Cryotherapy reduces muscle spasticity but does not affect proprioception in ischemic stroke: a randomized sham-controlled crossover study

Objective To evaluate the immediate effects of cryotherapy (using an ice pack) on ankle joint position sense (JPS) and the degree of spasticity following chronic hemiparetic stroke. Design We used a sham-controlled crossover design. Sixteen chronic hemiparetic patients were randomly assigned to two groups: 1) those who received cryotherapy followed by a control intervention 15 days later (cryotherapy [CT] group) and 2) those who received the control intervention followed by cryotherapy 15 days later (control intervention [CI] group). Ankle JPS was measured on the paretic side using a Biodex Multi-joint System 3 dynamometer before and after 20 min of either application on the calf muscles. Lower absolute error scores were calculated for data analyses and were used to determine JPS. The degree of spasticity of the plantar flexor muscles was scored according to the Modified Ashworth scale. Results Sixteen patients completed the crossover experiment; however, data analysis was successfully conducted in 15 participants. Cryotherapy reduced the degree of spasticity of the plantar flexor muscles without altering ankle JPS. Conclusion Cryotherapy (using an ice pack) may reduce plantar flexor spasticity without influencing proprioception. *Both authors contributed equally to this study. Corresponding Author: Thiago Luiz de Russo and Luccas Cavalcanti Garcia, Laboratório de Pesquisa em Fisioterapia Neurológica. Departamento de Fisioterapia. Universidade Federal de São Carlos – UFSCar. São Carlos, SP, Brazil. Rodovia Washington Luís, Km 235. Zip Code: 13565-905. Telephone: +551633519578. E-mail: thiagoluizrusso@gmail.com or russo@ufscar.br Author Disclosures: This study was supported by the São Paulo Research Foundation – FAPESP (grants: 2013/25805-1, 2014/25845-6 and 2017/13655-6) and the National Council for Scientific and Technological Development – CNPq (funding: 442972/2014-8). The authors have no conflicts of interest to declare. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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