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Minerva Medica 2021 Sep 29

DOI: 10.23736/S0026-4806.21.07581-9

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Short-wave diathermy for spastic equinus foot in chronic stroke patients: a proof-of-concept pilot study

Alessandro PICELLI 1, 2, 3 , Daniele MUNARI 2, Anna SERINA 1, Mirko FILIPPETTI 1, Alessio BARICICH 4, Andrea SANTAMATO 5, Flavio GUERRAZZI 6, Angela MODENESE 2, Nicola SMANIA 1, 2

1 Section of Physical and Rehabilitation Medicine, Department of Neurosciences, Biomedicine and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona, Verona, Italy; 2 Neurorehabilitation Unit, Department of Neurosciences, University Hospital of Verona, Verona, Italy; 3 Canadian Advances in Neuro-Orthopedics for Spasticity Congress (CANOSC), Kingston, ON, Canada; 4 Department of Health Sciences, University of Piemonte Orientale, Novara, Italy; 5 Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy; 6 Recovery and Functional Rehabilitation Unit, Department of Neurosciences, University Hospital of Verona, Verona, Italy


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BACKGROUND: Physical modalities may be useful to manage post-stroke spasticity. Shortwave diathermy has been demonstrated to improve extensibility of the myotendinous tissue. Spasticity may alter morphology of the muscle and its elastic properties. Our main aim was to evaluate the effects of shortwave diathermy on spastic equinus foot in stroke patients.
METHODS: Ten chronic stroke patients with spastic equinus foot received 10 shortwave diathermy sessions, 5 days/week for 2 consecutive weeks to the spastic calf muscles. Clinical (modified Ashworth scale and ankle dorsiflexion passive range of motion) and ultrasound (spastic gastrocnemius muscle echo intensity and hardness percentage measured by sonoelastography) evaluation was done before, after treatment, and at two weeks of follow-up.
RESULTS: A significant difference in calf muscle spasticity (P=0.004), ankle passive range of motion (P=0.014), and spastic gastrocnemius muscle hardness percentage (P=0.004) was found after treatment. A significant difference in calf muscle spasticity (P=0.004) was found also at the follow-up evaluation.
CONCLUSIONS: Our preliminary findings support the hypothesis that shortwave diathermy might improve calf muscle tone, ankle passive range of motion, and gastrocnemius muscle elasticity in chronic stroke patients with spastic equinus. This might be due to the deep thermal effects coupled with the rheological direct action of shortwave diathermy on spastic muscles.


KEY WORDS: Muscle spasticity; Physical modalities; Rehabilitation

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