Physiotherapy Efficiency in Post-stroke Upper Extremity Spasticity: TENS vs. Ultrasound vs. Paraffin.

Abstract

Post-stroke spasticity is a significant debilitating condition with negative consequences on individual functional independence and quality of life. This study aimed to identify the differences between transcutaneous electrical stimulation (TENS), ultrasound therapy and paraffin procedures on post-stroke upper extremity spasticity and dexterity. Twenty-six patients were enrolled in the study, divided into three therapy groups: TENS (n=9), paraffin (n=10) and ultrasound therapy (n=7). For 10 days, the patients received specific group therapy and conventional physical therapy exercises for upper extremities. Modified Ashworth Scale, Functional Independence Measure, Functional Coefficient, Stroke Specific Quality of Life Scale, Activities of Daily Living score and ABILHAND questionnaire were used to assess the participants before and after therapy. The results of the group comparisons by analysis of variance showed no significant difference between outcomes by the applied treatments. In contrast, one-way analysis of variance suggested significant improvements in patients in all three groups after therapy. Step-wise regression results on functional independence measure and quality-of-life scales suggested that functional range of motion values for elbow and wrist influence individual independence and quality of life. TENS, ultrasound, and paraffin therapy bring equal benefits in the management of post-stroke spasticity.