EFFECT OF PERCUTANEOUS ELECTRICAL NERVE STIMULATION (PENS) ON WRIST FLEXOR SPASTICITY AND MOTOR FUNCTION IN STROKE INDIVIDUALS

S. Kamble¹, G. Baxi¹, T. Palekar¹

¹Dr. D. Y. Patil Vidyapeeth, Dr. D. Y. Patil College of Physiotherapy, Pune, India

Background: Literature suggest that TENS has been hypothesized to regulate spasticity by various mechanism such as reducing stretch reflex excitability, modulation of reciprocal inhibition and by increasing pre synaptic inhibition³ .As dry needling has an positive effect on both pre and post synaptic inhibition where as it is been postulated in previous studies that TENS does pre synaptic inhibition to reduce spasticity. So there is a need to combine both Dry Needling and TENS to see the effect on wrist flexor spasticity in hemiplegic individuals.

Purpose: To find out the effect of PENS on spasticity and motor function in stroke individuals.

Methods: 42 stroke individuals were randomly allocated into (A) Experimental Group VR (B) Control Group by coin toss method. On the affected side, needles were inserted into the flexor carpi radialis and ulnaris muscles total 3 treatment sessions of 15 minutes each with gap of 48hrs were given to the patients using PENS plus conventional treatment. Whereas in Group B only conventional treatment was given. A pre(1) and post(2) and follow up(3) measure of H reflex-(Amplitude) Modified Modified Ashworth Scale (MMAS), Modified Tardieu scale (MTS), and Wolf Motor Functional Test (WMFT) were taken.

Results: within group analysis for the (EG) showed statistical significance for H reflex 1, 2,3 (<0.0001). MMAS 2 VR 1 and 3 VR 1 were statistically significant (0.0001), MTS 2 VR 1 (0.001) and 3 VR 1 (0.003) also showed statistical significance. All 3 measures of WMFT showed statistical significance in (EG). Whereas in (CG) statistical significance was found for H reflex and WMFT (2 vs 1 and 3 vs 1). MMAS 2 vs 1 (0.025) showed statistical significance and MTS 1,2,3 didn’t show any statistical significance. Between-group analysis, the h-reflex 2 vs 1 (0.0001) and 3 vs 1 (0.012) showed statistical significance also, MMAS and MTS showed statistically significant results for 2 vs 1 and 3 vs 1 (0.0001) whereas for motor function no statistical significance was found.

Conclusions: This study suggest that PENS reduced wrist flexor spasticity and improved the motor function in stroke individuals.

Implications: PENS application seems to have immediate effect in reducing tone of the spastic muscle.
These results are very promising, further research on a larger sample size with long term fallow up assessment needs to be conducted to further validate the findings.

Funding acknowledgements: self

Keywords:
Stroke
PENS
Spasticity

Topics:
Neurology: stroke
Disability & rehabilitation
Neurology

Did this work require ethics approval? Yes

Institution: Dr. D. Y Patil Vidyapeeth , Pune, India

Committee: Dr. D. Y Patil college of Physiotherapy, Pune.

Ethics number: DYPCPT/424(9)/2022