, 2018, Pages 98-100