title: Physical modalities other than stretch in spastic hypertonia.
abstract: This article reviews various physical modalities that have been used in spastic hypertonia, particularly superficial heat and cold, diathermies (ultrasound, microwave, and short-wave irradiation), electrical stimulation (transcutaneous electrical nerve stimulation), implanted spinal stimulation (rectal stimulation), and massage (deep friction, superficial contact). The duration of the effects of most physical therapies is relatively short (e.g., cooling, heating, and massage), which often may limit their application to immediate prestretch or pre-exercise periods. The potential capacity of ultrasound therapy to improve the efficacy of chronic stretch in lengthening muscle may be a promising option. The neurodestructive potential of high intensity microwave for the personnel involved and controlled evidence of its value is required before this modality can be recommended in spasticity. Overall, controlled, double-blind studies are mandated to evaluate the long-term impact of repeated use of these short-term modalities on function and recovery in patients with spasticity.
authors.affiliation: Department of Neurology, Mount Sinai Medical Center, New York, New York, USA. jean-michel.gracies@mssm.edu
authors.forename: J M
authors.initials: JM
authors.lastname: Gracies
mesh_terms: D000818:Animals; D017679:Cryotherapy; D003972:Diathermy; D004599:Electric Stimulation Therapy; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D008872:Microwaves / Q000627:therapeutic use; D009128:Muscle Spasticity / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities