Effect of Transcutaneous Electrical Nerve Stimulation on Plantar Flexor Muscle Spasticity and Walking Speed in Stroke Patients.
OBJECTIVE
Spasticity is a major disabling symptom in patients post stroke. Although studies have demonstrated that transcutaneous electrical nerve stimulation (TENS) can reduce spasticity, the duration of single session TENS is a subject of debate. The purpose of this study was to determine the sustainability of the effects of TENS applied over common peroneal nerve in the reduction of ankle plantar-flexor spasticity and improving gait speed in patients post stroke.


METHODS
Thirty patients (11 women and 19 men) (mean age of 46.46 years) were randomly assigned to group 1 (task oriented exercises), group 2 (TENS for 30 min and task oriented exercises) and group 3 (TENS for 60 min and task oriented exercises) for a period of five sessions per week for 6 weeks. All patients were assessed for ankle plantar-flexor spasticity, passive ankle dorsi-flexion range of motion, clonus and timed up and go test at the time of recruitment to study, at 3 and 6 weeks of therapeutic intervention.


RESULTS
The overall results of the study suggest that there was a decrease in ankle plantar flexor spasticity, ankle clonus and timed up and go score in all the groups. A greater reduction of spasticity was seen in TENS groups (groups 2 and 3) when compared to control. No significant improvement was found in timed up and go test (TUG) scores between groups.


CONCLUSIONS
Both 30 min and 60 min of application of TENS are effective in reducing spasticity of ankle plantar flexors, improving walking ability and increase the effectiveness of task related training. Based on the effect size, we would recommend a longer duration application for the reduction of spasticity. Copyright © 2015 John Wiley & Sons, Ltd.
Swami Vivekanand National Institute of Rehabilitation Training and Research, Olatpur, P.O. Bairoi, Cuttack Dt., Odisha, 754010, India.
Darshan
D
Laddha
Swami Vivekanand National Institute of Rehabilitation Training and Research, Olatpur, P.O. Bairoi, Cuttack Dt., Odisha, 754010, India.
G Shankar
GS
Ganesh
Swami Vivekanand National Institute of Rehabilitation Training and Research, Olatpur, P.O. Bairoi, Cuttack Dt., Odisha, 754010, India.
Monalisa
M
Pattnaik
Swami Vivekanand National Institute of Rehabilitation Training and Research, Olatpur, P.O. Bairoi, Cuttack Dt., Odisha, 754010, India.
Patitapaban
P
Mohanty
Swami Vivekanand National Institute of Rehabilitation Training and Research, Olatpur, P.O. Bairoi, Cuttack Dt., Odisha, 754010, India.
Chittaranjan
C
Mishra
D000054:Acceleration; D000368:Aged; D000704:Analysis of Variance; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000534:rehabilitation*; D010543:Peroneal Nerve / Q000503:physiopathology*; D011446:Prospective Studies; D018570:Risk Assessment; D020521:Stroke / Q000175:diagnosis / Q000628:therapy; D000071939:Stroke Rehabilitation / Q000379:methods*; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*
electric stimulation therapy; exercise; gait; muscle spasticity; stroke