Efficacy of cryo-airflow therapy on calf muscle spasticity in stroke patients: a randomized controlled trial

Abstract

AimTo determine the effect of cryo-airflow therapy on spasticity of calf muscle in stroke patients. MethodsThis randomized controlled study took place in the outpatient clinic of Mansoura General Hospital and Mansoura University Hospital, Mansoura, Egypt. Thirty stroke patients were divided into two groups and assigned randomly into the study group (n = 15), which received cryo-airflow therapy, a conventional physical therapy program, and were advised to wear a night ankle-foot orthosis (AFO), or into the control group (n = 15), which received the same program, but without the cryo-airflow therapy. Pre- and post-treatment assessments for all patients were done by the modified Ashworth scale (MAS), the Hoffman reflex / Myogenic response (H/M) ratio of the soleus muscle on the affected side, and by two-dimensional (2D) motion analysis for ankle dorsiflexion range of motion (ROM) during the stance phase of gait. ResultsMann–Whitney and MANOVA tests revealed a significant improvement of MAS scores (P = .006) and ankle ROM scores (P = .005), while the difference in H/M ratios was non-significant (P = .063) between study and control groups. Clinical and electrophysiological measures of spasticity were significantly correlated with each other (ρ = 0.765) and negatively with ankle ROM (ρ = -0.635) (P < .001). ConclusionCryo-airflow therapy is considered an effective method to reduce spasticity in calf muscle and to improve ankle dorsiflexion ROM of the affected limb in stroke patients. Exercises accompanied by night AFO with or without cold air therapy enhance functional outcomes.

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