Table 4.13 Electrical Stimulation for the Treatment of Spasticity Post ABI
by stwadmin | Dec 6, 2018
Table 4.13 Electrical Stimulation for the Treatment of Spasticity Post ABI
| Author Year
Country
Study Design
Sample Size |
Methods |
Outcome |
| Leung et al. (2014)
Australia
RCT
PEDro=8
NInitial=35, NFinal=32
|
Population: TBI; Experimental Group (EG; n=17): Mean Age=38yr; Gender: Male=14, Female=3; Mean Time Post Injury=140d; Mean GCS=5. Control Group (CG; n=18): Mean Age=38yr; Gender: Male=15, Female=3; Mean Time Post Injury=83d; Mean GCS=5.
Intervention: Participants were randomly allocated to either the EG or CG group. The EG group underwent a treatment of tilt table standing and electrical stimulation (30 min 5d/wk) and splinting (12hr 5d/wk) for a total of 6 wk. For the next 4wk EG group participants underwent tilt table standing alone (30 min 3d/wk). The CG group underwent tilt table standing (30min 3d/wk) for the full 10 wk. Measures were taken at baseline, 6wk and 10wk.
Outcome Measure: Passive ankle dorsiflexion, Functional Independence Measure (FIM). |
1. The CG group had a greater range of motion for passive ankle dorsiflexion than the EG group at 6 wk (3 degrees) and 10 wk (-1 degree).
2. The EG group had a greater mean reduction in spasticity (1 point) at 6 wk; however, the effect disappeared at 10 wk.
3. There was no between group differences in walking speed.
4. There were no differences between groups for tolerance to treatment, perceived treatment benefit, perceived treatment worth, and willingness to continue with treatment. |
| Seib et al. (1994)
USA
Pre-Post
N=10 |
Population: TBI=5, Spinal Cord Injury=5; Mean Age=38yr; Gender: Male=6, Female=4; Mean Time Post Injury=6.3yr.
Intervention: After baseline assessments, 20 min of Surface Electrical Stimulation to the ipsilateral (the more spastic side) tibialis anterior. Parameters: 2sec rise time, 15 sec on, instant fall, 20sec off. Rate of stimulation was 30 pulses/sec. Intensity varied on subject tolerance. Assessments occurred at baseline, immediately post intervention, and 24hr after the intervention.
Outcome Measure: Path length, Spasticity Measurement System.
|
Ipsilateral Effect:
1. There was a significant reduction in spasticity immediately following simulation for all participants (p<0.05). However, the change in path lengths pre to post stimulation was not significantly different in the TBI group alone (median length 82nm/rad before versus 73nm/rad after).
2. Twenty-four hours after stimulation, ipsilateral path length (spasticity) reduced significantly in 8 of 9 subjects (p<0.01).
Contralateral Effect:
3. Six of 9 participants showed increased contralateral path lengths immediately post intervention.
4. TBI median path length increase was from 14nm/rad to 34nm/rod.
5. Twenty-four hours post stimulation, 4 patients had decreased spasticity, 3 had an increase and 1 patient had no change. |
