Influence of Stretching & Icing In Neurological Conditions to Relieve Spasticity - A Systematic Review
DOI:
https://doi.org/10.46858.VIMSJPT.2202Abstract
Background: Spasticity is a consequence of neuromuscular disorders, which affects quality of life in those who experience this phenomenon. Spasticity results from an upper motor neuron lesion that disinhibits the tendon stretch reflex; spasticity results in a velocity dependent tightness of muscle. Icing inhibits the proprioceptive afferent pathways responsible for the transmission of information to the spinal cord and the thalamus. Where in muscle influence the excitability in spinal cord to decrease spasticity. This could be suggested as one of the mechanisms of relieving spasticity by cold therapy. Stretching suppresses monosynaptic spinal reflex excitability in stretched muscles also included as part of a training and recovery and improves flexibility and range of motion of joints.
Objective: To investigate the literature evidence for the effect of stretching and icing on spasticity in neurological conditions.
Methodology: Review contain latest literature, studies included within last 20 years. They were entered into PubMed, Google scholar and Ovid databases, which included Medline, CINAHL, and Journals at Ovid full text, EBM reviews. The population which was selected were adults and children with spasticity developed after neurological conditions. A systematic literature search was evaluated 50 articles related to effect of stretching & icing on spasticity. Out of 50 articles we selected, 40 articles which were found suitable for reviewing the effect of stretching and icing on spasticity in patients with neurological conditions. Studies written in English language were only included.
Conclusion: Stretching helps in reducing the contracture and prolonged muscle stretch reduces the motor neuron excitability. The study as well suggested that icing applied to the spastic muscles is effective in decreasing muscle tonus level, but indicating short term benefits in the context of clinical practice. There is also hypersensitivity reactions to cold were observed.
Key words: Cryotherapy/ Cold therapy/Icing, Stretching, Spasticity, Physical therapy.
References
N. SMANIA, A. PICELLI1, D. MUNARI et.al, Rehabilitation procedures in the management of spasticity – EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE 2010;46:423-38
Burridge JH, Wood DE, Hermens HJ, Voerman GE, et.al. Theoretical and methodological considerations in the measurement of spasticity. Disability and rehabilitation. 2005 Jan 1;27(1-2):69-80.
Bovend’Eerdt TJ, Newman M, Barker K, et.al, The effects of stretching in spasticity: a systematic review. Archives of physical medicine and rehabilitation. 2008 Jul 1;89(7):1395-406.
Haselkorn J, Loomis S. Multiple Sclerosis and Spasticity. Phys Med Rehabil Clin N. 2005; 16:467-481.
Luccas Cavalcanti Garcia, PT, Carolina Carmona Alcântara, PhD, Gabriela Lopes Santos, PhD, et.al, Cryotherapy Reduces Muscle Spasticity But Does Not Affect Proprioception in Ischemic Stroke –A Randomized Sham-Controlled Crossover Study, American Journal of Physical Medicine & Rehabilitation 2019;98:51–57.
Al-Zamil ZM, Hassan N, Hassan W. Reduction of elbow flexor and extensor spasticity following muscle stretch. Journal of Neurologic Rehabilitation. 1995 Sep;9 (3):161-5.
Stokes M, editor. Physical management in neurological rehabilitation. Elsevier Health Sciences; 2004.
Roberts JM, Wilson K. Effect of stretching duration on active and passive range of motion in the lower extremity. British journal of sports medicine. 1999 Aug 1;33(4):259-63.
Bakheit AM, Maynard V, Shaw S. The effects of isotonic and isokinetic muscle stretch on the excitability of the spinal alpha motor eurons in patients with muscle spasticity. European journal of neurology. 2005 Sep;12 (9):719-24.
Pin T, Dyke P, Chan M. The effectiveness of passive stretching in children with cerebral palsy. Developmental medicine and child neurology. 2006 Oct;48 (10):855-62.
Kim EH, Jang MC, Seo JP, Jang SH, et.al, The effect of a hand-stretching device during the management of spasticity in chronic hemiparetic stroke patients. Annals of rehabilitation medicine. 2013 Apr;37 (2):235.
Elanchezhian Ch, Swarnakumari P. Efficacy of Cold Therapy and Passive Stretching to Improve Gait in Spastic Diplegic Cerebral Palsy Children. Int J Pediatr 2019; 7(9): 10109-118. DOI: 10.22038/ijp.2019.41071.3461
Anaya MC, Herrera E. Immediate effect of cryotherapy on reflex excitability in people with post-CVD spasticity. Rev. Univ Ind Santander Salud 2016; (48) (4); 496-507
Michlovitz S, Smith W, et.al, Ice and high voltage pulsed stimulation in treatment of acute lateral ankle sprains. J Orthop Sports Phys Ther 1988;9(9):301–4.
Anaya MC, Herrera E. Immediate effect of cryotherapy on reflex excitability in people with post-CVD spasticity. Rev. Univ Ind Santander Salud 2016; (48) (4); 496-507
Gehan M. Abd El-Maksoud, Moussa A. Sharaf, et.al, Efficacy of cold therapy on spasticity and hand function in children with cerebral palsy. Journal of Advanced Research (2011) 2, 319–325
Westerlund T, Oksa J, et.al, Thermal responses and after whole-body cryotherapy. J Therm Biol 2003; 28: 601-608.
Chinnavan Elanchezhian , P Swarnakumari Efficacy of Cold Therapy and Passive Stretching to Improve Gait in Spastic Diplegic Cerebral Palsy Children. Int J Pediatr 2019; 7(9): 10109-118. DOI: 10.22038/ijp.2019.41071.3461
Tsai KH, Yeh CY, et.al, Effects of a single session of prolonged muscle stretch on spastic muscle of stroke patients. Proceedings-National Science Council Republic of China Part B Life Sciences. 2001 Apr;25 (2):76-81.
Yeh CY, Tsai KH, et.al, Effects of prolonged muscle stretching with constant torque or constant angle on hypertonic calf muscles. Archives of physical medicine and rehabilitation. 2005 Feb 1;86(2):235-41.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Suvarna ganvir, Rabina Nayak, Maheshwari Harishchandre
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
