A COMPARATIVE STUDY BETWEEN THE IMMEDIATE EFFECTS OF TENDINOUS PRESSURE TECHNIQUE VERSUS MYOFASCIAL RELEASE IN THE REDUCTION OF SPASTICITY: A CROSS OVER STUDY

IMMEDIATE EFFECTS OF TENDINOUS PRESSURE TECHNIQUE VERSUS MYOFASCIAL RELEASE

Authors

  • Dhanashri N. Marathe Intern,Department of Neurophysiotherapy,DVVPF’s College of Physiotherapy, Ahmednagar
  • Chetana Kunde Asst. Professor,Department of Neurophysiotherapy,DVVPF’s College of Physiotherapy, Ahmednagar
  • Suvarna Shyam Ganvir HOD and Professor, Department of Neurophysiotherapy,DVVPF’s College of Physiotherapy, Ahmednagar

DOI:

https://doi.org/10.46858/VIMSJPT.2105

Keywords:

Stretching, Spasticity , Physiotherapy

Abstract

Background- Spasticity following stroke is often associated with pain, soft tissue stiffness, decreased quality of life, increased treatment cost, and increased caregiver burden. Myofascial release is a new approach to relieve spasticity. It may act in the future as a facilitator and intensifier of treatment for a more consistent effect. Also, Inhibition techniques are used in spastic patients. In tendinous pressure, manual pressure is applied to the tendinous insertion of the muscle or across long tendons produces an inhibitory effect. AIM- To To find the immediate effect of tendinous pressure technique versus myofascial release in the reduction of spasticity. METHOD- The study was conducted in Vikhe Patil Hospital, Physiotherapy OPD, and Phuntamba Stroke Center. It was a cross over study conducted on spastic stroke patients using a purposive sampling method. Twenty-seven patients were included in the study. The duration of the study was of 6 months. Modified Tardieu scale was the outcome measure used at pre, and post-treatment measurement and the subject was treated with both the techniques with 2 hours of the interval to see which of the technique is more beneficial for reducing spasticity. RESULT-Result of within-group analysis of pre and post-treatment measurement of myofascial release showed clinical and statistical significance, but muscle reaction testing (X) showed no significant difference in  MTS whereas the result of within-group analysis of pre and post-treatment measurement, and muscle reaction testing (X) of tendinous pressure showed clinical and statistically significant improvement in MTS. The result of between the post-treatment measurement and muscle reaction testing of myofascial release and tendinous pressure showed no significant difference. In contrast, muscle reaction testing showed a significant difference in MTS of both the techniques.               CONCLUSION-So the conclusion can be made that tendinous pressure is more effective as compared to MFR in reducing the spasticity of stroke patients.

References

Chan L, Lin YD, Liu CH. World stroke day in Taiwan: raising public awareness of stroke. International Journal of Gerontology. 2016 Sep 1;10(3):175-9.

Hu GC, Chen YM. Post-stroke dementia: epidemiology, mechanisms and management. International Journal of Gerontology. 2017 Dec 1;11(4):210-4.

Monosaki R, Kakuda W, Kinoshita S, et al. Clinical effectiveness of board- certified phyiatrists on functionalrecovery in elderly stroke patients during convalescence: a retroseptive cohort study. Int J Gerontal.2017;11:7-11.

Baricich A, Picelli A, Molteni F, et al. Post- stroke spasticity as a condition: a new perspective on patient evaluation. Funct Neurol. 2016;31:179-180.

Wissel J, Manaack A, Brainin M. Toward an epidemiology of poststroke spasticity. Neurology. 2013;80:S13-S19.

Opheim A, Danielsson A, Alt Murphy M, et al. Upper-limb spasticity during the first year after stroke: stroke arm longitudinal study at the University of Gothenburg. Am J Phys Med Rehabil. 2014;93:884-896.

Gracies JM. Pathophysiology of spastic paresis. II: Emergence of muscle overactivity. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 2005 May;31(5):552-71.

Kheder A, Nair KP. Spasticity: pathophysiology, evaluation and management. Practical neurology. 2012 Oct 1;12(5):289-98.

Dewar L. The Myofascial Release Manual. Physiotherapy. 2001 Jun 1;87(6):330.

Fugl-Meyer AR, Jääskö L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scandinavian journal of rehabilitation medicine. 1975;7(1):13-31.

Kumar C, Vaidya SN. Effectiveness of myofascial release on spasticity and lower extremity function in diplegic cerebral palsy: Randomized controlled trial. Int J Phys Med Rehabil. 2014;3(253):2.

Suvarna Ganvir, Shyam Ganvir. Manual Therapy Approaches in Neuro physiotherapy, 1st edition, New Delhi: Jaypee Brothers Medical Publishers; 2016. Chapter: 5 Roods Approach.

Patrick E, Ada L. The Tardieu Scale differentiates contracture from spasticity whereas the Ashworth Scale is confounded by it. Clinical rehabilitation. 2006 Feb;20(2):173-82.Shah S, Bhalara A. Myofascial release. Inter J Health Sci Res. 2012 May;2(2):69-77.

Duncan B, McDonough-Means S, Worden K, Schnyer R, Andrews J, Meaney FJ. Effectiveness of osteopathy in the cranial field and myofascial release versus acupuncture as a complementary treatment for children with spastic cerebral palsy: a pilot study. The Journal of the American Osteopathic Association. 2008 Oct 1;108(10):559-70.

Finch E. Physical rehabilitation outcome measures. A guide to enhanced clinical decision making. 2002;64.

Boehme R. Myofascial Release and its application to neuro-developmental treatment. Boehme Workshops.

Ph. E. Greenman, Principles of Manual Medicine, 3rd edition, 2003, pg. no. 157.

Christina M Ammann, Lena M Kawanami, Mona M Giratalla, Robynn A Hoetmer, Valerie J Rodriguez, and Kirsten K Munro: Choosing a Spasticity Outcome Measure: A Review for the Neuromodulation Clinic UAHSJ 2005, 2, 29-32.

Emily Patrick and Louise Ada: The Tardieu Scale differentiates contracture from spasticity whereas the Ashworth Scale is confounded by it ,Clin Rehabil 2006; 20; 173.

Love SC, Valentine JP, Blair EM, Price CJ, Cole JH, Chauvel PJ. The effect of botulinum toxin type A on the functional ability of the child with spastic hemiplegia a randomized controlled trial. European Journal of Neurology. 2001 Nov;8:50-8.

Downloads

Published

2020-06-30

How to Cite

Marathe, D. N. ., Kunde, C., & Ganvir, S. S. (2020). A COMPARATIVE STUDY BETWEEN THE IMMEDIATE EFFECTS OF TENDINOUS PRESSURE TECHNIQUE VERSUS MYOFASCIAL RELEASE IN THE REDUCTION OF SPASTICITY: A CROSS OVER STUDY : IMMEDIATE EFFECTS OF TENDINOUS PRESSURE TECHNIQUE VERSUS MYOFASCIAL RELEASE . VIMS JOURNAL OF PHYSICAL THERAPY, 2(1), 21–27. https://doi.org/10.46858/VIMSJPT.2105

Issue

Section

Original Article