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Cryotherapy reduces muscle hypertonia, but does not affect lower limb strength or gait kinematics post-stroke: a randomized controlled crossover study.
Alcantara, Carolina Carmona; Blanco, Julia; De Oliveira, Lucilene Maria; Ribeiro, Paula Fernanda Sávio; Herrera, Esperanza; Nakagawa, Theresa Helissa; Reisman, Darcy S; Michaelsen, Stella Maris; Garcia, Luccas Cavalcanti; Russo, Thiago Luiz.
Afiliação
  • Alcantara CC; a Laboratory of Neurological Physiotherapy Research, Department of Physical Therapy , Federal University of São Carlos (UFSCar) , São Carlos , Brazil.
  • Blanco J; a Laboratory of Neurological Physiotherapy Research, Department of Physical Therapy , Federal University of São Carlos (UFSCar) , São Carlos , Brazil.
  • De Oliveira LM; a Laboratory of Neurological Physiotherapy Research, Department of Physical Therapy , Federal University of São Carlos (UFSCar) , São Carlos , Brazil.
  • Ribeiro PFS; a Laboratory of Neurological Physiotherapy Research, Department of Physical Therapy , Federal University of São Carlos (UFSCar) , São Carlos , Brazil.
  • Herrera E; b Physical Therapy School , Universidad Industrial de Santander (UIS) , Bucaramanga , Colombia.
  • Nakagawa TH; a Laboratory of Neurological Physiotherapy Research, Department of Physical Therapy , Federal University of São Carlos (UFSCar) , São Carlos , Brazil.
  • Reisman DS; c Department of Physical Therapy , University of Delaware , Newark , DE , USA.
  • Michaelsen SM; d Department of Physical Therapy , Universidade do Estado de Santa Catarina , Florianópolis, SC , Brazil.
  • Garcia LC; a Laboratory of Neurological Physiotherapy Research, Department of Physical Therapy , Federal University of São Carlos (UFSCar) , São Carlos , Brazil.
  • Russo TL; a Laboratory of Neurological Physiotherapy Research, Department of Physical Therapy , Federal University of São Carlos (UFSCar) , São Carlos , Brazil.
Top Stroke Rehabil ; 26(4): 267-280, 2019 05.
Article em En | MEDLINE | ID: mdl-31012824
BACKGROUND: Based on the premise that spasticity might affect gait post-stroke, cryotherapy is among the techniques used to temporarily reduce spasticity in neurological patients. This effective technique would enhance muscle performance, and ultimately, functional training, such as walking. However, understanding whether a decrease in spasticity level, if any, would lead to improving muscle performance and gait parameters is not based on evidence and needs to be clarified. OBJECTIVES: to investigate the immediate effects of cryotherapy, applied to spastic plantarflexor muscles of subjects post-stroke, on tonus level, torque generation capacity of plantarflexors and dorsiflexors, and angular/spatiotemporal gait parameters. METHODS: Sixteen chronic hemiparetic subjects participated in this randomized controlled crossover study. Cryotherapy (ice pack) or Control (room temperature sand pack) were applied to the calf muscles of the paretic limb. The measurements taken (before and immediately after intervention) were: 1) Tonus according to the Modified Ashworth Scale; 2) Torque assessments were performed using an isokinetic dynamometer; and 3) Spatiotemporal and angular kinematics of the hip, knee, and ankle (flexion/extension), obtained using a tridimensional movement analysis system (Qualisys). RESULTS: Cryotherapy decreased plantarflexor tonus but did not change muscle torque generation capacity and did not affect spatiotemporal or angular parameters during gait compared to control application. These findings contribute to the evidence-based approach to clinical rehabilitation post-stroke. CONCLUSIONS: The findings of this study suggest that cryotherapy applied to the calf muscles of subjects with chronic hemiparesis reduces muscle hypertonia but does not improve dorsiflexors and plantarflexors performance and gait parameters.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Crioterapia / Músculo Esquelético / Acidente Vascular Cerebral / Força Muscular / Marcha / Espasticidade Muscular Tipo de estudo: Clinical_trials / Etiology_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Top Stroke Rehabil Assunto da revista: ANGIOLOGIA / REABILITACAO Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Crioterapia / Músculo Esquelético / Acidente Vascular Cerebral / Força Muscular / Marcha / Espasticidade Muscular Tipo de estudo: Clinical_trials / Etiology_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Top Stroke Rehabil Assunto da revista: ANGIOLOGIA / REABILITACAO Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido