Brain injury from stroke commonly leads patients to specific involuntary muscle contractions, a condition called spasticity. Different therapeutic approaches, including medication, are currently available to treat spasticity, even though there seems to be no consensus with regard to their efficacy.
When spasticity occurs after brain injury, the joints consequently present a significant decrease of motion due to the resultant muscle stiffness, limiting the control of movements such as those performed in daily routine. When the tension in these muscles increases they become rigid or spastic.
There are varied therapeutic approaches to treat the condition include physical therapy and medication, but no overall consensus on their efficacy.
Conversely, some therapists have reported some positive results on relieving spasticity by using peripheral electrical stimulation of low intensity (SES). However, there is no clarity how the SES bottom-up effects could induce the brain to alleviate the spasticity symptoms. In a recent study, researchers investigated whether SES therapy may improve the wrist mobility and alter the brain-limbs top-down activation.
Five chronic post-stroke spastic patients (60 – 72 years old) participated in the study, which was published in the journal Biomedical Engineering. All subjects were submitted to a single session of SES therapy for 30 min applied over the spastic forearm flexors muscles. The wrist mobility was accessed measuring the wrist resistance to a passive movement before and immediately after the SES therapy.
The brain-limbs modulation was inspected stimulating the primary motor cortex with a non-invasive technique (transcranial magnetic stimulation – TMS), while recording the evoked myoelectric potentials (or motor evoked potentials – MEPs) from the forearm muscles. The TMS examination was performed before and immediately after the SES therapy. The results did not point out to any improvement on wrist mobility or changes in the MEPs characteristics after the SES therapy. The findings suggest no clear evidence of therapeutic benefits of a single session SES therapy.
Previous findings sound encouraging in terms of SES as an adjunctive therapy alternative to botulinum neurotoxin in relieving spasticity in post-stroke patients, even from one single session followed by a short-term improvement on wrist mobility. However, therapists and clinicians must take in account SES parameters when it is used as an alternative therapy in the treatment of spasticity in chronic post-stroke patients.
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André Salles Cunha Peres, Victor Hugo Souza, João Marcos Yamasaki Catunda, Kelley Cristine Mazzeto-Betti, Taiza Elaine Grespan Santos-Pontelli, Claudia Domingues Vargas et al.: Can somatosensory electrical stimulation relieve spasticity in post-stroke patients? A TMS pilot study, 05.05.2017