The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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The Effects of Interferential Current therapy on Spasticity, Range of Motion, and Balance Ability in stroke Patient

뇌졸중 환자의 경직 및 관절가동범위, 균형에 간섭전류 치료가 미치는 효과

  • Kim, Bo-Yong (Department of Physical Therapy, Graduate School of Public Health Gachon University) ;
  • Choi, Won-Ho (Department of Physical Therapy Gachon University)
  • 김보용 (가천대학교 보건대학원 물리치료학과) ;
  • 최원호 (가천대학교 물리치료학과)
  • Received : 2013.07.10
  • Accepted : 2013.08.12
  • Published : 2013.08.25
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Abstract

Purpose: The aim of this study was to investigate the effects of interferential current therapy (ICT) on spasticity, ROM, and the balance function in patients with stroke. Methods: 30 inpatients with stroke were randomly divided into 2 groups: the ICT group (n=15) and the placebo-ICT group (n=15). Two groups have got the traditional rehabilitation for 30 minutes before applying either ICT or placebo-ICT stimulation. The stimulus of ICT has been applied to gastrocnemius at the level of 100 Hz, two times of sensation threshold, while the placebo-ICT group has put on the electrode without electrical stimulus. To assess spasticity in ankle, the modified Ashworth scale (MAS) was used, and goniometer was applied to measure the passive range of motion (PROM). Also, the Berg Balance Scale (BBS), the Timed-up and go (TUG), and the Functional Reach Test (FRT) were carried out to examine the balance ability. Results: The ICT group showed a significant reduction of spasticity and significantly increased PROM than the placebo-ICT group (p<0.05). The placebo-ICT group did not show significant changes in the BBS, the TUG, and the FRT, while the ICT group significantly improved the BBS, the TUG, and the FRT (p<0.05). Conclusion: Our results demonstrated that ICT applied to gastrocnemius effectively decreased spasticity and improved range of motion and balance function in patients with stroke.

Keywords

References

  1. Kim CB, Choi JD. Comparison of Pulmonary and Gait Function in Subacute or Chronic Stroke Patients and Healthy Subjects. J Kor Soc Phys Ther. 2011;23(5):23-8.
  2. Kim JH. A study on the Correlation between Static, Dynamic Standing Balance Symmetry and Walking Function in Stroke. J Kor Soc Phys Ther. 2012;24(2):73-81. https://doi.org/10.1589/jpts.24.73
  3. Ivanhoe CB, Reistetter TA. Spasticity: the misunderstood part of the upper motor neuron syndrome. Am J Phys Med Rehabil. 2004; 83(10 suppl):S3-9. https://doi.org/10.1097/01.PHM.0000141125.28611.3E
  4. Welmer AK, Holmqvist LW, Sommerfeld DK. Hemiplegic limb synergies in stroke patients. Am J Phys Med Rehabil. 2006;85(2):112-9. https://doi.org/10.1097/01.phm.0000197587.78140.17
  5. Middleton JW, Siddall PJ, Walker S et al. Intrathecal clonidine and baclofen in the management of spasticity and neuropathic pain following spinal cord injury: a case study. Arch Phys Med Rehabil. 1996;77(8):824-6. https://doi.org/10.1016/S0003-9993(96)90264-6
  6. Kim MH, Lee WH, Yun MJ. The Effects on Respiratory Strength Training on Respiratory Function and Trunk Control in Patient with Stroke. J Korean Soc Phys Ther. 2012;24(5):340-7.
  7. Jang SH, Ann JJ, Kim JS. Effect of Trunk Control Training on Labile Surface on Relative Impulse in the Persons with Stroke. J Kor Soc Phys Ther. 2012;24(2):163-9.
  8. Nam SH, Kang KW, Kwon JW et al. The Effects of Handrails during Treadmill Gait Training in Stroke Patients. J Korean Soc Phys Ther. 2013;25(1):25-8.
  9. Lee JS, Nam KW, Kim KY et al. Effect of Weight Bearing Exercise on Weight Bearing and Balance for Patients with Chronic Stroke. J Korean Soc Phys Ther. 2012;24(4):253-61. https://doi.org/10.1589/jpts.24.253
  10. Yang DJ, Park SK, Kang JI et al. Effect of Computerized Feedback Postural Training on Balance and Muscle Activity in Stroke Patients. J Korean Soc Phys Ther. 2012;24(5):348-354.
  11. Satkunam LE. Rehabilitation medicine: 3. Management of adult spasticity. CMAJ. 2003;169(11):1173-9.
  12. Shakespeare DT, Young CA, Boggild M. Anti-spasticity agents for multiple sclerosis. Cochrane Database Syst Rev. 2003;(4):CD001332.
  13. Cho HY, In TS, Cho KH et al. A single trial of transcutaneous electrical nerve stimulation (TENS) improves spasticity and balance in patients with chronic stroke. Tohoku J Exp Med. 2013;229(3):187-93. https://doi.org/10.1620/tjem.229.187
  14. Ng SS, Hui-Chan CW. Transcutaneous electrical nerve stimulation combined with task-related training improves lower limb functions in subjects with chronic stroke. Stroke. 2007;38(11):2953-9. https://doi.org/10.1161/STROKEAHA.107.490318
  15. Sabut SK, Sikdar C, Kumar R et al. Functional electrical stimulation of dorsiflexor muscle: effects on dorsiflexor strength, plantarflexor spasticity, and motor recovery in stroke patients. NeuroRehabilitation. 2011;29(4):393-400.
  16. Goats GC. Interferential current therapy. Br J Sports Med. 1990;24(2):87-92. https://doi.org/10.1136/bjsm.24.2.87
  17. Pizzi A, Carlucci G, Falsini C et al. Evaluation of upper-limb spasticity after stroke: A clinical and neurophysiologic study. Arch Phys Med Rehabil. 2005;86(3):410-5. https://doi.org/10.1016/j.apmr.2004.10.022
  18. Gajdosik RL, Bohannon RW. Clinical measurement of range of motion. Review of goniometry emphasizing reliability and validity. Phys Ther. 1987;67(12):1867-72. https://doi.org/10.1093/ptj/67.12.1867
  19. Berg K, Wood-Dauphinee S, Williams JI. The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med. 1995;27(1):27-36.
  20. Podsiadlo D, Richardson S. The timed" Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  21. Duncan PW, Weiner DK, Chandler J et al. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45(6):M192-7.
  22. Yan T, Hui-Chan CW. Transcutaneous electrical stimulation on acupuncture points improves muscle function in subjects after acute stroke: a randomized controlled trial. J Rehabil Med. 2009;41(5):312-6. https://doi.org/10.2340/16501977-0325
  23. Li Y, Bennett DJ. Persistent sodium and calcium currents cause plateau potentials in motoneurons of chronic spinal rats. J Neurophysiol. 2003;90(2):857-69. https://doi.org/10.1152/jn.00236.2003
  24. Cramp FL, Noble G, Lowe AS et al. A controlled study on the effects of transcutaneous electrical nerve stimulation and interferential therapy upon the RIII nociceptive and H-reflexes in humans. Arch Phys Med Rehabil. 2000;81(3):324-33. https://doi.org/10.1016/S0003-9993(00)90079-0
  25. Kajbafzadeh AM, Sharifi-Rad L, Nejat F et al. Transcutaneous interferential electrical stimulation for management of neurogenic bowel dysfunction in children with myelomeningocele. Int J Colorectal Dis. 2012;27(4):453-8. https://doi.org/10.1007/s00384-011-1328-z
  26. Dickstein R, Laufer Y, Katz M. TENS to the posterior aspect of the legs decreases postural sway during stance. Neuroscience Letters. 2006;393(1):51-5. https://doi.org/10.1016/j.neulet.2005.09.039
  27. Robertson JA, Eng JJ, Hung C. The effect of functional electrical stimulation on balance function and balance confidence in community-dwelling individuals with stroke. Physiother Can. 2010;62(2):114-9. https://doi.org/10.3138/physio.62.2.114
  28. Hatzitaki V, Pavlou M, Bronstein AM. The integration of multiple proprioceptive information: effect of ankle tendon vibration on postural responses to platform tilt. Exp Brain Res. 2004;154(3):345-54. https://doi.org/10.1007/s00221-003-1661-8
  29. Lamb SE, Ferrucci L, Volapto S et al. Risk factors for falling in home-dwelling older women with stroke: the Women's Health and Aging Study. Stroke. 2003;34(2):494-501. https://doi.org/10.1161/01.STR.0000053444.00582.B7
  30. Lord SR, Clark RD, Webster IW. Physiological factors associated with falls in an elderly population. J Am Geriatr Soc. 1991;39(12):1194-200. https://doi.org/10.1111/j.1532-5415.1991.tb03574.x
  31. Hsu AL, Tang PF, Jan MH. Analysis of impairments influencing gait velocity and asymmetry of hemiplegicpatients after mild to moderate stroke. Arch Phys Med Rehabil. 2003;84(8):1185-93. https://doi.org/10.1016/S0003-9993(03)00030-3
  32. Picelli A, Tamburin S, Bonetti P et al. Botulinum toxin type A injection into the gastrocnemius muscle for spastic equinusin adults with stroke: a randomized controlled trial comparing manual needle placement, electrical stimulation and ultrasonography-guided injection techniques. Am J Phys Med Rehabil. 2012;91(11):957-64. https://doi.org/10.1097/PHM.0b013e318269d7f3