The Effect of Transcutaneous Electrical Nerve Stimulation on Spasticity in Multiple Sclerosis Patients: A Pilot Study

Abstract

The aim of this study was to examine the effects of transcutaneous electrical nerve stimulation on spasticity in patients with multiple sclerosis. The study was carried out in the Hacettepe University School of Physical Therapy and Rehabilitation. The subjects in the study were 10 clinically definite, primary and secondary progressive type multiple sclerosis outpatients with mild to moderate spasticity in the plantar flexor muscles of the ankle. Stimuli of frequency 100 Hz and pulse width 0.3 msec were used 20 minutes per day for 4 weeks. Patients were assessed by electromyography, Modified Ashworth Scale, and Ambulation Index. Electromyography was performed before and after the daily treatment of spastic muscles with transcutaneous electrical nerve stimulation in order to assess the effect on muscle relaxation. The Modified Ashworth Scale and Ambulation Index were used before and after 4 weeks' treatment. After 4 weeks of treatment, there were statistically significant reductions in spasticity of both extremities as assessed by myoelectric activity and the Modified Ashworth Scale (P < 0.05). Ambulation Index level was not improved significantly)P > 0.05).

References

1. Matthews WB, ed. McAlpine's multiple scleroses. New York: Churchill Livingstone ; 1985: 62-101.

2. Surinder P, Brar PT, Marcia B, et al. Evaluation of treatment protocols on minimal to moderate spasticity in multiple sclerosis . Arch Phys Med Rehabil 1991;72: 186-189 .

3. Link A, Kabus C, Haas J. Use of spasmography to assess the effects of botulinum toxin type A in patients with lower-limb spasticity . Eur J Neurol 1999;6(suppl 4): 69-73 .

4. Tekeoğlu Y, Adak B, Goksoy T. Effects of transcutaneous electrical nerve stimulation (TENS) on Barthel Activities of Daily Living (ADL) index score following stroke . Clin Rehabil 1998;12(4): 277-280 .

5. Potisk KP, Gregoric M, Vodovnik L. Effects trancutaneous electrical nerve stimulation (TENS) on spasticity in patients with hemiplegia . Scand J Rehabil Med 1995;27: 169-174 .

6. Goulet C, Arsenault AB, Bourbonnais D, Laramee MT, Lepage Y. Effects trancutaneous electrical nerve stimulation on H-reflex and spinal spasticity . Scand J Rehabil Med 1996;28: 169-176 .

7. Poser CM, Paty DW, Scheinberg LC, et al. New diagnostic criteria for multiple sclerosis. Guidelines for research protocol . Ann Neurol 1983;13: 227-231 .

8. Kurtzke JF. Further notes of disability evaluation in multiple sclerosis, with scale modifications . Neurology 1965;15: 654-661 .

9. Bohannon RW, Simith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity . Phys Ther 1987;67: 206-207 .

10.

10. Hauser SL, Dawson DM, Lehrich JR, et al. Intensive immunosuppression in progressive multiple sclerosis. A randomized, three-arm study of high-dose intravenous cyclophosphamide, plasma exchange, and ACTH . N Engl J Med 1983;27(308): 173-180 .

11.

11. Hui-Chan CW, Levin MF. Stretch reflex latencies in spastic hemiparetic subjects are prolonged after trancutaneous electrical nerve stimulation . Can J Neurol Sci 1993;20: 97-106 .

12.

12. Sonde L, Gip C, Fernaeus SE, Nilsson CG, Viitanen M. Stimulation with low frequency (1.7Hz) trancutaneous electrical nerve stimulation (low-tens) increases motor function of the post-paretic arm . Scand J Rehabil Med 1998;30: 95-99 .

13.

13. Han JS, Chen XH, Yuan Y, Yan SC. Transcutaneous electrical nerve stimulation for treatment of spinal spasticity . Chin Med J 1994;107: 6-11 .

14.

14. Joodaki MR, Olyaei GR, Bagheri H. The effects of electrical nerve stimulation of the lower extremity on H-reflex and F-wave parameters . Electromyogr Clin Neurophysiol 2001;41(1): 23-28 .