Reduction of Elbow Flexor and Extensor Spasticity Following Muscl

Abstract

To test the question that sustained continuous mechanical stretch could effectively reduce spasticity, sixteen patients with mild to moderate spasticity mainly in the elbow flexors and with an increased resistance to passive flexion and extension of the elbow joint were studied. Reduction of spasticity was measured as a decrease in the amplitude of the EMG response to the passive stretch. Mechanical stretch was maintained by applying a five pound sand bag in the ante rior proximal part of the wrist joint for thirty minutes. EMG recording was made before and after a continuous stretch of the elbow flexors at the end of ten, twenty, and thir ty minute intervals throughout the mechanical stretch. Stretch responses to passive movement were recorded before application and after release of the stretch. In all patients a marked decrease in the amplitude of the EMG response (average 82%) as well as higher threshold to the passive stretch response was obtained after mechanical stretch. The effect sustained and was observed by the patients up to two to three hours. By using sustained stretching of the spastic muscles one or several times a day, spas ticity can be diminished to a level to facilitate voluntary movement and improve EMG profiles during voluntary movement. The stretching can easily be included in a long-term home program or be used as a pretreatment in the rehabilitation program of spasticity. © 1995, Sage Publications. All rights reserved.