title: Anti-spastic effects of footbaths in post-stroke patients: a proof-of-principle study.
abstract: OBJECTIVE
  To investigate whether a footbath inhibits spasticity in the hemiplegic lower limbs of post-stroke patients.
  
  
  METHODS
  Randomized, controlled study.
  
  
  METHODS
  Rehabilitation education and research hospital.
  
  
  METHODS
  Twenty-two post-stroke patients were randomly allocated to control or experimental groups. After relaxing in a supine posture for 30min, the experimental group subject's legs were immersed in 41°C water below the knee joint for 15min, while the control group remained in a resting posture.
  
  
  METHODS
  Modified Ashworth Scale (MAS) scores of the affected triceps surae muscle and F-wave parameters (i.e., F-wave amplitude, F/M ratio, and F-wave persistence) were recorded before, immediately after, and 30min after each intervention. Physiological parameters were simultaneously monitored to determine the thermo-therapeutic mechanisms and side effects of footbath usage.
  
  
  RESULTS
  At the time immediately after the intervention, F-wave amplitudes decreased significantly in the experimental group, compared to the control group (p<0.01, difference: -106.8; 95% CI; -181.58 to -32.09). F-wave amplitudes decreased significantly after 30-min intervention in the experimental group, with a total reduction of 161.2μV being recorded compared to 8.8μV increase in the control group (p<0.01, difference: -170.0; 95% CI; -252.73 to -87.33). There were also significant differences between the experimental and control group for both F/M ratio and F-wave persistence, immediately after and 30min after the intervention. Further, there were significant differences between the experimental and control group for the MAS scores immediately after the intervention (p<0.05, difference: -0.72; 95% CI; -1.262 to -0.193), and 30min after the intervention (p<0.05, difference: -0.73; 95% CI; -1.162 to -0.293).
  
  
  CONCLUSIONS
  These findings demonstrate that the use of footbaths is an effective non-pharmacological anti-spastic treatment for use in stroke rehabilitation.
authors.affiliation: Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. Electronic address: shushusa71@yahoo.co.jp.
authors.forename: Shuji
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Shimodozono
authors.affiliation: Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Etoh
authors.affiliation: Department of Rehabilitation, Kirishima Rehabilitation Center of Kagoshima University Hospital, Kagoshima, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Noma
authors.affiliation: Department of Rehabilitation, Kirishima Rehabilitation Center of Kagoshima University Hospital, Kagoshima, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Uema
authors.affiliation: Department of Rehabilitation, Kirishima Rehabilitation Center of Kagoshima University Hospital, Kagoshima, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Ikeda
authors.affiliation: Department of Rehabilitation, Kirishima Rehabilitation Center of Kagoshima University Hospital, Kagoshima, Japan.
authors.forename: Kodai
authors.initials: K
authors.lastname: Miyara
authors.affiliation: Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kawahira
mesh_terms: D000328:Adult; D000368:Aged; D001494:Baths; D005260:Female; D006801:Humans; D007866:Leg / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000503:physiopathology / Q000628:therapy*; D018482:Muscle, Skeletal / Q000502:physiology; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation
keywords: F-wave; Footbath; Spasticity; Stroke; Temperature