Superficial warming and cooling of the leg affects walking speed and neuromuscular impairments in people with spastic paraparesis.
BACKGROUND
People with hereditary and spontaneous spastic paraparesis (HSSP) report that their legs are stiffer and walking is slower when their legs are cold.


OBJECTIVE
This study explored the effects of prolonged superficial cooling and warming of the lower leg on walking speed and local measures of neuromuscular impairments.


METHODS
This was a randomised pre- and post-intervention study of 22 HSSP participants and 19 matched healthy controls. On 2 separate occasions, one lower leg was cooled or warmed. Measurements included walking speed and measures of lower limb impairment: ankle movement, passive muscle stiffness, spasticity (stretch reflex size), amplitude and rate of force generation in dorsi- and plantarflexors and central and peripheral nerve conduction time/velocity.


RESULTS
For both participants and controls, cooling decreased walking speed, especially for HSSP participants. For both groups, cooling decreased the dorsiflexor rate and amplitude of force generation and peripheral nerve conduction velocity and increased spasticity. Warming increased dorsiflexor rate of force generation and nerve conduction velocity and decreased spasticity.


CONCLUSIONS
Superficial cooling significantly reduced walking speed for people with HSSP. Temperature changes were associated with changes in neuromuscular impairments for both people with spastic paraparesis and controls. This study does not support the use of localised cooling in rehabilitation for people with spastic paraparesis as reported in other neurological conditions. Rehabilitation interventions that help prevent heat loss (insulation) or improve limb temperature via passive or active means, particularly when the legs and/or environment are cool, may benefit people with spastic paraparesis.
School of Health Professions, Faculty of Health and Human Sciences, Plymouth University, Devon PL6 8BH, United Kingdom. Electronic address: amanda.denton@plymouth.ac.uk.
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A
Denton
School of Health Professions, Faculty of Health and Human Sciences, Plymouth University, Devon PL6 8BH, United Kingdom.
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L
Bunn
School of Health Professions, Faculty of Health and Human Sciences, Plymouth University, Devon PL6 8BH, United Kingdom.
A
A
Hough
School of Computing, Electronics and Mathematics, Faculty of Science and Engineering Plymouth University, Devon PL6 8BH, United Kingdom.
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G
Bugmann
School of Health Professions, Faculty of Health and Human Sciences, Plymouth University, Devon PL6 8BH, United Kingdom.
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J
Marsden
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000503:physiopathology; D016022:Case-Control Studies; D017679:Cryotherapy / Q000379:methods*; D005260:Female; D006801:Humans; D007866:Leg / Q000294:innervation / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology; D009431:Neural Conduction; D020336:Paraparesis, Spastic / Q000503:physiopathology* / Q000534:rehabilitation; D026741:Physical Therapy Modalities; D011897:Random Allocation; D017694:Rewarming / Q000379:methods*; D000072797:Walking Speed / Q000502:physiology*; D055815:Young Adult
Muscle spasticity; Neural conduction; Spastic paraparesis; Temperature