title: Neural tension technique is no different from random passive movements in reducing spasticity in patients with traumatic brain injury.
abstract: OBJECTIVE
  Neural tension technique (NTT) is a therapy believed to reduce spasticity and to increase range of motion (ROM). This study compared the ability of NTT and random passive movements (RPMs) to reduce spasticity in the knee flexors in 10 spastic patients with brain injury.
  
  
  METHODS
  An RCT study with crossover design evaluated muscle tone measured by: 1) hand-held dynamometer; 2) Modified Ashworth Scale (MAS); 3) and ROM by; 4) angles of resistance onset "catch" (R1) compensatory movement (R2); and 5) 'subjectively perceived reduction in muscle tone'. Outcome measures were recorded by three raters before and after a single treatment session.
  
  
  RESULTS
  Objective stiffness measured with the hand-held device showed no significant changes for the NTT or RPM (p ≥ 0.09-0.79). The subjective measures showed significant changes after the NTT for the non-blinded rater (MAS: p < 0.05: R1: p < 0.05; R2: p < 0.05), but for the blinded rater a significant reduction was found only for R1 (p < 0.05) and R2 (p < 0.05). For the non-blinded rater intervention effects were found for R1 (p < 0.01), R2 (p < 0.01) and subjectively perceived tone reduction (p < 0.01). For the blinded rater no intervention effect was found.
  
  
  CONCLUSIONS
  An objective evaluation of NTT demonstrates that it does not reduce spasticity. However, it does increase ROM with the same effect as RPM.
  
  
  CONCLUSIONS
  • Neural tension techniques does not reduce spasticity in patients with traumatic brain injury when evaluated with objective biomechanical evaluation methods. • Neural tension techniques may improve range of motion with the same effect as random passive movements.
authors.affiliation: Department of Physiotherapy, Hvidovre Hospital/Department of Neurorehabilitation TBI Unit, Copenhagen University Hospital, Glostrup, Denmark. jlorentzen@ifi.ku.dk
authors.forename: Jakob
authors.initials: J
authors.lastname: Lorentzen
authors.forename: Dorthe
authors.initials: D
authors.lastname: Nielsen
authors.forename: Karl
authors.initials: K
authors.lastname: Holm
authors.forename: Susanne
authors.initials: S
authors.lastname: Baagøe
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Grey
authors.forename: Jens B
authors.initials: JB
authors.lastname: Nielsen
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation; D018592:Cross-Over Studies; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D053581:Muscle Strength Dynamometer; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D055815:Young Adult