title: Effects of surface electrical stimulation on the muscle-tendon junction of spastic gastrocnemius in stroke patients.
abstract: OBJECTIVE
  The purpose of this study was to explore the effects of spasticity suppression by surface electrical stimulation (ES) o the muscle-tendon junction of spastic gastrocnemius muscles in stroke.
  
  
  METHODS
  Twenty-four neurologically stable stroke patients (aged 41-69 years, 12-35 months post-stroke), with spasticity graded 2 or 3 on the modified Ashworth scale, were recruited and divided into two groups. In the ES group, each patient received 20 min of surface ES once daily, 6 days per week for 1 month. In the control groups, ES was used with stimulation intensity kept at zero. To evaluate the therapeutic effect, the modified Ashworth scale, Fmax/Mmax ratio, H-reflex latency, H-reflex recovery curve, and the 10-m walking time were tested before and after the 1-month of treatment.
  
  
  RESULTS
  In the ES group, the modified Ashworth scale showed a trend toward reduced spasticity after 1 month of treatment. The Fmax/Mmax ratio decreased from 8.10% +/- 4.84% to 4.00% +/- 1.36%; the H-reflex latency increased from 28.87 +/- 2.45 ms to 29.40 +/- 2.57 ms; the H-reflex recovery curves indicated a downward shift; and the 10-metre walking time significantly decreased after ES. In the control group, none of the measures showed a statistically significant change.
  
  
  CONCLUSIONS
  In this study, we demonstrated a way to suppress spasticity at a metameric site and to increase walking speed effectively by applying surface ES on the muscle-tendon junction of spastic gastrocnemius muscles.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Taipei Medical University and Hospital, Taiwan.
authors.forename: S-C
authors.initials: SC
authors.lastname: Chen
authors.forename: Y-L
authors.initials: YL
authors.lastname: Chen
authors.forename: C-J
authors.initials: CJ
authors.lastname: Chen
authors.forename: C-H
authors.initials: CH
authors.lastname: Lai
authors.forename: W-H
authors.initials: WH
authors.lastname: Chiang
authors.forename: W-L
authors.initials: WL
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D004599:Electric Stimulation Therapy; D005260:Female; D006181:H-Reflex / Q000502:physiology; D006429:Hemiplegia / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000503:physiopathology / Q000534:rehabilitation*; D018482:Muscle, Skeletal / Q000503:physiopathology; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013710:Tendons / Q000503:physiopathology